Hypertension and Insulin Resistance

Julian Whitaker, MD

For years, doctors have been telling their patients with high blood pressure to cut down on sodium. And for those who are salt sensitive—about 50 percent of those affected with hypertension—this is great advice. In these individuals, even small amounts of sodium can trigger rises in blood pressure. But sodium isn’t the only dietary factor in blood pressure. I want to focus on an aspect of hypertension that is largely ignored by conventional physicians: insulin resistance.

The Case for Insulin Resistance

Insulin is the hormone that ushers glucose and other nutrients into the cells. When there is insufficient insulin or when the cells are resistant to insulin’s attempts to let glucose in, blood sugar levels climb and you have diabetes. In type 2 (insulin-resistant) diabetes the body responds by producing even more insulin, resulting in elevated levels of both glucose and insulin.

More than 20 million Americans have type 2 diabetes caused by insulin resistance. However, millions more—an estimated 25 to 40 percent of the entire population—have earlier stages of insulin resistance. In these individuals, glucose levels are not elevated, but their high insulin levels cause other things to go wrong.

Excess insulin is associated with increased body fat and obesity. It upsets the normal metabolism of fats, raising cholesterol and triglyceride levels. It disrupts intercellular communication, including blood pressure-regulating signals. It can provoke the sympathetic nervous system, causing the heart to pump with more intensity and the arteries to constrict. And it creates an imbalance in sodium and potassium (which increases blood volume) and calcium and magnesium (which causes arterial constriction), driving up blood pressure and increasing the risk of heart disease.

Are You Insulin Resistant?

If you have type 2 diabetes, you certainly have insulin resistance. If you have high blood pressure, your odds of being insulin resistant are 50-50. If you are more than 15 pounds overweight and carry that weight in your abdominal area, or if you have high triglycerides or low HDL (“good”) cholesterol, insulin resistance may be the root of your problems. There is also a strong genetic link, so a family history of abdominal obesity, hypertension, type 2 diabetes, or heart disease should also raise a red flag. This cluster of conditions is so common that it’s been given a name: metabolic syndrome (formerly called syndrome X).

Fortunately, insulin resistance and metabolic syndrome respond well to non-drug interventions. At the Whitaker Wellness Institute, we see many patients who present with classic cases of insulin resistance. Yet their physicians have never mentioned it as a probable cause of high blood pressure. The only recommendations they ever made were drugs and more drugs. Once these patients get started our nutritional and exercise program, blood pressures normalize—and they’re able to get off their drugs.

Lower Blood Pressure by Increasing Insulin Sensitivity

Our love affair with white flour, sugar, and other refined carbohydrates is a primary reason for the current epidemic of insulin resistance. These unhealthy foods disrupt blood sugar regulation and prompt a surge in the release of insulin. Dramatically cutting back on bread, pastries, white potatoes, white rice, and other high-starch foods is for some patients all that it takes to lower blood pressure.

But don’t just eliminate these foods. Replace them with vegetables, fruits, legumes, and limited amounts of whole grains. A study published recently in the Lancetshowed that increasing consumption of fruits and vegetables to at least five servings a day lowered blood pressure. In addition to improving the insulin response, fruits and vegetables are our best source of potassium, which is as important in blood pressure control as sodium. If these two minerals are out of balance—as they frequently are if you eat salt-laden processed foods—blood pressure rises.

Beyond Diet: Exercise and Supplements

In addition to dietary changes, anyone with hypertension or insulin resistance simply must exercise. Regular physical activity increases the cells’ sensitivity to insulin, helps with weight control, improves circulation, and modulates stress hormones. All of these exercise-induced physiological enhancements will help with blood pressure control.

You also need to get on a good nutritional supplement program. In addition to taking a potent multivitamin and mineral supplement that contains high doses of magnesium, calcium, and antioxidants, it is important to take nutrients that specifically address insulin resistance. In fact, at the Whitaker Wellness Institute, we treat our hypertensive patients who have insulin resistance as if they were in the early stages of diabetes—and in many cases they are.

Recommendations

• The Whitaker Wellness Institute specializes in the treatment of insulin resistance, diabetes, and cardiovascular disease. For more information, contact a Patient Services Representative at (866) 944-8253 or click here.
• For more information on natural ways to control blood pressure, read my book Reversing Hypertension (Warner Books, 2000), available in bookstores, online, or by calling (800) 810-6655.

References

• Lutsey PL, et al. Dietary intake and the development of the metabolic syndrome. Circulation. 2008 Feb 12;117(6):754-61.
• Cohn PF (ed). Study confirms high rate of uncontrolled hypertension; Uncontrolled hypertension common in workforce. Preventive Cardiology Clinic. 2002 June:6,7.
• John JH et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure. Lancet. 2002;359:1969-74.
• Mori TA et al. Dietary fish as a major component of a weight-loss diet. Am J Clin Nutr. 1999 Nov;70:817-25.
• Reaven GM et al. Syndrome X. NY: Simon & Schuster, 2000.
• Vasan RS. Residual lifetime risk for developing hypertension in middle-aged women and men. JAMA. 2002;287:1003-10.

Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2002. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.