Wonderfully Made

Hypertension & Insulin Resistance Syndrome

Three Angels Broadcasting Network

Program transcript

Participants: N. David Emerson

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Series Code: WM

Program Code: WM000430


00:01 The following program presents principles designed
00:03 to promote good health and is not intended to take
00:05 the place of personalized professional care.
00:07 The opinions and ideas expressed are those of the speaker.
00:11 Viewers are encouraged to draw their own conclusions
00:14 about the information presented.
00:36 Hello. I am Dr. Emerson,
00:38 Medical Director at Eden Valley Lifestyle Center.
00:40 And I wanna continue discussion on Hypertension today.
00:45 As we learned last time Hypertension
00:47 is part of the Insulin Resistance Syndrome.
00:50 We want to find out what are some of the underlying
00:53 causes of Essential Hypertension.
00:57 Also I mentioned last time,
01:00 in Insulin Resistance there are couple of problems.
01:05 The way it's supposed to work as you take a sugar in,
01:08 blood sugar increases in your blood.
01:11 The pancreases senses that, releases insulin
01:15 that is a little key which opens the doors to your cells,
01:18 allows sugar to leave the blood go into cells
01:20 and get burned and that brings your blood sugars down
01:22 and so is supposed to work.
01:23 Animal products we found increase amount of fats
01:28 in your diet and when those go into the system
01:30 they plug up the little keyholes
01:32 and they cause an increase in Insulin Resistance.
01:35 Now when you take a sugar, the blood sugar raises,
01:39 pancreases releases insulin, can't get in those keyholes.
01:42 The doors they shut, blood sugars rise,
01:44 that's Insulin Resistance leading to diabetes.
01:48 I want to look today how that affects your blood pressure also
01:52 What we find is that insulin's job is to get sugar
01:56 from the intestines into the cells.
02:00 And so part of what it does is,
02:01 opens the insulin doors to allow sugar
02:04 to enter the cells to be burned.
02:08 The other thing it does is it dilates arterioles
02:11 in a dose-dependent way to help blood flow from intestines
02:16 to the peripheral organs to help the delivery of sugar.
02:22 Insulin has been found to increase something
02:27 called nitric oxide in the blood arterioles.
02:31 Nitric oxide is what actually does the vessel dilating.
02:38 What they find is that in arterioles,
02:41 the inside lining of the walls of arterioles
02:44 are called Endothelial Cells,
02:45 and when insulin stimulates endothelial cells
02:49 they release something called Nitric Oxide Synthase
02:53 which changes arginine to nitric oxide
02:56 and that nitric oxide acts like
02:58 nitroglycerin under your tongue.
03:00 It's what dilates those arterioles.
03:03 It relaxes the arterial muscles
03:05 and allows it to become bigger and enlarged.
03:11 They are found that when they infuse insulin into arterioles,
03:15 the arterioles dilate and the nitric oxide levels
03:19 increase in a dose-dependent fashion.
03:22 In other words, the higher the insulin levels
03:23 the higher the nitric oxide levels.
03:26 This was true in both arterioles and also in venules.
03:32 Now this Vasodilatory Effect can be blocked
03:37 by insulin resistance just like fat can block
03:42 the effect of insulin in opening
03:45 the cell doors to allow sugar to enter a cell.
03:48 It also can block the effect of insulin
03:51 on dilating those arterioles.
03:53 This can occur in diabetics but it also can occur
03:57 in people who are obese and who have Hypertension.
04:00 It's been demonstrated that these people
04:02 have a resistance to the Vasodilatory Effect
04:06 of insulin on their arterioles.
04:14 So high sugar levels have also been shown to block
04:18 this Vasodilatory Effect of insulin on the arterioles.
04:22 So when people are having problems
04:27 with circulation in the heart,
04:29 they find that if you give insulin the perfusion
04:32 can actually increase but that this effect is blocked
04:35 if the sugar levels are too high.
04:38 So two things can block insulin's Vasodilatory Effect,
04:41 that's insulin resistance from the animal products
04:45 that we've talked about,
04:47 but also a high sugar levels can also block
04:49 that Vasodilatory Effect.
04:52 Well, the question then is what is this insulin resistance
04:58 on the Vasodilatory Effect of insulin
05:00 have to do with Hypertension.
05:02 In other words if you block insulin's ability
05:04 to dilate the arterioles how does that cause
05:08 or effect Hypertension.
05:10 Well, the first place we would look
05:13 is how does it affect the kidneys?
05:16 Kidneys get about a fifth of your blood supply
05:18 and there the organs that regulate your blood pressure.
05:22 They adjust the blood pressure thermostat
05:24 up and down based on their need.
05:29 Dr. Goldblatt did an experiment to demonstrate
05:33 how kidneys affect and adjust the blood pressure.
05:38 He took a dog and he took the artery
05:42 that would supply the dog's kidney
05:44 and he tied a string around that,
05:48 after removing the other kidney and he narrowed the artery.
05:52 So now the kidney thought it was not getting
05:55 the blood supply when kidney wasn't that it was before.
05:58 The pressure it saw was much lower
06:02 than the pressure to the rest of the body
06:03 because that constriction in the artery.
06:08 The kidney responded. how does the kidney respond?
06:11 Well, the kidney thought, you know,
06:13 I am not getting the blood pressure or the perfusion.
06:17 I was getting before I need to fix that.
06:20 What I need to do is turn up
06:22 the blood pressure thermostat and it did this.
06:26 It did this through a complicated system,
06:28 renin-angiotensin system in the kidney, turned on.
06:33 There was an initial hanging on to salt and water.
06:36 This increased the blood volume,
06:38 cardiac output increased transiently,
06:40 when that happened the other organs
06:43 tried to protect themselves from this increase
06:45 blood pressure by narrowing the arterioles
06:48 that were supplying each of those peripheral organs
06:51 that increase the pressure even more.
06:54 Once the pressure was increased the kidney said,
06:59 okay blood pressure is high.
07:00 Now we can get rid of that excess fluid.
07:03 The renal level came back to normal.
07:05 The excess fluid was released to the kidneys
07:09 and what you were left with was a higher blood pressure
07:13 and you had arterial constriction
07:15 to the peripheral organs.
07:17 Now you don't have to really understand all those steps
07:20 that led to this but the final picture was important.
07:23 It showed increased blood pressure
07:26 and arterial constriction to all the little blood vessels
07:31 supplying the peripheral organs.
07:34 Well, what is the picture that we see in Hypertension?
07:39 Is there any evidence that this is actually
07:41 what's happening in Hypertension the essential Hypertension?
07:47 Well, when they look at the physiologic picture
07:50 of essential Hypertension and this dog
07:54 with the artery that's narrowed,
07:55 we find the same identical picture between the dog
07:59 and people with essential Hypertension.
08:02 What they find is that the resistance flow through
08:05 the kidneys has increased 2-4 times in both the dog
08:08 and people with essential Hypertension.
08:12 Renal perfusion that flow of blood through
08:14 the kidneys is decreased in both the dog
08:17 and the people with essential Hypertension.
08:20 Sometime half normal.
08:23 Blood pressure is increased by 40% to 60%.
08:29 Cardiac output is maintained as the same,
08:32 you know, ability to make urines,
08:33 the same in both pictures.
08:36 Renin levels have come back down to normal.
08:39 Essentially what you have is the same picture
08:41 between essential Hypertension patients
08:44 and the dog with the narrowed arterial
08:47 or narrowed artery going to the kidney.
08:52 Dr. Guyton is a famous physiologist.
08:57 He's written the text book on "Medical Physiology"
09:01 for many years, in fact, he is the standing
09:04 feet of written the whole text book.
09:05 Most people write text book today will write a chapter
09:08 or two and sign the other chapters to other people.
09:12 He was in such caliber that he was able
09:14 to actually write the whole book.
09:16 He did and studies in Cardiac Physiology.
09:22 He gave us the concept of cardiac output,
09:26 peripheral resistance. All these things
09:28 were developed by Dr. Guyton.
09:31 He studied essential Hypertension
09:34 and question is, what did he believe,
09:36 was the cause of essential Hypertension.
09:41 He actually said that, according to him,
09:43 He said, the significant vascular changes in the kidney
09:46 that is the Increased Vascular Resistance through the kidneys,
09:53 suggest the basic kidney abnormality
09:55 is in essential Hypertension is these vascular changes
09:59 or the increased resistance to blood flow through
10:02 the kidney that is found in essential Hypertensions.
10:07 Well, what can cause increased vascular resistance
10:12 through the kidneys?
10:14 Well, as we've seen insulin resistance
10:16 can't do that very thing.
10:20 And so in essential, in insulin resistance
10:25 we would expect to see as part
10:28 of the insulin resistance syndrome,
10:29 essential Hypertension and in fact,
10:32 when we look at the list of things
10:33 that is included in the Insulin Resistance Syndrome
10:36 we have blood sugars above 100
10:40 which we've talked about diabetes.
10:44 We also have abdominal obesity but essential Hypertension
10:48 is part of the Insulin Resistance Syndrome
10:50 and it's through this mechanism
10:51 that the blood pressures are elevated.
10:56 Well, It would then follow that if we can do something
11:00 to decrease insulin resistance we should able
11:02 to increase insulin's ability to dilate those arterioles,
11:09 increase flow through the kidneys
11:11 and then allow the kidneys to say,
11:13 I don't need this high blood pressure anymore.
11:15 I can adjust the blood pressure down.
11:18 A plant-based diet we've found as we've talked
11:22 about earlier can help reverse insulin resistance
11:25 and in fact, bring blood pressures down.
11:27 And this is what we have found in patients
11:29 who chosen to try the plant based diet
11:33 that with essential Hypertension,
11:35 usually in a week or two we see blood pressures
11:37 coming down and we've been able to adjust
11:40 their medications in the downward direction.
11:45 Is there any evidence that vegetarians
11:46 actually have lower blood pressures?
11:49 Yes, there are. We find that male college students
11:51 that were Lacto-ovo vegetarians had lower blood pressures
11:54 than their carnivorous counterparts.
12:01 They found that Lacto-ovo vegetarian
12:03 German monks had lower blood pressures at all ages
12:06 compared to meat eating monks.
12:08 It's also found in Czechoslovakia areas
12:11 that had greater animal consumption
12:13 had higher blood pressures than those
12:15 that had lower animal consumption.
12:18 In Japan, greater consumption of animal products
12:22 which was also associated with higher blood pressures.
12:27 They also found that the differences
12:29 were not attributed to changes in salt intakes,
12:31 but the salt intakes were very similar between the two groups.
12:35 Railway clerks in South India had sixfold greater meat intake
12:39 than the Northern workers
12:42 and also had much higher blood pressures.
12:47 Studies in the Polynesians showed that areas
12:52 that had higher meat consumption
12:53 also had again higher blood pressures.
12:56 They've also found that in New Guinea,
12:59 the natives that had a higher meat rash
13:02 than the others again had higher blood pressures.
13:05 And numerous studies have been showing these.
13:09 Well, the question then is what about salt.
13:12 Haven't I have been told
13:13 that high salt intake causes Hypertension?
13:18 Actually what we want to look at,
13:19 what we were finding is that hanging on
13:22 to salt is the kidney's response to this narrowed arterioles
13:26 and we are going to look at that at this point.
13:29 What they found is that, yes, if we take
13:31 a general population give them a high salt intake.
13:36 Blood pressures can rise about 2.5 mmHg systolic.
13:42 If we take hypertenses
13:44 and give them a high salt intake,
13:47 their blood pressure rises about 4.5 points.
13:50 On the other hand, if we take normal tenses of people.
13:53 People who don't have high blood pressure
13:55 and give them a high salt intake,
13:57 blood pressure only rises 1.9 points.
14:00 So they have a lower response to salt
14:04 if they are not hypertensive to begin with.
14:08 And these figures can occur with Dr. Guyton's findings
14:12 that an average blood pressure drop 4 to 6 mm of Hg
14:17 occurs when you restrict salt.
14:21 Well, they found that vegetarians
14:25 again have a lower blood pressure
14:28 than non-vegetarians and one of the arguments
14:32 or hypothesis for this was that well maybe vegetarians
14:35 have a lower salt intake,
14:37 maybe that's why their blood pressure is lower.
14:39 So they want and they tested this.
14:42 They looked at a group of vegetarians and found that,
14:46 yes, the vegetarians blood pressure was significantly
14:49 lower than the meat eaters,
14:53 but when they measure the salt intake
14:55 between two groups they found that the vegetarians
14:59 were actually eating more salt than the meat eaters
15:02 but their blood pressure was less.
15:04 So he said, well, it can't be the salt
15:07 which is the advantage for the vegetarians
15:09 because they are eating more salt.
15:11 There must be something else going on
15:13 and of course, we understand
15:14 that it is the Insulin Resistance Syndrome
15:16 was not affecting the vegetarians
15:20 as it was the meat eaters.
15:24 The next question is what causes salt sensitivity?
15:27 What they found is that for some people
15:30 you give them a high salt intake
15:32 and the blood pressures go up, other groups of people
15:35 that blood pressures do not go up significantly,
15:38 what is the difference?
15:39 Well, they separated a large group of people
15:43 into those whose blood pressure went up with salt.
15:46 They were the salt sensitives.
15:48 Another group whose blood pressure
15:50 didn't go up significantly they were the salt insensitives.
15:54 And then they tested them for insulin resistance.
15:57 What they found was the people that were sensitive
16:00 to salt had insulin resistance.
16:02 They were resistance to the action of insulin.
16:05 Those that did not have sensitivity to salt,
16:08 the blood pressure stayed fairly normal
16:10 when they gave them large dose of salt,
16:11 were not insulin resistance. So what's going on?
16:15 Why does insulin resistance have anything
16:18 to do with salt sensitivity?
16:21 What happens is when there is insulin resistance
16:24 the arterials again to the kidneys
16:26 are narrowed and the kidney,
16:31 a normal kidney who has no insulin resistance
16:34 let say you know out of blood pressure 120/80,
16:37 I am getting all the perfusion I need.
16:39 I am going to leave the blood pressure 120/80.
16:42 But if they become insulin resistance
16:44 the arterioles narrow.
16:46 The kindney says, I am not getting
16:48 the perfusion I was before.
16:50 I need more perfusion.
16:51 I am going to turn up the thermostat.
16:54 And we found how the kidney does that,
16:56 hangs on the salt water and goes through process
16:59 to eventually come to a higher
17:00 equilibrium point for Hypertension.
17:03 The blood pressure is now says 160/100.
17:07 The kidney says, well, this is better perfusion.
17:11 This is better than it was. It's not ideal.
17:14 I wish I could bring it maybe upto 180,
17:16 but this is better.
17:18 If that person takes salt, a high dose of salt,
17:21 the kidney says, oh, salt.
17:23 This is just what I am looking for.
17:24 It hangs on to the salt.
17:26 Blood pressure goes up even higher.
17:29 And now kidneys say, okay 180/100
17:32 that's getting better perfusion
17:34 and he will leave it at a higher level
17:36 with addition of that salt.
17:39 If this person on the other hand would go on a say
17:42 plant based diet, the kidney's vascular system can now dilate.
17:48 It gets better perfusion and then what we find
17:51 is the kidneys can now get rid of that extra fluid
17:57 and that extra salt and bring the blood pressures
18:00 back down to say 120/80.
18:03 And it says now with these dilated arterioles,
18:06 since we don't have insulin resistance,
18:08 I am getting all the perfusion
18:09 I need with a blood pressure 120/80.
18:11 If this person gets a high dose of salt,
18:14 the kidneys say, thanks for the salt
18:17 but I really don't need it
18:18 and just dumps it out into the urine.
18:21 And so these people without insulin resistance
18:23 are not salt sensitive and are not as sensitive
18:28 to the effects of salt in their diet,
18:29 because the blood pressure can stay normal.
18:33 Now I shared this concept at a Lifestyle Center once
18:37 and I got in trouble for it.
18:39 One of the patients was furious after I shared this concept
18:44 about salt being not the core issue
18:46 but that was insulin resistance.
18:48 And she wrote an awful evaluation
18:51 and stormed out of the room and one of the patients
18:53 who had been listening said, see that lady.
18:55 She was very upset. I said, yes, what happened?
18:57 Why was she so upset?
18:59 And he explained it, well, she had been following
19:02 another patient around who had Hypertension
19:04 and every time he put salt on his food
19:06 she was behind him saying I saw you do that,
19:08 don't you put salt on that food.
19:10 I am going to watch you
19:11 and when I said that salt wasn't the core problem,
19:14 he turned around and looked at her
19:15 and said, nah, nah, nah, nah.
19:18 So she was not happy but nevertheless
19:24 salt wasn't the core issue.
19:26 Now if you have insulin resistance
19:29 it would be prudent towards salt
19:31 until you are not insulin resistant anymore.
19:33 Once you are out of the insulin resistance face
19:36 then you should be able to handle salt
19:39 much more easily then before.
19:42 So question then is, how can I lower my blood pressure?
19:47 Well, it's helpful do things that can avoid
19:53 the short term elevations of blood pressure.
19:57 Things that will cause a transient elevations
20:00 of blood pressure include caffeine, smoking, alcohol
20:05 these can cause transient elevations of blood pressure.
20:09 Nicotine, for instance cigarette can elevate
20:12 your blood pressure for about 30 minutes.
20:15 You might think well, this is in lung.
20:17 How can that really be of significance?
20:21 Well, a pack-a-day smoker will smoke about 20 cigarettes a day
20:24 and that's about 10 hours worth of blood pressure elevation.
20:28 That can be almost your whole waking time during the day.
20:35 Caffeine can also cause
20:37 elevations of blood pressures again transiently.
20:40 They are both vessel constrictors.
20:43 They cause vasoconstriction and actually this is part
20:48 of the problem with withdrawal headaches
20:52 because they cause vasoconstriction
20:54 when you come off of the caffeine
20:56 or the nicotine you actually get a vasodilation.
21:00 Now this is not a problem in the arms
21:02 or the legs where there is plenty of room
21:03 for the arteries to dilate.
21:05 But what happens in the head you can get that vasodilation
21:08 and it causes pounding headache.
21:13 The people that make aspirins realize
21:15 that many of the headaches they are treating
21:17 are caffeine withdrawal headaches
21:19 or nicotine withdrawal headache.
21:22 So what do they add to the aspirin to treat that?
21:26 Many times they will add caffeine.
21:28 This will then cause a vasoconstriction
21:30 and help relieve the vascular dilation in their head
21:34 causing that pounding headache.
21:36 The problem is that this prolongs the nicotine
21:40 and the caffeine addiction.
21:42 So what you need to do is do something
21:45 which can cause vasoconstriction in the brain
21:49 without prolonging the caffeine or nicotine addiction.
21:53 One of the best ways is to use a Hot Foot Bath,
21:56 put your feet in hot water that helps
21:59 give you some vasodilation in the feet,
22:00 helps pull blood away from the heads,
22:03 eyes to the forehead can also cause some vasoconstriction
22:06 and help relive that pounding headache.
22:09 The benefits' of this approach is that if you do it
22:12 for three or four days, by the fifth day
22:14 you are over the nicotine withdrawal syndrome
22:17 or the caffeine withdrawal symptoms.
22:19 And you don't have to worry about having to repeat
22:23 the nicotine or caffeine to cause vasoconstriction.
22:26 If on the other hand, you continue to treat
22:28 with nicotine or caffeine you gonna continue
22:30 the addiction and every time you go into withdrawal,
22:33 you can have the headaches again.
22:35 People who use high levels of caffeine and nicotine
22:41 when they go at night and go to sleep,
22:43 they go through withdrawal and what happens
22:47 is their Arterioles dilate and what do they wake up
22:50 with but many times a pounding splitting headache
22:53 and the first thing they need to do
22:54 to get rid of that is to get a cup of coffee or the nicotine
23:00 again to help relief that.
23:02 If you can, however, break the cycle
23:05 and get over these addictions, you can do much better.
23:09 Things that can be done to help get over these addictions,
23:16 drinking plenty of water can flush the nicotine and caffeine
23:20 out of your system more quickly.
23:22 You can do warm showers.
23:26 It actually flushes it out through your system.
23:31 There are people have gone through
23:36 nicotine and caffeine withdrawal programs,
23:39 where they actually put them in the sauna.
23:41 They come out and give them a massage
23:43 and the towel comes up yellow.
23:45 Because the nicotine is actually coming out their sweat pores.
23:48 So if you take warm showers or saunas,
23:50 you can actually get rid of that nicotine,
23:53 caffeine much more quickly than otherwise.
23:58 You also want to avoid triggers that will cause
23:59 you to want to smoke or use caffeine
24:03 and the biggest trigger for smokers is caffeine.
24:06 It triggers a desire to smoke.
24:08 So it's best if you can stop them both together.
24:12 They have done a study at one lifestyle center
24:14 where people that stopped nicotine and caffeine
24:18 at the same time, they were followed
24:20 after they left the program.
24:22 Those that stayed off of caffeine,
24:25 90 percent of those were able to stay off the cigarettes.
24:29 Those that went back to caffeine,
24:31 90 percent of those went back to smoking.
24:34 So there is high correlation between
24:36 smoking and cigarettes and caffeine.
24:41 You also want to avoid other triggers
24:43 that will cause you to want to smoke
24:44 or and those include alcohol, lack of sleep
24:49 and the smell of smoke.
24:51 You can avoid those.
24:52 You can decrease your risk of going back to those habits.
25:00 Also, encourage patients to pray
25:02 because giving up smoking or tobacco
25:06 can be a spiritual battle.
25:09 A friend of mine, we helped him in Guam.
25:12 He was able to stop his hard drugs
25:15 and he stopped his alcohol
25:18 and then when he stopped cigarettes,
25:20 he was coming out of the store
25:22 and somebody in the parking lot,
25:23 said hey, you wanna cigarette.
25:26 In fact, he handed the whole pack.
25:27 In fact, you can have the whole carton.
25:30 And I asked Mr. John, you are 30 years old.
25:32 Does everyone ever offer you
25:34 a free pack of cigarettes before?
25:35 And He said, no and certainly never a whole carton.
25:38 And I said, do you think it's a coincidence
25:40 that on the day you stop someone
25:41 offers you a whole carton.
25:43 I said God's got His angels, Satan's got his angels,
25:45 and they are fighting over territory.
25:47 You are the territory.
25:49 I shared this with a nurse, friend of mine.
25:50 She was a Christian. She said, oh yes, I know that.
25:54 I told the friend of mine the same thing
25:56 and he didn't believe me but the day after
25:58 he stopped smoking, there was a knock on his door.
26:00 He answered the door.
26:02 It was friend of his and his friend said, dear George
26:03 You remember that cigarette I borrowed
26:06 from you a year ago?
26:08 I never gave it back. Here it is.
26:10 So I consult patients. You gonna stop cigarettes.
26:14 Remember it is a spiritual battle
26:16 and prayer is really needed
26:18 because they are bigger than we are.
26:20 So, it's important to remember that if for any reason
26:25 your blood pressure does not response
26:26 to simple lifestyle changes, you may have a secondary
26:29 cause of Hypertension. Endocrine tumor can do this.
26:36 Renal artery stenosis can do this.
26:38 There are several things that you should be checked for.
26:40 And so for any reason it does not respond,
26:43 check with your doctor.
26:45 You may need a further evaluation,
26:46 further work up. But 95 percent of hypertensive
26:50 is essential Hypertension and does respond
26:53 very well to lifestyle programs.
26:56 So again the things to remember,
26:59 plant based diet, eliminate the animal products,
27:03 eliminate the oils, caffeine, nicotine, the alcohol,
27:08 and try to get on a walking program.
27:11 Do things proactively to avoid stress in your life
27:15 that could be very healthful.
27:17 And you will find that if you actually do these for lifestyle,
27:21 things that many times,
27:23 the stress in your life will go away.
27:26 If you are struggling remember God's grace can give us
27:30 the power to follow through on the choices
27:32 that we know are going to give us the best help,
27:36 encourage you to seek God and prayer.
27:38 He can give you the strength and guide you
27:41 in the choices that will help you to obtain the good health
27:46 that He does want you to have.
27:49 He does encourage us that He does want us
27:51 to have good health, that we might reflect His image
27:56 and be of better service to Him
27:57 and to our brothers and sisters. I enjoyed talking with you.
28:00 Look forward to talking with you again.
28:03 Until next time, God bless.


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Revised 2014-12-17