Taking an integrative approach, Dr. Jennifer Ashby, DAOM, MS, discusses how to educate patients on hypertension and its consequences, including by providing accessible definitions (such as for systolic and diastolic) and straight talk on the gray zone in which early-stage hypertension is often labeled as normal (even by doctors). She covers the many lifestyle factors – from poor sleep to alcohol use to chronic stress – that can raise a patient's numbers and ways to address unhealthy habits, dispelling myths about what works and offering guidance on discussing sensitive topics.
And I really appreciate being invited to do this today. So my name is Doctor Jennifer Ashby and I am actually an acupuncturist with a clinical doctorate. Um I'd like to say that uh uh people that practiced East Asian medicine are really the true integrated medicine clinicians because within our practice, um we cover all of the disciplines within integrated medicine. And um I've been in practice for 30 years, I've been at U CS F now for 10 um where I teach lifestyle medicine, primarily in women's health oncology and with kidney disease. And I love the idea of medical literacy is what I call it, which is I can just sit here and tell you what to do for 30 minutes or I can teach you why, how, why then how so I'm going to start today by just kind of explaining what blood pressure is. Um I find that in clinical practice, I make assumptions sometimes about a common body of knowledge. And I believe that when I teach you more um un understanding of a diagnosis or a problem, then you're actually more well equipped to make better decisions on your own. So without any more chit chat. I'll get on to it. So this is science based natural approaches for controlling blood pressure. And it's important to know what's in your control and what's not. So, what is blood pressure? Well, blood pressure is called a high, low blood pressure and low blood pressure. Um, also hypertension for high and hypotension for low. Hold on a second. I've got something blocking. Ok. And, and what, what blood pressure actually is, it's, it's the force of the blood against the walls of your arteries as your heart pumps through your blood throughout your body. And it's measured in something called millimeters of mercury or M MH GS. And it's made up of two numbers, a systolic and a diastolic pressure. Hold on. We're dead. That funny thing again. So how's it diagnosed? Blood pressure is taken with a cuff that squeezes against your brachial artery. And it's usually diagnosed by reading a reading that's recorded on two separate sessions. Um, uh, with your doctor, nurse practitioner, nurse P A and cy systolic blood pressure is the upper number. It's the top number. And systolic shows how much pressure your blood is pushing against your artery when the heart itself beats. And the lower number, the diastolic shows how much pressure your blood is pushing against your arteries while the heart is resting between beats. So, hypertension or high blood pressure is diagnosed if blood pressure reading is equal to or greater than 30/80 and the diagnosis of blood pressure, as I said before is based on two or more separate ratings because so many other different things can influence your blood pressure even in a moment. Right. It doesn't have to be chronic. And so they need to see that that blood pressure is elevated or in some cases too low more than once. So this is the blood pressure reading chart and you can see that a normal blood pressure is actually less than 100 and 20 systolic and less than 80 diastolic. And as we age, we see less and less of those numbers and those lower ranges, elevated blood pressure starts at 120 to 129 systolic. And it's still, if it's less than 80 diastolic and a lot of people I know still refer to this as normal. I too still refer to this as normal. And part of that has to do with just the stress of everyday modern life. But once you get that systolic into the 130 to 139 range, again, the upper number and the diastolic, the lower number into the 80 to 89 range, then we're really starting to talk about stage one high blood pressure. And I think that that's important to note because some people come into my office and they'll say, oh, my blood pressure is normal. It's like 1 35/85 and I'm like what? It's not exactly normal. So it's important to understand what the numbers are when you hear them. So what affects blood pressure even within, from acutely or chronically, there's so many factors. First is lifestyle, um smoking being a big contributor to high blood pressure, a lot of alcohol consumption which will be going over, you might be surprised to find out what is considered moderate alcohol consumption. I was um diets that are uh high in salt and also stress and anxiety. Physical factors that affect blood pressure are exercising or being excited. So both not exercising enough or just after exercise or something that induces excitability or anxiety can both raise low pressure and then as soon as you rest, it sh that blood pressure should come back down. Dehydration can affect blood pressure. It can cause lower potassium levels and potassium acts with other chemical receptors to help manage sodium. And when you're dehydrated, the potassium and sodium levels get all wonky and it can actually lead to high blood pressure. There's also medications, some medications can lead to high blood pressure. Um including those for blood pressure, those can actually also reduce your blood pressure. Too much sleep apnea. Medications can affect blood pressure, um and blood pressure readings. But there's other factors to age. The older you get, the more prone you are to high blood pressure just changes in position can change your blood pressure. So sometimes standing up too fast, can create something called orthostatic hypotension. You might feel a little dizzy or see stars. Um And like I said before, even being in the doctor's office and feeling anxious about that can um elevate your blood pressure and these are some of the reasons why they like to take it more than once. So what can contribute to low blood pressure? Today, we're gonna focus mostly on high blood pressure because that's more of an epidemic in our culture. But there are low blood pressure problems. Dehydration can create low blood pressure as much as it can create high blood pressure, blood loss, obviously from trauma can create bleeding that um can lower your blood pressure, very fast. Medications for blood pressure, Parkinson's and other conditions. Uh like the um medications like diuretics or painkillers or anti anxiety medications can lower your blood pressure, too much nervous system issues, right, which control blood pressure in response to the body's needs and diagnoses like type two diabetes or Parkinson's or Celiac's disease. And even some neuropathies can cause this um other medical conditions. Again, diabetes, infections can drop blood pressure. It can also raise blood pressure. Allergic reactions can both raise and lower blood pressure and some glandular disorders. Um but life events can do it too. So sudden emotional stress or fear can make a blood pressure drop. But also because it should be part of our fight flight freeze natural response. Those events can also raise blood pressure. Um uh pregnancy can also create low and high blood pressure situations and um prolonged bed rest can really make a blood pressure drop as well as standing because the heart can struggle to get the blood back up from your legs. If you're standing for long periods of time, especially if you're deconditioned or out of shape. With aging, we get plaque build up that can narrow uh your, your blood vessels and reduce blood uh flow. And then also there are some nutritional deficiencies that can lower blood vessels or blood pressure. And those include uh lack of vitamin B 12 and folic acid as well as some anemias and other low uh red blood cell counts. So what increases the risk of high blood pressure, diet, alcohol, caffeine, not enough physical activity, poor or not enough sleep stress, both high acute and chronic um the use of substances and illicit street drugs, genetics and disease. And we're gonna go through all of these things that increase the risk of blood pressure so that you understand how and then we'll talk about what you can do to avoid them and you'll understand why. So what can diseases directly contribute to high blood pressure, kidney diseases? So, chronic kidney diseases and there's a variety um affect how we control uh the fluid, sodium and hormones in our blood. And as I mentioned earlier, that can affect our blood pressure. Diabetes increases blood pressure by affecting blood vessels. Uh sleep apnea is a big one for affecting high blood pressure and sleep apnea, which will go over more as a difficulty breathing while sleeping, um, thyroid problems, overactive thyroid can cause increased heart rate, alcohol consumption. This one is interesting. So in a 2019 study, they found that moderate, I put a question mark here because I think this might be questionable. Um, moderate alcohol consumption being 7 to 13 drinks per week, which I would consider rather high with a patient can significantly increase the risk of hypertension. But then a 2020 study also found a link between moderate alcohol consumption, high blood pressure and people with type two diabetes. There are multiple reasons why that that is true. Um I don't know about you guys but 7 to 13 drinks a week is a little bit higher than moderate in my book. So, obesity also can contribute to high blood pressure and it has to do with how fat cells trigger adipose tissue fat cells trigger inflammation. And that increases a, a protein called called a cytokine. And that can help lead to high blood pressure. So a high pressure, blood pressure and diet, this is a general avoid processed foods, processed packaged foods can be really high in salt, sugar and fat. All three of which contribute to raising blood pressure. Even if they're seemingly healthy brands, they can still be high in salt, sugar and fat. Avoid canned foods, canned foods like soup sauces and juices are notoriously high in salt and also some in sugar and avoiding saturated fats. You can find saturated fats and desserts, processed meats, cooking oils, cooking fats, red meat and full fat dairy products. They contribute to the health of our blood vessels which can contribute to high blood pressure. Also, then things you can do. You can choose healthy cooking methods, broiling, great grilling, great poaching, great baking, great deep fried, not so good. So these are healthy ways to cook leaner meats. So when you, when you cook lean meats in a healthy way, they can have a healthy effect on your body instead of an unhealthy effect on your body. Chicken and and fish can be lean. Certain cut uh cuts of pork can either even be lean. And then within red meats, there's a variety venison is much more lean than beef elk is more lean than beef. Bison is more lean than beef. But beef often is the unhealthiest of all the red meats. And then also ways of helping redo your reduce your risk of high blood pressure. With diet, you can choose foods that are high in soluble fiber. And these would include foods like oats and bran and beans and lentils and split peas, even some cereals and brown rice, not white rice. So more about diet. So diets high in sodium or salt and low in potassium, raise blood pressure. Sodium, which was also is table salt can increase blood pressure once when you eat salt, your body retains more water. And this fluid puts pressure and increases your blood volume and that's how it increases uh your blood pressure. Potassium is another nutrient that the body needs to regulate blood pressure by counteracting um salts effect on blood pressure. They kind of act synergistically but not totally directly. There's a few other receptors that happen in between. The other thing you can do is um reduce your sugary foods. You don't have to drink juice, right? You can put fruit in your water and eventually you get used to it and it's good. But reducing sugary foods sweets will help you maintain a healthier blood pressure. And then again, reducing high saturated fats also can reduce lead uh red uh uh reduce blood pressure. Red meats seem to be and fatty red meats, hamburger. Um things with gristle processed meat, bacon. Oh big offender bacon. So high blood pressure and alcohol. So alcohol is consumed by over 2 billion people worldwide. It's a common substance of abuse because it's socially acceptable and its use can lead to more than 200 different disorders. Chronic use can lead to over 200 different disorders. Think about that including hypertension and alcohol itself can have both acute effects and chronic effects on blood pressure. Um raising them both. So what does the alcohol actually do? It narrows your blood vessels and that makes the heart have to work harder to pump the blood all the way through your body. This increases blood pressure. It does a vasodilation, squeezing your blood vessels. And it can also as in the narrowing and the vasodilation is the expansion of the blood vessels. And this increases blood flow which makes the heart work harder. And then that can also increase blood pressure, stress hormones that alcohol um can, can help us secrete um stimulate alcohol, stimulates the releases of stress hormones like adrenaline, adrenaline, like epinephrine and norepinephrine that we release as normal stress responses. And all of those can lead to high blood pressure. And then there's these things called baroreceptors that prevent uh they're like these relays of information from detecting when blood pressure decreases. So when blood pressure decreases, the the blood vessels don't respond properly. Ah Caffeine America's sweetheart. Caffeine and blood pressure are not friends. Um Caffeine can cause both short term and long term increases in blood pressure even in people who don't have high blood pressure. Um It's because the caffeine blocks some of the receptors that stimulate other receptors which cause an increase in blood pressure. Caffeine is also really interesting that it doesn't not make us tired. What it does is it blocks our receptors in our brain that tell us we're tired. So you might be exhausted, but you're not feeling it because the receptors for that chemical are blocked by caffeine that makes stresses our body out in and of itself and can also increase blood pressure. And as I said earlier, caffeine releases stress hormones. So, noradrenaline norepinephrine are fight flight free stress hormones and that increases heart rate and therefore our blood pressure. So blood pressure, not enough physical activity, which means not enough exercise. So this is this statistic actually caught me less active people have a 30 to 50% greater risk of developing high blood pressure just by not moving your body. So what does that do? Not moving your body body creates arterial stiffness and it makes it harder for the heart to circulate your blood. And that forces the heart to work harder again, which raises blood pressure as we age two. And we, if we're less active, we get plaque build up from non lean foods, saturated fats and that will create high blood pressure because our blood can't circulate as well. There's also compromised parts of the vascular system from inactivity and, and um this can create a high actually or low blood pressure. The vessels become engorged with fluid. This one l low pressure is included in this one and this can change with body positions from lying to standing up, from standing to sitting and someone who doesn't exercise regularly. Um In a 2018 meta analysis, it was determined that each hour of increased sedentary behavior is associated with a small increase in systolic and diastolic blood pressure. The analysis also found that for each hour, it equaled to a 2% increased risk of developing hypertension for each hour of your life that you're not active during waking hours, not sleeping hours, you have a 2% increased risk of developing hypertension. That statistic shocked me too. So high blood pressure and sleep, what does sleep have to do with our blood pressure? Well, we naturally have something called nocturnal dipping where blood pressure typically decreases to 10 to 20% compared to when we're awake. Um, and this is partly due to like our decreased sympathetic output. We don't have a lot of stimuli and the heart's just resting and nothing is requiring a lot of it. That is normal. But in sleep deprivation, which is not getting enough sleep, it increases um blood pressure for people who sleep six hours or less. How many of us actually sleep six hours or less and how often I think embarrassingly, a lot of us would raise our hands in this situation. Um But, but sleeping six hours or less may, um they have steeper increases in blood pressure throughout the day. And during sleep, it can make high blood pressure worse in people who already have it too. And then sleep apnea. The condition that causes breathing to stop periodically during sleep, um which leads to poor sleep and frequent wakings and gasping for air. It deprives the body. This condition deprives the body of oxygen and that is a major risk factor uh for high blood pressure because when we're depriving our bodies of oxygen. Our heart has to work super fast to get it, the blood that it has to pump oxygenated as quickly as it can. So sleep apnea is a big risk faster and risk factor in sleep. And insomnia itself or when people are unable to sleep for periods of time, you develop high blood pressure for similar, similar reasons. And because insomnia is often due to stress, we then have stress hormones contributing as we lay awake at night. Ruminating, trying to solve problems. Those the hormones chemicals that we release due to those stressors also contribute to a risk of high blood pressure as well as irregular sleep sleep schedules. We often say, oh, I, I'll have to catch up on sleep tomorrow night. Well, we can't actually catch up on sleep. The damage of that lack of sleep is already done. So an irregular sleep schedule can also contribute to high blood pressure. I know this is sounding really depressing. Stick with me, it gets, it gets more, it gets better soon. Let's talk about high blood pressure and stress. So we have acute stress and we have chronic stress. When under stress, our body releases the surge of hormones which we discussed adrenaline nor epinephrine, no adrenaline cortisol too. And these hormones cause the heart beat to beat faster, causing blood vessels to narrow and temporary increased blood pressure. Now, this is an appropriate stress response. This is not bad. This is our fight flight freeze response. This is what gets us to be able to run and get away from the tiger that's chasing us, that might kill us. But the problem is is that we're living our lives in this state of tiger chasing us chronically or responding to everyday things. Uh um a difficult to email, um a deadline, a presentation, um a conversation, um, traffic, I mean anything, the list just goes on and on. We are responding daily to to daily modern stressful life as though the tiger is chasing us. We are having the same fight flight, freeze response to things chronically throughout the day. And this is creating a lot of our blood pressure situations that I'm seeing in younger and younger people. And over time, this this can damage your heart like your actual organ of your heart. It damages your arteries, right, which are the major vessels that take blood away from your heart. And it can also damage organs having that blood pressure increased because of this chronic stress over time. And these things then put us at a greater risk for heart attack, stroke and other cardiovascular diseases. I try to tell people that I think in society today we are, we are taught, we are, we are actually fed the notion that our value and maybe sometimes even our lov ability is somehow tied into our productivity that somehow if we're not stressed out and multitasking that we're doing it wrong and it's a lie. I call these relics of uh of, of times of war and the industrial revolution where both men and women had to work triple time, both at home and at work where we had to overproduce be overly productive constantly. And then somehow I feel like industry got a hold of this and determined that it worked in their favor and has fed us this notion of our value being tied into our productivity. And I, I sometimes I feel like I'm a one woman army here to tell you that you are valued and you are loved taking care of yourself, which we're gonna get into in a minute. That, that, that this notion of just constant output serves no one but the industries that are telling us to do it and don't give your health away for an industry that would replace you in a nanosecond. Sometimes I'm asked, well, what's the difference between self care and self centered behavior? And I'll tell you what it is. It's intention, self care. Well, self-centered behavior is when you're doing things just for yourself that the benefit ends at the tip of your own nose. Self care is when you're taking care to replenish yourself first because we can't fill from an empty vessel, right? We can't fill from an empty cup. So we're careful to fill our own cup first so that we're better to our own bodies first and then we can be better to our families, our friends, our coworkers, our communities and society at large. Uh This slide seems almost, um, not important except for in terms of illicit drugs, but it does cover nicotine, which I think is important. So street drugs, illicit drugs, ra raise blood pressure. I mean, mostly because I think most of them now involve some level of amphetamine. Um, then all is another talk but that those uppers increase your blood pressure, narrow your arteries that supplies the blood to your heart, raising this heart rate and they can actually over time damage the heart muscle. Um, but nicotine is a drug cigarettes or vaping or gum or lozenges or those other, I forget what they're called thyme zite, whatever patches that you can put in your mouth, they increase your blood pressure by stimulating that sympathetic fight flight, freeze nervous system. And this causes the release of the same stress hormones as being chased by a tiger leads to an increase in heart rate and blood pressure and systemic vasoconstriction which narrows those blood vessels are. And I think you're seeing, you're hearing the same terminology used repeatedly. These are the same processes that happen that lead to chronic high blood pressure. Nicotine also increases blood flow to the heart that eventually might contribute to hardening of the arteries, high blood pressure and genetics. Well, genetics come in some fun different forms. We have family histories and then certain genes that are turned on and off just within us and then these inherited conditions. So the family history of blood pressure is when you have a, a close family member that has been diagnosed with high blood pressure before the age of 60 that doubles your risk of developing high blood pressure, having three or more relatives with high blood pressure before the age is considered, uh, 60 is considered a strong family history, check the time. Ok. Let me continue. genes, genes involving, regulate, regulate that regulate blood pressure that include fluid and salt balance are the most are the ones that are studied the most. Um, there's all different kinds of variations as well and then there's inherited conditions with blood pressure, um, that can cause severe hypertension in childhood and, and both in childhood and adulthood diseases that contribute, as we said earlier, kidney diseases, they're named here, diabetes, heart diseases that contribute to high blood pressure, thyroid diseases that contribute to sleep apnea again. And other con change conditions are glandular, some tumors, metabolic syndromes being overweight and obesity. A some autoimmune conditions like lupus and pregnancy. So, can you take control of it without taking medications? Well, maybe it depends, depends on why you have the blood pressure. So, if it's due to lifestyle and you've caught it relatively early, yes, you can probably do it solely without medication. But if it's due to genetics or disease or the advanced results of an unhealthy lifestyle, probably not. Does that mean that you should not contribute what you can to maintaining that blood pressure so that your blood pressure medication can be taken at minimum doses. No, it does not mean to stop trying a healthy lifestyle. You should be contributing what you can to keep your medication load as low as you can. But it is also it's a commitment. So how do you prevent it? Heart healthy lifestyle, great, great, first start. But some lifestyle changes that are really important are healthy foods being physically active, maintaining healthy weight, not smoking and doing drugs, limiting your alcohol. Getting enough good quality sleep, managing stress, which is not a statement about not having it. We'll get into that in a minute and proper hydration. So many people are dehydrated. How do you naturally manage low blood pressure, healthy eating the first beginnings, ways to address it or something called the Dash diet. The dash diet was, was created for hypertension. Its dietary approaches to stop hypertension. It focuses on low salt, high veg and fruit, whole grains, low dairy fat and lean proteins. Then there's also the Mediterranean diet and this is again, very similar, but it also includes nuts and beans, whole grains, lots of olive oil, lots of seeds, low, low consumption of alcohol and sweets. Um and, and then fish and eggs, dairy and then super lean meats. Although I know that there's a lot of lamb and whatnot in Mediterranean diets. If you're doing it in a heart healthy way. We take those fatty meats out. Always choose lean meats when you can. And then if you're having a hard time figuring out Dash and Mediterranean, just start with an anti inflammatory diet. This, these are the best ways to naturally use food to manage blood pressure, being physically active, even modest amounts of exercise count, walking is great. Never underestimate walking. The current recommendation for exercise and this includes people that are even in chemotherapy is 100 and 50 minutes a week of elevated heart rate. And what we find is that the term elevated heart rate is totally key here. So what does that mean? Elevated heart rate can be kind of equivalent to something called zone two and zone two, you can find your zone two because all of our zone twos are different by taking your age, subtracting that from 220 and you get an estimate of your, that's your maximum maximum heart rate. But zone two would be take exercising within 60 to 70% of that number. Again, that is zone two and 100 and 50 minutes of that is like 30 minutes, five times a week. It's just a matter of making the commitment and then you've got, you should vary your exercise because it's not just about lowering blood pressure, right? So I say there's four different kinds of exercise. There's cardio, there's strength training, great for your bones, balance and flexibility. So important for aging, do not forget to stretch before and after and incorporate balance exercises. And then there's something that I call because I'm a Chinese medicine practitioner. I call Yin style exercise. These are things like Qi Gong slow Yin style yogas, walks in nature and Tai Chi, how do we maintain a healthy weight? Since we've learned that weight has to do with an increased risk of blood pressure. It's not about your size, it's about your health within your size. Labs will tell you a lot. I'm not a huge fan all the time of checking somebody's BM I, because I don't think it really takes into consideration when people have a large muscle mass to their body, but they are a larger weight in size. But in terms of size, how do you actually feel in your body? How are your energy levels? How's your mood? How are, are you getting sick often? Are you finding that you have a lot of food intolerances or allergies? Are your joints achy? So when you're determining your size, when also checking your cholesterol levels and other labs that your doctor will give you? How are you feeling and have that help determine a good weight for you. Again, don't smoke, don't do drugs. There's so many programs out there to help you, especially when it comes to nicotine. It's just so um it, it, it, it, there's so many bad industries promoting why we should in take in nicotine products and take your power back. Don't buy it. Limit your alcohol. And I know this is really hard if there's young people on the webinar. Um just limit how much you drink, drink a pint of water in between each alcoholic beverage to get your body to be able to flush out the alcohol and the sugar faster. Having more than three drinks in one sitting temporarily raises your blood pressure. And we just learned how much stress that puts on our blood vessels. And our heart repeated binge drinking can lead to long term increases in blood pre pressure. You can actually cause chronic blood pressure by binge drinking. Uh college students. I wish I could talk to them. The American Heart Association recommends no more than two drinks per day for men and one drink per day for women for people who choose to drink alcohol. But a drink is considered something with 5% alcohol, which is equal to a 12 ounce beer that it is not liquor, right? Liquor is like 80 proof, that's 40% alcohol. So don't think that like three martinis a day or a martini a day is acceptable, that's actually eight times uh the allotted amount. And then also for perimenopausal and menopausal women. These gauges of how much alcohol you can drink don't count. Perimenopausal women have a much, much more severe reaction to alcohol. Get enough sleep, setting, regular sleep schedules. If you wanna sleep, eight hours, try to be in bed for 8.5 or nine. Give yourself time to fall asleep. Wake up after pee get back to sleep. So more time in bed than you want to sleep, no less than seven hours a day a night, please, if you can exercise during the day but not too close to bed, helps sleeping in a cool dark room. Like creating your sleep hygiene is really important. Finding what works for you. Cool warm rooms tend to really help no screens for an hour to an hour and a half before bed scheduled decompression time before bed, not screens, you can listen to something that's calming, reading a book, take a hot shower, stretch on your floor, no fluids for an hour before bed to avoid having to get up to pee a lot. And if you need to wear earplugs and an eye mask, you'd be amazed what sensory deprivation can do for sleep, managing stress. Ok. This is not a statement about not having stress. I'm not unrealistic. This is modern day, but managing your stress, having tools to manage that stress can really affect your blood pressure again, exercise, good quality sleep and enough of it, hobbies that bring you joy, social connections really help to reduce stress coming up with a breathwork that speaks to you. There's a wonderful book called Breath by James Nestor that changed the game on understanding on how we breathe in our nose. I recommend it to everybody. It changed the the game in western medicine, but it's a wonderful read. Um I like to teach people diaphragmatic box breathing M BS R, which we teach here at U CS F, which was mindfulness based stress reduction. Wonderful tools in your toolbox for not embodying stress that increases your blood pressure. A gratitude and appreciation practice helps and then again, healthy food choices which both stabilize our mood because 90% of our serotonin is produced in our gut. Not our brains. Healthy foods help to um lead us to more stable moods that help control our blood pressure, hydration. So important to stay hydrated for a gazillion reasons. But in terms of blood pressure, here's how you figure out how much you should drink. You take your weight, you divide it in two and that is the minimum number of ounces of just water, juice, lemonade, anything with sodium or sugar in it does not count. So just water. So your weight divided by two is the minimum number of ounces of water you should drink a day just so you know what your minimum is and ounces. 34 ounces equal a liter. Women should have in general 2 to 2.5 L of water a day. Men, 3 to 3.5 L a day, don't drink a ton so that you're peeing out all your electrolytes because we learned in this webinar that electrolytes like salt and potassium if you're peeing them all out, that will affect your blood pressure too. Now, there are supplements that you can add magnesium helps regulate blood pressure. These four magnesiums Tate orate, glycinate and citrate. They help by relaxing blood vessels. Koku 1017 studies found that it also can reduce systolic blood pressure. Fish oils contain omega three fatty acids. They're super good for our heart and our blood, our blood vessels and may reduce blood pressure, potassium that electrolyte you can take it as a supplement, which helps to lower blood pressure, folate. One of the bees folic acid. Large study found that women who consume more folic acid had significantly reduced risk of developing high blood pressure because it relaxes blood vessels and improves blood flow, vitamin C same thing. And it also acts as a diuretic so that you're not retaining weight water, which again, we found out can increase up pressure, probiotics and calcium also help one calcium with uh affecting veins and arteries and probiotics helps with heart health by lowering our low density lipids, which are bad cholesterol. And that will prevent our blood pressure from rising too high. Vitamin D and garlic are in there. There's not a lot of research to prove that they're super beneficial. They're not gonna hurt, but I wouldn't rely on them to lower your blood pressure. So there you have it, you can naturally manage your risk of high blood pressure. And sometimes you can also help control high, low blood pressures if you've already been diagnosed. Thank you.
