Nutrition Goals and High Blood Pressure

Jordan,

I’ve had a few blood pressure readings over the last year that suggest I’m regularly in the 150s/90s range. I have had a readings higher than that. I’m 30 years old. I want to get this issue under control, but god damn I hate the internet, and even doctors, because I get conflicting advice everywhere I turn. I’m hoping you can give me your opinions.

I have come across a few factors when discussing high blood pressure.

  1. Quality of sleep, specifically - do you sleep enough, and do you suffer from sleep apnea. I definitely get my hours in, but I do occasionally wake with headaches (possibly from teeth grinding).

  2. Sodium intake. Recommended amounts seem to be around ~2g/day?

  3. Potassium. Recommended amounts seem to be around ~4.7g/day?

  4. Magnesium. Recommended amounts seem to be around 400 mg/day?

  5. Calcium. Recommended amounts seem to be around 1200/day?

  6. Weight loss.

I’d say that I can improve in all of these areas, although I’m not sure how much I can control the sleep factor. I have a few questions.

Q1: What do you think of these recommendations in general? Are they worthwhile? Would you change anything?

Q2: Perhaps bundled in with Q1, but for the average 30 year old strength trainee, would you say its worth my time to address all six of these at once? For an average case, is it reasonable to expect that addressing all of these can help reduce blood pressure?

Q3: If the answer to Q2 is that it is reasonable to expect a drop in blood pressure, in what kind of timeframes should I expect to see results?

Q4: If my goal is to gain BW over time, are there any useful protocols that I can undergo to manage BP?

Q5: Like many other trainees, I’ve often neglected my cardio. I definitely get some cardio in under the bar though, but 30min - 1 hour LISS sessions are pretty rare. To what degree can cardio help manage BP? Should I consider trying to be exceptionally aggressive with cardio? By that, I mean, if I’m running a BBM template, should I consider adding in additional cardio than is currently recommended? My in-the-gym performance is fine cardiowise, I’d really only add this to manage BP.

If all of this is totally off base, I’d like to know your opinion on what I can try on my own.

I understand that this post may be unnecessarily long. I can trim if needed. Thank you for your time!

Mazrim,

Thanks for the post and I can empathize with your frustrations. Hopefully these answers help!

  1. Sleep apnea is definitely a potential issue here. Screen yourself here: The Official STOP-Bang Questionnaire Website If you’re high risk, talk to your doctor.
  2. No, the recommended amount is <2400mg sodium per day, but average intake is 3400mg ish in the US. I do not think this is a contributor to your or (most) others’ high blood pressure.
  3. Yes. I think to the extent you can eat more fruits and vegetables, you should aim to hit that potassium intake, but I would not recommend potassium supplements for this issue.
  4. I would not recommend supplementing or tracking this in any way, shape, or form in the context of hypertension
  5. Same answer is number 4
  6. Depending on context here, yes, weight loss, exercise, smoking cessation, sleep apnea treatment, would all be initial, general recommendations.

Tl;dr- I wouldn’t focus on sodium, potassium, magnesium, or calcium at all. Please don’t supplement any of these things. I would screen for sleep apnea and initiate lifestyle changes in general, though I am not your doctor and do not know your specifics.

Onto your other questions:

  1. See above
  2. I wouldn’t address the micronutrients at all, but yes addressing sleep apnea, obesity (if present), training, smoking cessation, etc. would be tackled at once. This is known as multiple behavioral changes and it does at least as well, if not better, than single behavioral changes (think of “nutrition LP”). Single small changes don’t work better and do not produce greater compliance, on balance, compared to multiple changes that can produce greater improvements.
  3. Depends on your clinical situation.
  4. I would not gain weight with poorly controlled blood pressure. Full stop.
  5. Combined RT and AT can improve blood pressure greatly in those who are hypertensive. That said, I don’t know if you’re overweight or obese, if you have sleep apnea, if you’re taking other medications or substances that are playing a role here and, in general, I cannot predict how your BP will respond to one intervention without knowing any of the background here.

Wow, that’s totally conflicting with some of what I’ve heard. Thanks.

I know this isn’t a consult forum, so if this is too much its ok. As far as some of my background, BMI tells me I’m obese, but I am most definitely not obese. I can put up a picture if it’s somehow useful.

My walk around weight is now around 230 at 5’11, but sometimes I go above that to help hit lifts. I’m not shredded to the bone, but I can get into 32/34 inch waist jeans at this weight and its not a problem. But 230ish is still heavier than the average guy. I train pretty decently in the gym. PRs of 250 press, 500 squat, 500 dead. I could gut out a set of 315x20 squat, so I know my cardio isn’t just like utter complete dog shit. But running a mile would be a rough go.

My screening on the sleep apnea thing indicated that I’m unlikely to have it. My fiancee tells me my snoring isn’t too bad either.

Other notes: I use no medications, have never smoked in my life. I drink maybe once every 2 months.

So asking more advice on this, if you have time sir:

  1. I like being 230, I look good at 230. Is there no other check boxes besides cardio to hit here? Do RT and AT refer to types of cardio?

  2. If I get to 210, I think I’d be getting to visible abs territory, and I just don’t know if that level of body fat is going to be useful for hypertension? Not sure if it’d be a useful weight for me for training either.

  3. I am really skeptical about doctors in general (no offense). Just don’t want to be another dude popping a shit load of pills. I want to tackle this from every reasonable avenue that I can before putting it in the doctor’s hands. If you tell me that’s a stupid idea, I’ll take your advice. Is there anything else I can try? Should I get a CPAP and just see if it helps, even if I’m low risk for sleep apnea?

I guess what I’m taking from this is: “Don’t worry about the nutrition too much as it relates to hypertension, get that cardio into shape and see what it does for you.” And I’m totally cool with that, I’m just looking to enact everything reasonable that I can. In my mind, if I make like 4 good changes at once, the effect should be solid. I am just looking for 4 things worth doing.

Thank you again Jordan.

Josh

What is the measurement around your waist? See video:

Just guessing, but I would wager your bodyfat to likely be in the 25-30% range if you’re 230lbs at 5’11. I am 5’10.5 and 205lbs and in the 15% range. If my prediction is correct, your blood pressure control is likely to improve.

If you lose 20lbs your blood pressure is likely to improve secondary to decreased body fat. I would not expect your strength to suffer if programming is correct.

Why are you skeptical though? What I mean by that is- what reason(s) do you have that are based in actual evidence to support being skeptical of licensed physicians operating within their scope of practice?

I don’t understand this line of thinking, Josh. We have good evidence that seeing a primary care doctor and participating in preventative medicine such as vaccinations, age-appropriate screenings, diagnostics based on risk factors, etc. all improve mortality and burden of disease. I’m not sure that resisting expert-level care in favor of doing it yourself is something I would recommend.

At this point, your blood pressure is high and needs to be managed. I do not know your medical history and other clinical factors that would help me construct my assessment and plan for you so I’m afraid I cannot tell you what to do from here other than HIGHLY ENCOURAGE YOU to see your doctor for management. I would not treat someone without sleep apnea with a CPAP.

I wouldn’t agree with that interpretation and I would encourage you to make nutrition changes that lead to fat loss. Aerobic training would likely be beneficial as well.

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Just wanted to chime in here based on my own experience - I absolutely understand the desire not to be “another dude popping a shit load of pills”, but there are many medications for hypertension that are well-studied, effective, and safe. Taking them won’t prevent you from pursuing longer-term lifestyle modifications, and you can go off the medication if you get to a point where you no longer need it. Taking a pill to address a common condition that can reduce your quality and quantity of life isn’t a failing.