Exercise, blood pressure and cholesterol

[DeusXM]

Ok, I had a weird clinic visit this week and I want to check a few things to get your thoughts everyone!

Here's the deal: everyone on my father's side of the family gets dxed with high blood pressure in their 20s, and I've also been lucky enough to get it too. I'm currently treating it with lisinopril.

I also had my cholesterol readings done after 2 weeks of drinking at least 8 pints of beer every single day and eating rice for every meal (big party holiday in Thailand). Total cholesterol was 5.1 and trigs were 2.0. I'm aware these are 'elevated'. I'm expecting them to be substantially different next time around.

Here's the thing.

My doctor told me there's three steps to reducing cholesterol. The first is getting diabetes under control, which according to him, I have done. I disagree (last A1C was 7.1, so I'm not calling that 'good' control by any measure). Then there's diet, and if those don't work, statins. I've got a fun appointment booked in with the dietician now. My doc has already told me that the more insulin I have, the more 'stress' is put on my blood vessels which causes more cholesterol and higher blood pressure, so I'm going to be fascinated to find out how this dietician is going to recommend a diet that is supposedly more heart healthy but doesn't involve eating more carbs and thus taking more insulin!

Firstly, I want to check whether exercise plays a role in reducing cholesterol levels - I'd have assumed that the more cardio I do, the better my body will be at processing this stuff.

The next thing he told me was about high blood pressure and exercise. He basically said "don't". His rationale is that exercise will raise my blood pressure and so I should do 'isotonic' exercise and never do 'isometric' exercise.

The thing is, surely if my body gets used to blood pressure going up when I exercise (and then returning to normal), it will adapt, in much the same way that lifting weights will cause muscle growth? Surely I should be exercising MORE to help tackle my blood pressure?

 

[everydayupsanddowns]

I keep meaning to do a proper read of cholesterol - but I keep coming across interesting articles which seem to go against 'conventional wisdom' on the subject.

I read a couple this morning which you might find interesting...

Here's a scatter plot based on pan-european data which suggests exactly the opposite of what you'd expect. The more saturated fat in a countries diet, the lower the incidence of heart disease. Not always (it is a scatter plot after all) but the general trend is really not what you would expect: http://www.drbriffa.com/2012/10/02/the-french-paradox-is-not-a-paradox/

And on the same site, new data pulled from an old study that suggests switching from 'deadly' butter to a nice 'heart healthy' sunflower spread rich in Omega 6 might just kill you: http://www.drbriffa.com/2013/02/06/...heart-attack-and-can-have-fatal-consequences/

In and around that are studies that suggest that as cholesterol levels rise, risk of heart disease falls, and that simply reducing cholesterol as a marker does not necessarily correlate with better health outcomes in an individual. They simply have their heart attack with a lower cholesterol reading.

Quite what one does with that information in terms of trying to reduce your own risk I'm not sure! For my money TC of 5.1 seems well within the reasonable range, though those trigs are at a level I'd not like. Any idea on the HDL/LDL split?

As to exercise with elevated BP, I'm not sure. How high is high? Higher BP won't do your fine blood vessels any good (eyes/kidneys), but becoming fitter does seem to reduce some people's BP (though mine seems to stay a bit on the high side whether I'm going to the gym or not!). The main dietary BP-reducing thing I have left to try is to cut out alcohol, which is a bit of a pain really!

Sorry probably not much help - but good to know someone else wrestles with the same uncertainty!

 

[Northerner]

From my own experience exercise definitely helps reduce both my blood pressure and my cholesterol - also improving my HDL/LDL ratio at the same time. I've had sufficient ups and downs with reviews coincident with either lots of running or complete slobosity for this to be confirmed to me.

Aerobic exercise will initially increase blood pressure as your cardiovascular system gets 'up to speed', but once you are going it will settle back down again. Frequent sustained aerobic activity will reduce blood pressure overall - I can be at 130/90 after being lazy, but within a week of running again I will be around 100/70. I do take a very small dose of candesartan for BP (I take 4, max dose is 32).

It also helps with my cholesterol. Lazy (like last November when I had been hit by the cyclist and couldn't run) I was 5.2. On previous tests I have been between 4.2-4.5.

My consultant agrees that this is what he would expect 🙂

 

[Twitchy]

I keep meaning to ask my eye specialist what the heck he means by 'avoid raising your bp' too - does that mean I can't shouldn't exercise?! Doesn't he know I have rascally children & a deranged neighbour & am trying to hold down a job?! 🙄 I do wish they'd be a tad more explicit in 'real life' terms sometimes...

 

[Dory]

I was initially out on statins 'as a preventative' which I hated (i was mid 20's - I did not want to be a walking pill bottle!) so I sneakily did a test where i stopped the tablets for 3 month, started drinknig benecol/flora chol reducing drinks and then retested my chol levels. TC levels had come down (to about 5.1 from 5.5 if memory serves me) and bad chol were well within the limit.

docs were too impressed when i told them their answer of shoving pills down my throat wasn't the best way 🙂

anyhoo....point I'm getting round to is that I was told by my GP years ago that 90% of your TC levels is made up by genetics. Only 10% can be controlled by diet and exercise. Which certainly seems to be the case for me: I do about 5-6 hours of HIT a week, have a ridicuously low fat, balanced diet thanks to slimming world, and yet my TC levels always hover around the 5 marker.

I've never heard of the high BP resutling from exercise adversely affecting diabetics though and will admit that scares me. I think i'm at about 80% during 20% of my classes (so about 160bpm), i mostly stick to around 60-70% (so about 140bpm). Hoping that all this exercise I'm doing isn't actually damaging me!!

PS Alan LOVING the pig! keep it please!! 🙂

 

[Northerner]

I keep meaning to ask my eye specialist what the heck he means by 'avoid raising your bp' too - does that mean I can't shouldn't exercise?! Doesn't he know I have rascally children & a deranged neighbour & am trying to hold down a job?! 🙄 I do wish they'd be a tad more explicit in 'real life' terms sometimes...

I've always thought it meant 'don't go lifting any huge weights' - you only need to see an episode of World's Strongest Man to see what effect that has, with all the nose bleeds! 😱

 

[Caroline]

when I asked my doctor what I should do to help myself he just said eat less salt and cut down on fizzy drinks.

I do make an effort (a half hearted one at best) to be more active, but I took up knitting and the BP seems to be going down since I started knitting...

 

[DeusXM]

In and around that are studies that suggest that as cholesterol levels rise, risk of heart disease falls, and that simply reducing cholesterol as a marker does not necessarily correlate with better health outcomes in an individual. They simply have their heart attack with a lower cholesterol reading.

This is precisely what I've read as well - almost all sources I've read fat intake or dietary cholesterol has rather less of an impact on blood cholesterol than most people make out. At the moment, I am trying an experiment on myself where I'm increasing my fat intake and reducing my carb intake to see what it does.

I decided to horrify my doc with the plans I've got - I'm currently eating probably around 2-3 omelettes a week ("oh no, you shouldn't be eating more than 5 eggs a week!"), quite a lot of steak with salad ("steak has a lot of fat, that's bad for your blood sugar(!)" and worst of all, I snack on nuts, pork rinds and biltong (at which point it was nearly HIM who had the heart attack).

So I've been referred to the dietician who is most likely going to trot out the same 'lots of starchy carbs that work gradually to keep your BG steady (no such thing!), then do essentially the opposite and see what happens. At least that way I'll know what works for me.

Quite what one does with that information in terms of trying to reduce your own risk I'm not sure! For my money TC of 5.1 seems well within the reasonable range, though those trigs are at a level I'd not like. Any idea on the HDL/LDL split?

Yeah, 1.4 to 2.8 so not great at this stage - I'm hoping that this is largely the result of those two weeks of booze and rice and not something intrinsically long-term. The 'official' range of cholesterol for non-Ds is 5.2 so I just shave under the TC amount, although apparently for people with diabetes this should be 4.0. On a philosophical level I object to this - assuming I can get my A1c down to near non-D levels, I don't understand why I should be at greater risk than a non-D and thus don't need to meet stricter targets.

At the moment, I think the HDL/LDL split is more important so i want to see how I go with this. The point is, I've known these results since December so since then I've joined a gym and modified my diet to be more fat and protein-based - time'll tell if this works.

As to exercise with elevated BP, I'm not sure. How high is high? Higher BP won't do your fine blood vessels any good (eyes/kidneys), but becoming fitter does seem to reduce some people's BP (though mine seems to stay a bit on the high side whether I'm going to the gym or not!). The main dietary BP-reducing thing I have left to try is to cut out alcohol, which is a bit of a pain really!

I'm working on the principle there's a correlation between insulin levels, cholesterol and blood pressure - the more insulin you have in you, the higher the other two will be. If that's true, then exercise that builds muscle mass and work the cardiovascular system should increase metabolism and improve insulin sensitivity - meaning less insulin, and thus lower cholesterol and blood pressure.

This year's shaping up to be one of experimentation!

 

[PattiEvans]

Deus

I wouldn't be worrying about a total chol level in the 5s, though I admit your Trigs should be lower, but they can be affected by having alcohol in the 48 hours prior to the test and if the test was not a fasting test. There is so much hype about cholesterol these days and you know chol is a natural substance, not a poison. More than that, it's a very very essential element which contributes to your brain functioning, and every cell of your body being healthy. Why do people get muscle pain as a side effect of statins? Because their cholesterol is too low. The links Everydayupsandowns has given you are very good. I'd also recommend a read of http://people.csail.mit.edu/seneff/why_statins_dont_really_work.html It's about statins, OK you aren't on them, but point 2 explains very well the role of cholesterol in your body.

Dory.... statins should NEVER be given to a young woman in her childbearing years, even if she has no intention of getting pregnant.

 

[HelenM]

I've always thought it meant 'don't go lifting any huge weights' - you only need to see an episode of World's Strongest Man to see what effect that has, with all the nose bleeds! 😱

Yes, I agree, isn't that what he means by isometric exercise ie holding your muscles in one position as you do when you hold a press up, hold a weight in one position or even try to push a bus.

I walk, run, cycle, swim, ski (not all in the same week) They're all isotonic.
My diabetologist sends me to the cardiologist every couple of years for a stress test and a 24 hour BP monitor because she worries about by BP (it's always up when I see her) . He tells me to carry on with the exercise.