Transcription
Okay, this video is called the secret of hypertension that doctors don't know and it's K plus greater than NA plus. So K plus is K is for calium which is the Latin word for potassium. Na is for natrium that is the Latin word for sodium. And so the big secret of hypertension is that potassium is more important than sodium.
So why do I say that? Because we do know that lowering your dietary sodium will help to lower your blood pressure. But what people don't realize is it's actually more important to increase your potassium than to lower your sodium. If you lower your sodium from a very high amount, like let's say a Japanese amount of something like you know 12,000 10,000 uh milligrams per day down to um uh you know 2,000 you'll get a benefit, but it won't be a giant benefit. If you get down to around 500 or lower or 200, then you get a um a much much bigger benefit. And uh Walter Kempner showed that in tremendous fashion.
But what I'm trying to say is for example um if you look at the African-Americans in the United States, they have tremendously high incidence of hypertension. And when I was in residency, everybody goes, "Oh, well, it's genetic. There's nothing you can do. It seems to be salt sensitivity. You know, it's an advantage in a hot climate to not excrete as much salt and what are you going to do?" And I'm here to tell you that's not correct. What I'm saying is it's because their diet's low in potassium is the primary reason and anybody whose diet is low in potassium is going to have high blood pressure. This has been shown across multiple different populations and the good news is it's very easy to increase your potassium because potassium stands you know for calium K. So this is called the K factor and that means the ratio of potassium to sodium in the diet and what you want in the diet is to have at least 5 to one. Our ancestors ate a primarily plant-based diet were probably eaten at least 20 to one. If you look at fruits and vegetables, they're routinely over 20 to1, quite often 100 to one times more potassium than sodium. So a lot of people will try to reduce their dietary sodium and they don't make enough effort to increase their potassium and if they did so increase their potassium they could really improve their blood pressure.
So if you remember that you want a ratio they call it the guy who wrote this is Richard Moore. He wrote a magnificent book called The High Blood Pressure Solution. It's one of the best medical books ever written. He was an MD/PhD who devoted his life to researching uh blood pressure and especially ion pumps. I'm going to show some more diagrams of this stuff, but I wanted just to show this as the first slide. K factor greater than five. Get that potassium five times higher than that um than that sodium and you will probably have great blood pressure. And this is easy for vegans to do because plant foods, P for plant, P for potassium, they've got tons of potassium. So that's a real important point. If you remember this, you'll be like the the the most knowledgeable person around for understanding how to improve blood pressure. And if you look at the the doctors, you know, the big greatest one ever was Kempner who dramatically lowered both sodium and dietary fat. And he got dramatic improvements in hypertension, taking people down from systolic 250 down to 120. Um, if you look at uh Pritiken and McDougall, they'll especially emphasize reducing dietary fat as a way to improve blood pressure. Anytime you switch from eating meat and processed foods to eating plant foods, you're automatically going to be increasing your potassium as well. There's other hypertension experts who just especially emphasize reducing sodium. And what I'm saying is if you keep this idea of potassium in mind, it'll give you a big advantage in uh dealing with these issues here.
Okay, a couple quick slides. This is the heart, the left ventricle contracting. So that's called cy. When the heart contracts, pushes blood into the ascending thoracic aorta. The ascending thoracic aorta is stretched outward by the force of the contraction and it has elastic fibers that store this up as kinetic energy. Then during diastily, cardiac relaxation, these elastic fibers recoil inward and that propels blood during diastily. So the ascending thoracic aorta is the second heart in a sense. This is called a wind kessle meaning like the the blowers if you blow on a fireplace with a thing that looks like an accordion that's called a wind kessle. So this is called the windessle effect of elastic recoil during diastily to maintain blood flow. Typically people who are hypertensive for decades will overstretch these elastic recoil fibers in their ascending thoracic aorta and they will lose that capacity to generate good diastolic flow. You can't replace those fibers after the age of about 20 or so and thus you'll be more at risk for chronic uh hypertension because to compensate you'll have to increase your systolic uh pressure to compensate for the lack of diastolic pressure when that occurs.
Okay, this is just showing an arterial a small artery and the green cells on the margin on the outer part are called the smooth muscle cells. The inner lining cells that are sort of spindle shaped here's a nucleus of one are the endothelial cells. That's for lining endomines inside. Okay. This green stuff, I'm sorry, this yellow stuff here is the capillary basement membrane or the arterial basement membrane. Um, so when these contract, they narrow the diameter of this vessel and that's called um stenosis is another word, the medical word for narrowing. Let me close this door. My dog's barking. Sorry about that. Okay, so you don't want those arteries clamping down in general. Um, you want open arteries. So sodium causes these muscles to contract. It inhibits nitric oxide. The vasoddilator are associated with these muscles. Nitric oxide is the one that Esleston talks about all the time. Dr. Esleston versus potassium dilates these arteries. So does magnesium. That's what you want. And where do you get mana uh magnesium and potassium? From plant foods.
So here's the endothelial cells. They're spindle shaped. They're aligned in the normal direction of blood flow. They've got mechano receptors like little hair cells that sense the direction of blood flow. When the blood flow is abnormal, turbulent or retrograde, they will sense that as vascular injury and start to express prothrombotic molecules on their cell surface. So here's an endothelial cell looked at from the side. And N is nitric oxide. It does lots of great things. It prevents platelets from clotting. It causes the smooth muscles to relax. So the artery, the arterial will dilate. So that's all good. That's all we need to know for our purposes. uh this talk here today about the endothelial cells.
Now I'm going to get to the really cool stuff about ion pumps. Within every cell, at least about a third of its energy is used to run this pump right here. I call it the knatpas for potassium sodium ATPAS. It pumps two potassium into the cell while simultaneously pumping out three sodiums. So this net charge effect of two positive charges come in and three positive charge going out leads to a negative uh membrane voltage a negative 65 millolts across this plasma membrane. It's like a battery and this is like an electric current ions flowing and this gives the cell energy to do all kinds of things. Most importantly for our purposes, this um pumping of sodiums out of the cell is coupled later on to bringing sodium into the cell while simultaneously pumping out calciums. And this is how a cell pumps out calcium. That's very important because calcium is like the onoff light switch inside a cell. In a skeletal in a smooth muscle cell, calcium makes the cell contract. So it causes vasal constriction, narrowing of the artery. So if this pump is running well, you got a lot of dietary potassium around, everything runs well and it's easy for the cell to pump out the calcium. If you have high dietary sodium and not enough potassium, you can't run this pump effectively. You also need magnesium to run this pump because magnesium interacts with ATP, adenosine triphosphate to keep those negative charges of the phosphate under control, sort of stabilizes them with its positive charge. I'll show examples of this in just a moment, but I'm letting you know you need magnesium and potassium. These two things that come from plants to run your pumps and to control your blood pressure. My little abbreviation is here's how I write it for KC2 meaning cytoplasm 2. Two uh potassium is pumped in. I remember there's two end points on the letter C. And so that's how I remember two of them. And then the sodium is pumped into the extracellular matrix. And I remember E for extracellular matrix. And it has three little end points on the letter E. one, two, three for three sodiums pumped out. Um, I also remember K for come in potassium, N for knockout sodium. Okay, so you don't need to know all those details. You just need to know eat more potassium. But for for what it's worth, I like to remember it that way. Oh, what am I doing here? Um, trying to get the slide to move along here. How do I move the slide along? I think this will do it. Okay, here we go.
So what I'm showing here is that calcium inside a neuron has the effect of causing the neurotransmitter vesicles to fuse the synaptic vesicles to fuse with the plasma membrane and the synaptic cleft and release this neurotransmitter across the synaptic cleft. So it goes to the post synaptic neuron and it will activate this. So glutamate is the excitatory neurotransmitter for about 80% of the neurotransmitters in the brain and the hippocampus in particular. It's associated with the memory circuits and this can also make a person anxious. So basically if you have high dietary sodium you could be releasing more glutamate across this neurotransmitter and causing a bit of anxiety um ex unnecessary increase in excitatory neurotransmitter being transmitted. You don't want that.
Okay. So here's another point. The cell has to maintain a constant positive charge inside of itself. Amount of positive charge of these ions. These are positively charged ions. Okay. They're also called cations. That's another word for positively charged ions. So the point is that the total amount of potassium and sodium inside a cell will be constant. Therefore, if you increase your dietary sodium, you are going to decrease your potassium. You don't want that. Humans, because of the lousy modern SAD diet and processed food diets, they're eating way too much sodium. We're routinely eating like 5,000 or more uh milligrams a day of the sodium when we really should only be eating about 200 to 500 much much much less. So the easy way to do it is don't add salt to your food. Don't eat processed food and eat plant foods. Okay? And you'll do that and everything will fix itself. Okay? So to maintain osmolality inside of a cell it has to keep this amount constant. And when one goes up the other goes down. So what almost everybody should be doing is eating more potassium and less sodium. And that simple concept will help people to really improve their blood pressure. Like I said, this is the great secret of hypertension that people's biggest problem is they're not eating enough potassium. Yes, they also need to lower the sodium, but you got to get that increase in potassium. And you got to make sure your kidneys work well. Somebody's in kidney failure. They're a special case. This doesn't necessarily apply, but that's a very, very, very small percentage of the population.
Okay. Now, here's this beautiful slide. This is a big AO, academic orgasm. All right. And now, the vast majority of the ion pumps on the cell membrane are going to be this knatpas. Like I said, in a regular cell, typically about one-third of its energy goes to running this KN&NP pump. Um, in a neuron, about twothirds of the cell's energy are going to go to run this pump. And the reason is it generates tremendous electrical power for the cell. This is called primary active transport. using ATP the cell makes this in the mitochondriate the ATP and that energy being used to pump two potassiums in three sodiums out but now you've generated this electrochemical gradient it's electric because you have a charge difference on the inside of the plasma membrane of the cell versus the outside negatively charged inside the 65 molts positively charged outside okay then what this enables the cell to do is to couple the electrochemical gradient to other things to pumping other things sodium concentrations much higher outside the cell about 140 compared to the cell about 14. So it's a 10 to1 concentration difference that's a concentration gradient. This difference in charge outside versus inside a cell is an electrical gradient. That's why it's called an electrochemical gradient. So sodium really really really really wants to get into the cell. When you bring sodiums into the cell you can simultaneously pump out calcium. And this naka exchanger as it's called naka stands for na for sodium ca for calcium exchanger. It's also called NCX is abbreviation. It's super fast. It can pump out thousand of these per second. So neurons need these fast calcium pumps. So do muscle cells, skeletal muscle cells and smooth muscle cells. And this is how a cell quickly pumps calcium out. And it needs to do that to be able to turn itself on and off to contract and relax. contract and relax or to release neurotransmitter, stop releasing neurotransmitter or to do whatever that particular cell does. And then you can simultaneously couple this increase in cellular calcium that occurs, you know, under some circumstances when you want it, let's say, to release neurotransmitter to contract a smooth muscle. But if you get abnormal increased amount of calcium inside a cell because you're eating too much sodium, it causes problems. It keeps these smooth muscles contracting arterial walls causing hypertension. It actually also causes insulin resistant. It contributes to causing insulin resistance. The uh establishment of the electrochemical gradient of high concentration of sodium outside the cell compared inside the cell that can be harvested is also used to pump protons. It's used to pump protons. These H+ ions right here outside of the cell. And that's highly relevant because when you're eating excess dietary sodium, you're going to have a tendency to pump too many protons outside the cell. And that actually has an anabolic effect on a cell, meaning it promotes growth in a way you don't want and it increases cancer risk. Okay? In addition, this is coupled to pumping amino acids into the cell. So what I'm trying to say is it's not just a question of hypertension. Hypertension is just a symptom of abnormal excess in dietary sodium and deficiency in potassium. And it messes up cell function in multiple ways. It messes up calcium metabolism. It messes up pH metabolism. and pumping of these protons, it'll contribute to causing insulin resistance. Um, so that's why also if you increase dietary potassium and minimize dietary sodium, even if you haven't made much of a difference yet in your blood pressure, that will have dramatic improvement in reducing the risk of stroke. It makes your cells function better in the long run. It's going to make you smarter, healthier, and happier.
So, these are just concentration gradients. the concentration gradient for calcium is is it's like 10,000 times higher outside the cell than it is inside the cell. So outside the cell millar concentration inside the cell nanomar concentrations. Okay, potassium um is much higher inside the cell. Okay, more than 10 to one and sodium is just the opposite of potassium 10 to one more outside the cell.
Okay, here's a paper, you know, one of these papers and there's tons of them saying, "Oh, hypertension is so severe in African-Americans and um you know, oh, it's so sad. Tons of strokes, tons of kidney failure." You walk into any dialysis unit, you'll see lots of guys with um hypertension induced kidney failure. And here's this guy, Richard Moore, and he says, "The problem is not so much excess sodium intake, because their sodium intake isn't that much more than lots of other populations that don't have nearly as much problem with hypertension. It's because their sodium, their potassium intake is so low. And that's a totally fixable problem. This is wonderful news. This is a fixable problem. This is great news. This is an AO, academic orgasm. You can save a lot of people's lives with this knowledge.
Okay, so here's a paper showing, okay, going back to Kenya. This is article in the Lancet Medical Journal, 1929, author is Donison. And for 1,800 consecutive admissions to the hospital, they checked the patients blood pressure and there was not a single case of high high blood pressure. Okay, so that's funny. When they eat a plant-based diet, as they did traditionally back in 1929 in Kenya, they didn't have any high blood pressure. It's not genetic. That's all BS. Okay. Whenever sodium goes up, potassium goes down and vice versa. They're like a seessaw, a teeter totter. So, you want to get your potassium up and get your sodium down. Easy to do. Okay. Um, normally your diet should really only have about 200 to 400 milligrams a day of uh potassium. McDougall says let the persons eat a little more salt. Let them put some salt on their food because otherwise they won't eat the plant foods. Most important thing is to not eat any animal foods or any oil foods. Um, and if you do that, you'll be way ahead of the game. To optimize things though, you know, I like to not add any salt to my food. And this has been shown across numerous populations. The Tata compared to the Puma, Polynesian Islanders in New Guinea, rural canyons, rural Chinese, almost zero hypertension in populations that eat this way. High potassium, low sodium, plant-based diets without added salt.
Okay. And here's just examples of some foods. You look at sweet potatoes. An incredibly great food. They only have about 1% fat. So you'll be skinny eating them. Their difference in potassium to sodium is a little more than 10 around 10 to one. Around 10 to one. That's pretty typical for plant foods. And a lot of times it's much more than that. In a blueberries, it's more like let's say this was one on the sodium. I got zero in one package, but it's like a 100 to one. Incredibly big differences in having more potassium. So that's partly why I think people that eat a lot of fruits and vegetables are so healthy. Everybody talks about all these other things, antioxidants, etc. But the potassium is an essential component of the whole thing. Gets all your cells to function well because when you get right down to it, what is, you know, illness? It's cellular dysfunction. And here's an example of a food that this was a generic cereal. I'm not going to say the names of this, but it was considered a very healthy cereal in the health cereal category. It had 330 milligrams of sodium, zero potassium. That's not a misprint. zero potassium. Now, that's going to cause hypertension. Of course, also, let's say there's 15 ounces. I would always eat the entire box of cereal. So, I'd be eating 15 times 330. That's a lot of sodium with no compensatory potassium when you should be eating five times at least, preferably 10 times at least as much sodium. So, you can see how you very quickly get hypertensive if you're eating processed foods.
Okay. So, here's a guy Richard Moore MDPhD. Again, his book is High Blood Pressure Solution. I've read hundreds of medical books. It's the best one. It's one of the top 10 medical books I've ever read in my life. It's it's a masterpiece. The guy's, you know, old guy ready to retire and he summarizes his field. You know, I tried calling him on the phone. I wasn't able to call him. I think he's probably dead. Uh but man, it's a genius level book. Okay. So, sodium inhibits endothelium nitric oxide, the big vasod diilator. So, it messes up your blood pressure that leads to the smooth muscle cells of the artery being contracted leads to hypertension. Okay, here's the guy. Here's the name of the book. The newer edition is 2001. Um, there's a whole more interesting things about insulin, but we're not going to get into all that.
Here's just a picture showing magnesium with its two positive charges helps to stabilize the second and third phosphate on the ATP, adenosine triphosphate, so they don't bust away. This phosphate, you know, it wants to break away from this other negative charge. Negative charges don't like being held together. But that's why you need magnesium to run these ATP reactions. Where do you get magnesium? It's sitting right in the center of chlorophyll. When you eat uh plant foods, you will get the magnesium. It's right in the center of chlorophyll. You'll also get the potassium because it's sitting inside the plant cells. Oh, this is just a picture of Kempner. Kempner used to have his [clears throat] patients in North Carolina at the weigh-in and he put them on a super low-fat diet, only 2% fat. So, forget about all this good fat stuff. It's a bunch of nonsense. There aren't any good fats except the secret fiber fat. That's a topic for another lecture. The point is he fed him only 2% fat and he had fed him incredibly low amounts of sodium and he had the best results for controlling blood pressure with diet of anybody in the history of the world. Okay.
And this is just more examples from epidemiology. The tata age you know sort of demographically matched with the puma in northern Mexico. The puma absorbed into Arizona start eating the standard American diet. They're tons of them are all fat and sick. Whereas the tata are running ultramarathons 100 miles in two days with great numbers. None of them are fat or hypertensive. Same thing goes for the Yanomamo. They don't add any salt to their diet. They eat a plant-based diet primarily. They got the same blood pressure in their elderly years as they do when they're teenagers. Normal. We just talked about Kenya. They got a lot of the best marathon runners in the whole world. When they eat plant-based diets, they're super healthy. So, anyways, that was the whole point. Increased potassium is one of the secrets, unknown secrets. Doctors don't know that. Vast majority of them don't know that. And it's easy thing to learn, easy thing to improve. And with that, one can dramatically improve their ability to control hypertension. If you do have hypertension and you're taking any medicines, make sure you talk to your doctor and work with them to manage your doses, to titrate your doses to the effective amount. Don't start eating tons of plant foods and potassium right away. You'll lower your pressure perhaps too fast, and you don't want to do that. Okay, good luck to everybody.