 Hi guys, this is Dr. Ahmet Ergen. I'm an endocrinologist and a diabetes education specialist. Today we are going to talk about high blood pressure. Now you guys are going to tell me, well, you're a diabetes guy. Why are you talking about high blood pressure? Well, number one, I am a doctor and I have to treat you holistically. I have to make sure that while your blood sugars are okay, I still have to take care of your blood pressure. While your blood pressure is okay, I still have to take care of your cholesterol. So when you guys are listening and watch videos and they're just concentrating on one thing and ignoring the other things, like they say, eat whatever salt you want or eat whatever cholesterol you want. You don't want to listen to those guys because they're not treating you holistically. They're there to support some sort of ideology. Here I am trying to help you guys on my weekend, trying to explain to you so you can understand better. That's how every other doctor will treat you. So I would suggest relying on this and then anything else. Now we're going to try to talk about today and I want you to understand high blood pressure and topics are going to be what it is. First of all, you have to understand what the high blood pressure is. It has nothing to do with being tense, okay, although it says hypertension. The blood pressure. Why is it important? Why is blood pressure so important? So you have to understand the importance because if you don't think it's important, you're not going to do anything about it. So what causes high blood pressure? Extremely important because if you know the cause, then you can fix the problem sometimes because there are some factors that you can fix and sometimes you just can't do nothing about it. Genetically, if you're genetically prone to it, you may still do a lot of things to prevent the blood pressure, but genetics, something you cannot just change easily. Now, how do we reduce blood pressure naturally? Of course, we're going to talk about this because I know you all guys want natural stuff and we want to make sure that we try everything possible in our lifestyle changes or whatever we can get our hands on that's natural. We'll use it to our advantage. Let's get started. Let's talk about the definition of high blood pressure, which is hypertension. I just abbreviated that for you or for me. So you can hear three different things, right? So is it 140 over 90? Is it 120 over 70? Is it 130 over 80? So you go to the doctor's office and they check your blood pressure and the nurse says, Sir, your blood pressure is 120 over 70. It's all great, great. And then next time you go and the same nurse checks your blood pressure and it's like 142 over 88, she goes like, that's good, that's good. And then next time you go, they check it in like 130 over 80. And then they're like, oh, yeah, that's great. That's great. Then you're like, wait a minute, you know, so you always tell my blood pressure is great. Is it 120 over 70 grade or 140 over 90 grade? So what is really great, right? So number one, don't really ask your medical assistant about that. I mean, they are not qualified to tell you what a high blood pressure is. And to be honest with you, high blood pressure will depend on your age. So like if you are like my age, like what, 37? Oh, I'm getting old, man. Anyways, if I'm more than 120 over 70, that's probably a little high. And I'll tell you why. But if you are like, say 65 years of age and you're 140 over 90, I'll take that, you know, because it's a natural thing that I'll explain to you in a minute that the blood pressure can actually tend to go high as we get older and you become more resistant to treatment and you have more side effects from treatment. So we kind of adjust our goals as we go. It's like, you know, like if you're a marathon runner, if you're a 65 year old marathon runner, my expectation for me is going to be different than a 20 year old marathon runner, just like that, you know. But the bottom line, you can go with the middle, middle age man or a woman, 130 over 80 would be a good goal. The lower, the better, of course. And I'll explain to you why. But I think, you know, general guideline would be 130 over 80. If you're young, 120 over 70. If you're on the older age, I will say 140 over 90. Okay, let's move on and discuss about why high blood pressure is so important to consider and think about. Well, blood pressure is really what affects your arterial wall. So basically, the blood pressure difference between 115 over 75, after this blood pressure, every 20 over 10, every 20 on systolic blood pressure, which is systolic is this part, the first number you call it, you say like, when you read this, you say 115 over 75 or 115 over, 115, 75, whatever you call it. This is diastolic. This is systolic. This is the pressure when your heart beats. And then this is the pressure when your heart is relaxed. So that's why you call this systolic. This is diastolic. Every systolic 20 increase in your blood pressure number and 10 increase in your diastolic blood pressure after this number doubles the risk of heart attacks and strokes. So think about this. If you are someone who lived with a blood pressure of like 135 over 85, although it sounds kind of pretty normal and innocent, you are still at double the risk of someone who has a blood pressure of 115 over 75. So, and if you're letting your blood pressure go more than that, so let's say you're like 155 over, let's say, 85, 95, which is not uncommonly seen. If you're running with 155 over 95, you're having four times the risk of general population for a heart attack or stroke. Now, if you have diabetes, that also puts you anywhere from two to four times higher risk of heart attacks. On top of that, if you have a blood pressure problem like this, that's another four times risk. So that becomes like 16 times more likely to have a heart attack and stroke. That pretty much means that you're going to get it. So, prevent that. Make sure that the blood pressure is under control. For general guidelines, since getting to 115 over 75 may be difficult for some cases. We try to get it down to 130 over 80 as I explained before. Let's talk about what causes high blood pressure. So, it is fundamentally two things. Number one, increased cardiac output, which means that your heart is pumping too much blood. And that happens from eating too much salt. Unfortunately, when you have a lot of volume in your system, that creates a lot of pressure. And the vascular construction, which means that your blood vessels will be narrower. And that leads to a lot of pressure. Think like a hose. When you open the hose, when you turn the hose on, and you apply pressure at the tip of the hose, what happens is that pressure accumulates and backs up in the hose. And you can see the hose is getting hard and angry. So, it may even start leaking. So, too much pressure in your arterial wall, unfortunately, will create damage in your endothelial lining. This endothelial lining here is very important because it is actually like an organ. It secretes hormones such as nitric oxide, which keeps your blood vessels dilated. If you do not have enough nitric oxide, and that typically happens from inactivity. So, if you're not very active, you're not going to create nitric oxide. As a result, your blood vessels, your arteries will be narrower. And if you're eating a lot of salt, and so it will make you thirsty, and you get a lot of blood volume, that blood volume will increase the pressure inside. And since you are not getting the arteries dilated, you will be having a problem. Alright, now let's go over exactly what's happening here in terms of causes. Now, being overweight. So, if you're overweight, as we discussed, you are going to activate sympathetic nervous system, which interestingly, your blood vessels, your arteries are innervated, which means that there's a lot of nerves around your arteries and veins. And when you're overweight, unfortunately, insulin resistance will activate the sympathetic nervous system, which in turn will increase the vascular tone and the elasticity of that vascular wall is going to be low. So, think like this. This is your vascular wall, alright? And normally, you should be able to get dilated like this when you need to. But if the blood pressure is increasing and your elasticity is lost, and your arteries are not getting dilated, then you will have increased blood pressure. It's simple physics, right? So, unfortunately, increased vascular tone and sympathetic tone due to insulin resistance can directly lead to high blood pressure. Now, inactivity, as we discussed also, when you are not very active, nodric oxide levels are very low, and that also prevents your vessels to become dilated when they need to. And too much salt, we discussed about this, increases your volume. And there's too much volume and there's not enough dilation in your arteries that also leads to high blood pressure. Now, when I say high salt, I'm not talking about just adding salt to your diet. If you're having canned food, pre-packaged food, you have to pay attention to what you're eating. Here you will see an A sign or sodium sign. If you are, you know, if you have high blood pressure, you definitely need to keep your salt in less than three grams a day. But you can see sometimes one portion of these packaged foods can have upwards of 1,000 or 2,000 milligram of sodium, which can put you over your limit very easily. Now, old age, now, something that I cannot really do anything about, guys. So unfortunately, as you get older, your blood vessels become stiffer. That's not what you can change about, but definitely if you change your overall lifestyle like we discussed, you can definitely help yourself. Genetics, now, unfortunately, 40% of African Americans and 30% of white Americans have high blood pressure. That's an enormous number. And then the kidney disease. If you have underlying kidney disease, definitely we'll have more problems because kidney is the major regulator of blood pressure. The renin hormone that basically is the ultimate hormone that goes up when your sympathetic nervous system is activated, that hormone comes from kidneys. Now, when the kidneys are messed up, the whole system gets messed up, and then you end up with a bunch of hormones that comes from the kidney that causes high blood pressure. Ironically, high blood pressure causes kidney disease, and kidney disease causes more blood pressure problems, so it becomes a vicious cycle. So very important. If you have diabetes, you want to also make sure that you don't get into kidney disease because once you have kidney disease, then you have more high blood pressure that it's harder to deal with, and da-da-da-da. It goes on, it gets really complicated eventually. Now, low potassium is another big thing. Now, if you guys are not paying attention to this in vegetables and fruits, so if you totally ignore your vegetables and fruits because you're diabetic, you say, I can't eat this, I can't eat that, it shows that not just the sodium in your diet, but also, sodium-potassium ratio is very important. So if you're increasing your potassium in your diet, you will definitely have a much better luck with dealing with your blood pressure, plus you will have more energy, you will have better muscle function, and so forth. So make sure that you are going for low carbohydrate, high potassium, vegetables and fruits. Smoking and alcohol. Smoking and alcohol, unfortunately, is something you can totally avoid, and definitely something that you... When I said, unfortunately, it's unfortunate that a lot of people are smoking and drinking, not paying attention to what's going to happen to them later in life. You may be young right now, you may be enjoying your life, you think that nothing's going to happen, but that smoking and alcohol will catch up, because the same thing that happens with inactivity and being overweight, even if you're super skinny. If you're smoking, your blood vessel wall will be disturbed, you're not going to excrete the nitric oxide we talked about. Alcohol does the same thing, it basically kills your arteries, it increases your insulin resistance. All these things boils down to insulin resistance, lack of nitric oxide, low potassium in your diet, and if you can't change that, then you will not have to deal with high blood pressure. Now, you may have high blood pressure just from old age, then there's nothing you can do about that, you do everything else, but your blood pressure is still high, then you have to take medications, and we'll talk about more maybe natural medications or natural ways to treat that, but the bottom line, you have to make sure that you're physically active, you're dumping some weight off, even 5% of weight to reduction will be a tremendous effect, and of course, high potassium in your diet will be very helpful. In addition to that, we will talk more about how to treat blood pressure naturally, anyone with the medications, and we will talk about that in the next video. Now, if you like this video, remember to subscribe, and give a thumbs up, and remember to share this video with friends and family.