Hypertension and Insulin Resistance

Blood Pressure SurpriseHypertension (elevated blood pressure) is one of the triad symptoms of metabolic syndrome.  I see this to some degree a very large majority of the people seen in my office.  Many people are so used to having borderline or elevated blood pressure, and not successfully controlling it through caloric restriction, they are told it is a “genetic problem,” placed on blood pressure medication and sent on their way.  The problem is that most of these people will have a progressive elevation in blood pressure over time and these medications are continually raised until the person is on four or five different blood pressure medications at maximal doses.  Again, their genetics are blamed and that is the end of it.  Or is it?!

When I first started treating the insulin resistance problem in the human, rather than the blood pressure problem, I began to see immediate reductions in blood pressure within one to two weeks.  So much of a reduction that if I didn’t warn the patient that they should begin to back down their medications, they would experience symptoms of dizziness, light-headedness, headache and a few patient’s nearly passing out.  I often wondered why applying a ketogenic diet had such a profound effect on blood pressure so quickly.  Dr. Robert Lustig helped answer that question for me.

In order to understand how the Standard American Diet (we call it the SAD diet in my office) raises your blood pressure, it is important to understand how the body processes the basic sugar molecule.  Sugar is one glucose molecule bound to a fructose molecule.  This is broken down in the body and 20% of the glucose is metabolized in the liver, the other 80% is sent on to be used as fuel throughout the body. Fructose, however, is where the problems arise.  100% of the fructose is metabolized in the liver, and the by product of fructose metabolism is increasing the liver’s production of MORE glucose and the byproduct of uric acid. Uric acid is produced and this inhibits the production of nitric oxide. The diminished nitric oxide in the presence of an increased level of glucose (stimulating increased insulin production) constricts the blood vessels and raises blood pressure.   Yes, that donut you just ate raised your blood pressure for the next 12 hours.

All of this can be seen in the really complex diagram found in Dr. Lustig’s 2010 article:

Metabolism of Fructose

Lustig R. J Am Diet Assoc. 2010

So, how do you lower your blood pressure through diet?  First, cut out all the simple sugars. These include anything with table sugar, high fructose corn syrup and corn syrup.

Second, limit your overall intake of other sources of carbohydrates including any type of bread, rice, pasta, tortilla, potato, corn and carrots.  Realize that fruit is fructose, and when taken with other forms of glucose can have the same effect as table sugar.

Third, if you are taking blood pressure medications, see your doctor about close monitoring of your blood pressure as it can drop within 1-2 weeks of making these dietary changes.

One Comment on “Hypertension and Insulin Resistance

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