Wednesday, November 30, 2011

Autoimmunity and Hypertension

If someone takes your blood pressure, make sure they use the right sized cuff. A cuff too small gives an artificially high reading. 

I received this question from a reader the other day:
I have Sjogren's Syndrome/mild Lupus and constant High Blood Pressure.  I have tried all types of blood pressure meds unsuccessfully in lowering my pressure.  I truly believe the problem may be due to the inflammation from the Sjogren's S.  Could you recommend something?  I have also seen a naturopath with no success
Here's a modified version of the response I sent to her:

First, I'm assuming that you have discussed this with your rheumatologist and other doctors, since they have been prescribing blood pressure medications. If you haven't mentioned your concern about the inflammatory component, you may want to bring this up at your next appointment.

Secondly: While Sjogren's can and does affect almost any part of our bodies, usually hypertension - high blood pressure - is not usually one of those conditions routinely linked to Sjogren's.

You don't mention what type of lupus you are dealing with. Some of the milder forms not considered systemic or body-wide would not typically cause these types of problems. However, hypertension caused by Systemic Lupus Erythematosis -SLE- is more common. Your suspicion that the underlying cause may be inflammation has occurred to other researchers:
Studies suggest a high occurrence of hypertension during SLE, with some reporting as many as 74% (1). Several studies also suggest that the increase in blood pressure is not dependent upon glomerulonephritis that is prevalent in individuals with SLE (4, 34, 35). In addition to hypertension, SLE is associated with an accelerated risk for atherosclerosis (38), coronary artery disease (27), and stroke (26). Inflammatory responses in the endothelium are known to contribute to the pathogenesis of each of these, and numerous studies implicate a role for cytokines in the progression of SLE.  
You can read this study from 2007 here.

 Other causes of hypertension in systemic lupus patients would include kidney disease caused by the lupus, in turn causing hypertension, or high blood pressure.

Another potential cause of hypertension related to your autoimmune diseases may be side effects of the medications used to treat these diseases. Corticosteroids such as prednisone and other drugs such as cyclosporine can cause elevated blood pressure. So can some of the over the counter medications used by some sjoggies to ease their symptoms, such as allergy and cold medications.

And finally, sometimes hypertension is idiopathic, meaning that the cause isn't clear.

Dumb stupid idiopathic hypertension.

I'm sure that your doctors have talked to you about the usual methods of control of hypertension: losing weight, using less salt and sodium containing foods and condiments, and getting regular exercise. The US National Institutes of Health have an excellent brochure which explains more about reducing high blood pressure, found here.

More recently, some doctors are also recommending eating an anti-inflammatory diet, which in a nutshell is this:
Eating fewer sugars, omega 6 fatty acids, trans fats, dairy products, meats, and refined or enriched grains.

Instead, this diet recommends eating more foods containing omega 3 fatty acids, proteins, fiber, and drinking more water.

There are several good anti-inflammatory diet books out there. The one that I have is written by Dr. Artemis Morris and Molly Rossiter and is entitled Anti-Inflammation Diet for Dummies.

The Sjogren's Syndrome Foundation, which is an excellent resource for all things Sjogren's, has developed a patient education sheet which discusses this type of diet:

1 comment:

annie said...

I also suffer from hypertension, but thankfully it is under control. I do notice, though, when I'm more fatigued or have more pain, my blood pressure will tend to rise. I believe that is the body's natural response. Also, I read somewhere, and I'm not sure how true this is, that caffeine tends to raise blood pressure. Thank you for another informative post, Julia.