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High altitude residents
Published in Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson, Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson
Without direct, well-controlled comparisons between high altitude populations, it is difficult to sort out why variations exist in the prevalence of hypertension across groups, but several factors warrant consideration. One potential explanation for the differences in the prevalence of hypertension between high altitude populations may be differences in diet. A key difference between Tibetans and Andeans, for example, is the consumption of Tibetan tea, which is made with salt and yak butter and, as a result, is associated with a high sodium intake. Older reports, for example, have noted that some Tibetans and Sherpa drank 20–30 cups of this tea per day (Sehgal et al. 1968) and consume 4–7 g of sodium on a daily basis (Goldstein and Beall 1990; Smith 1999), far higher than the recommended intake in published guidelines (Government of Canada). Sherpa with SBP ≥140 mmHg consumed a greater amount of Tibetan tea compared to those with SBP <140 mmHg. In a patient-blinded randomized controlled trial, a low-sodium, high-potassium, salt-substitute intervention was effective in lowering SBP and DBP by 8.2 mmHg and 3.4 mmHg, respectively, in Tibetans living at 4300 m (Zhao et al. 2014).
Low magnesium plays a central role in high blood pressure
Published in Kupetsky A. Erine, Magnesium, 2019
If the above salt substitute supplements do not fully normalize the patient’s blood pressure or allow the patient to discontinue anti-hypertensive medications, the addition of Mg and/or potassium supplements should be initiated. In addition to the aforementioned dietary changes, 700 mg Mg/day can be added and then gradually titrated up to 1200 mg/day, giving each dose several weeks to work. (For patients taking anti-hypertensive medications, 240–500 mg elemental Mg/day should be adequate.) When Mg appears adequate, but hypertension is still evident, potassium repletion may begin. Potassium supplements can begin at 2600 mg/day and then be titrated up to 3600 (or higher, up to 7800 mg/day),80 giving each dose at least 4–6 weeks to take effect. Caution is advised in chronic kidney disease patients. If a patient has had hypertension for an extended period of time, his or her blood pressure may not entirely normalize even as Mg and potassium status are brought into adequacy. Nonetheless, the risk factor for heart disease is the underlying Mg and/or potassium deficiency versus the hypertension itself. As such, patients can still reduce their risk of stroke and heart disease with adequate Mg/potassium status despite continued hypertension. The key to treatment success is to make gradual, rather than sudden, changes in the patient’s nutritional status, as this allows the patient’s body to normalize its blood pressure as it is slowly weaned from anti-hypertensive medications.
Catalog of Herbs
Published in James A. Duke, Handbook of Medicinal Herbs, 2018
According to Ochse, “the young leaves may be safely eaten, steamed or stewed.”183 They are favored for cooking with goat meat, said to counteract the peculiar smell. Though purgative, the nuts are sometimes roasted and dangerously eaten. In India, pounded leaves are applied near horses’ eyes to repel flies. The oil has been used for illumination, soap, candles, adulteration of olive oil, and making Turkey red oil. Nuts can be strung on grass and burned like candlenuts.3 Gaydou et al. discuss the possibilities of the species as an energy source.184 Mexicans grow the shrub as a host for the lac insect. Ashes of the burned root are used as a salt substitute.42 It has been used for homicide, molluscicide, piscicide, and raticide.32 The latex was strongly inhibitory to watermelon mosaic virus.185 Bark used as a fish poison.3 In South Sudan, the seed as well as the fruit is used as a contraceptive.33 Sap stains linen and can be used for marking.6
Effects of salt substitute on home blood pressure differs according to age and degree of blood pressure in hypertensive patients and their families
Published in Clinical and Experimental Hypertension, 2018
Jihong Hu, Liancheng Zhao, Brian Thompson, Yawei Zhang, Yangfeng Wu
Hypertension remains the most common cardiovascular risk factor in developing countries, yet most patients have no access to pharmacological therapy (1). The World Health Organization has proposed that a 30% reduction in salt/sodium intake may reduce the risk of hypertension (2). To this end, the Center for Disease Control and Prevention recently released dietary sodium guidelines, for 2015–2020, recommending that no more than 2,300 mg of sodium be consumed daily (3). Despite these recommendations, Chinese and American salt and sodium intakes have remained high, at 9.1 g per day and 3330 mg per day, despite dietary shifts in recent years (4,5). In the International Population Study on Macronutrients and Blood Pressure, only 41.6% of Japanese participants achieved the target of <10 g/day of salt during salt-restriction (6). This investigation highlights the difficulty of attaining and maintaining long-term voluntary salt control and indicates the need for alternative approaches with equivalent effects. Thus, a salt substitute with a low sodium content and an acceptable salty flavor would be an ideal population-wide preventative strategy.