Do medications blunt the association?
There is a theory, not a study, that angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) may be harmful by increasing ACE2 receptors in the lungs, which COVID-19 binds to. However, there is also a case for these medications having benefits.
Do not stop or change your hypertension medications without talking to your doctor. Remember, this is just a theory, and theories are very dangerous; we don’t have research to support them, by definition.
I view this as a call to arms to control and, even better, treat and reverse hypertension. Presently, only 54 percent of hypertension patients are controlled with medication.
Potential to control and reverse hypertension through diet
We have the capability to treat and reverse hypertension with lifestyle, including diet, exercise, sleep and stress management. Here, we are going to focus on diet.
A whole foods plant-based diet (WFPBD) that is dark green leafy vegetable-rich has been shown to help prevent, control and possibly reverse hypertension. I call this the LIFE diet, which stands for Low Inflammatory Foods Everyday.
The most researched WFPBD is the DASH (dietary approach to stopping hypertension) diet, which emphasizes fruits, vegetables, grains and reductions in saturated fats and total fat. DASH was the first randomized control trial to show that a predominantly whole food plant-based approach reduces blood pressure.
Diet has an effect, because it directly influences inflammation, phytonutrients, and electrolyte balance.
Why is inflammation so important?
Inflammation is a culprit in most chronic diseases, including hypertension. It also plays a crucial role in COVID-19 severity. Those who take a turn for the worse in COVID-19 have high inflammation. Several studies show a direct relationship between high sensitivity C-reactive protein (hsCRP), one of the most well-studied biomarkers for inflammation, and hypertension in both men and women.
Anti-inflammatory drugs, including NSAIDS like ibuprofen, worsen hypertension and may increase the risk for cardiovascular events, such as heart attacks. Prescription NSAIDS carry an FDA warning about this dangerous side effect.
They also may suppress the immune system and make patients more susceptible to COVID-19. Anti-inflammatory drugs should not be the “go-to” solution.
Fortunately, a WFPBD is associated with reducing hsCRP. We recently published a study showing that the LIFE diet has an inverse relationship between blood levels of beta carotene, a phytonutrient, and hsCRP.
As you increase the intake of dark green leafy vegetables, the higher the beta carotene and the lower the hsCRP. There was a 75 percent reduction in inflammation with those that increased their beta carotene over the normal level, compared to those who were non-adherent.
The DASH diet also emphasizes an increased vegetable intake.
Electrolytes - sodium and potassium
The optimal approach for these electrolytes is to have a sodium-to-potassium ratio that is less than one. For most, this means consuming less sodium and more potassium. The American Heart Association emphasizes low sodium, less than 1500 mg of sodium per day, and higher potassium intake.
What I find in my practice is that blood levels that are south of 140 mmol/L are better and that the bottom of the 135-145 mmol/L range is ideal. Potassium should be 4.5 (units) or higher.
These electrolytes should come from vegetables, especially dark green leafy vegetables, which have a natural balance of potassium and sodium. Other good potassium sources are beans and nuts.
Ultimately, the power is in your hands. Changing your diet to one that is more vegetable-rich can reduce your inflammation, strengthen your immune system, possibly reduce or even get off anti-hypertension medications, and reduce your susceptibility to severe COVID-19.