Stubborn Hypertension

Sometimes no matter what you do, you just can’t bring down your blood pressure.

But if you are over 60, perhaps you should know that the new guidelines for blood pressure (from the famous SPRINT Study [Systolic Blood Pressure Intervention Trial]) in which it was found that 150/90 is the new normal. You can read more about this and new information we’ve found on blood pressure since first publishing our investigations here: Hypertension Update.

So let us assume you’ve done everything you possibly can and still your blood pressure is too high. Then we have to get back to the basics and first take an inventory of what we’ve been doing.

The Basics

You think you’ve tried everything, but only the blood pressure meds you get are helping. Sure, they reduce your blood pressure, but they will never cure you. You’ll be on them forever. You’ll always have the problem, but the drugs will keep it at bay. The only thing you have to worry about are the side effects of the drugs, the nutritional cost of the drugs, and the long term effects of these drugs that reduce your numbers, but do nothing to eliminate the cause of the problem.

The basics include:

• losing weight
• exercising
• drinking pure water
• cutting excess alcohol consumption
• cut out smoking
• substituting Celtic Sea Salt for table salt (the white stuff is poison)
• using proper nutritional supplements, which include flax oil (we recommend only Omegasentials), fish oils, Vitamins B, C, E, D, and A, Folic Acid, B-12, and finally Arjuna, an Ayurvedic herb that truly works miracles. [Role of natural herbs in the treatment of hypertension]

It always helps to get an evaluation from a competent nutritional practitioner for specific individual imbalances and deficiencies, because every person with high blood pressure is different.

Any program you start to reduce you blood pressure requires three to four to even six months before you and your doctor design an experimental program to wean you off your drugs.

You must do this only with the help of a physician, because no matter how good your program is, a rebound effect should be expected even when you start to reduce your drugs slowly and in small increments.

It would be very smart to get yourself a home kit to take your blood pressure. They’ve really come down in price.

Be sure that when you start monitoring your blood pressure that you take into account a possible upswing as you reduce your drugs. When you start getting normal results, then you and your doctor can plan to reduce them even further, with the goal of reaching healthy levels without the use of drugs at all.

Note: we have posted an article on the dos and don’ts of how to take your blood pressure. Worth the quick read.

But keep in mind that in cases of severe hardening of the arteries, you’re not going to get your blood pressure back to normal without drugs. And the process of reversing that is long and tedious and most people don’t live long enough to accomplish that. This is why prevention at an early age is the best way to avoid CVD (Cardiovascular Disease).

The Stubborn Cases

In the event you do not have severe hardening of the arteries and you’ve worked on the basics for months and you’ve not lowered your blood pressure (without drugs) to safe levels, then you definitely have got yourself a severe case of stubborn hypertension.

And there are four factors we’ll have to look at.

• Food allergies
• Kidney Support
• Stress
• Skeletal/Muscular issue

Food Allergies

In the case of food allergies, use an elimination diet to determine and eliminate food allergies. Many have found their blood pressure lowers dramatically after cutting out foods they’re having problems with.

Kidney Support

Test for renin. If you have had a diagnosis of kidney problems or disease, visit your physician or naturopath (I’m lucky, I have both in the same person) to determine the precise kidney products that are good for you. Renatrophin, for instance, is a very unique kidney protomorphogen therapy product. But work with your health care professional to get your kidney function up to par.

Stress

Perhaps the most overlooked stubborn cause of high blood pressure is stress.

We had originally worked with a physician/writer who called this situation hypertonia. But hypertonia is a disorder of the central nervous system and we had to split with him when he said it was easily cured with deep breathing exercises.

Here is the definition according to medicinenet.com:

Hypertonia: Increased tightness of muscle tone and reduced capacity of the muscle to stretch caused by damage to the motor nerve pathways in the central nervous system. Untreated hypertonia can lead to loss of function and deformity. Treatment can include physical and/or occupational therapy or medications. Injections of botulism toxin (botox) are sometimes used in the treatment for chronic hypertonia in cerebral palsy and other disorders. Also known as spasticity.

What this guy had been talking about could be called pseudohypertonia. A condition of tight muscles caused by stress, but not a neuromuscular condition caused by injury or a brain malfunction. And for this, because the cause is stress (though in diabetics, the cause can be a lack of l-carnosine) deep breathing can help immensely.

Inner Workings of Stress

• Hormones, a flood of hormones: We know which one too: that damn fight or flight hormone, also called the “stress” hormone cortisol. Did you know it increases belly fat (which produces inflammation)? It also contributes to insulin/leptin resistance.
• Dearing Johns, MD, director of preventive cardiology at the Midlife Health Center at the University of Virginia in Charlottesville discovered that mental stress can raise LDL cholesterol while lowering HDL, but have yet to find a physiological cause. We do know that when damage to our arteries occurs, LDL levels go up to repair the damage.
• Stress can increase inflammation and oxidative damage in our arteries. [Ref]

Only you know the cause of your stress from bills to pay to a partner who’s not being a loving partner to that boss you just can no longer put up with.

Here are five things that will help you manage stress:

1. Meditation. And this can take the form of prayer, yoga, tai chi, or just simple meditation using tapes.
2. Laughter. Yes, amazing how laughter releases stress.
3. Exercise. This has been a treatment for nearly every disorder from depression to Post Traumatic Stress Disorder. The problem with exercise is it’s last on the list when we need it the most.
4. Sleep. Get good sleep. Get tested for a CPAP or BiPAP machine. Don’t watch scary movies at night. Listen to relaxing music. Fall asleep with headphones on listening to meditation tapes. But get some good sleep, because studies show that deep sleep can lower blood pressure. [Source: Susan Redline, MD, MPH, the Peter C. Farrell Professor of sleep medicine at Harvard Medical School and a senior physician in the division of sleep medicine at Brigham and Women’s Hospital, both in Boston, Massachusetts.]
5. Deep Breathing Exercises. You should know that deep breathing exercises—performed properly—will drastically alter your entire body’s physiology; the chemistry of your blood, nervous function, muscle actions, digestion, and even attitude will change. Everything will change and change immensely.

The Final Factor: Skeletal/Muscular Issues

Problems with structures of the body can interfere with nerve function and cause high blood pressure. Once you’ve exhausted everything above, it is time to go visit a good chiropractor or osteopath. They can create a “release” that will break up  nerve interference and allow a normalized blood flow.

Deep Breathing Exercise

Deep breathing is a science. At the US National Institutes of Health you’ll find well over a thousand studies on deep breathing exercises.

Here is one that says: Both listening to music and deep breathing exercise were associated with a clinically significant reduction in SBP [systolic] and DBP [diastolic].  [Ref]

And here’s one that concludes: “not only reduces resting BP in ISH [patients with hypertension] but also the responses to both static and dynamic exercise . . . .” [Ref]

I could go on and on, but the science is conclusive.

How to Breathe Deeply

First, lie down on a couch or bed. Wear loose clothing, remove undies, bras and anything constructive, or just lie there naked.

We will do baby-breathing. If you watch a baby breathe, its chest does not rise. The diaphragm presses downward and the belly rises.

So breathe in through your nose,  pushing your diaphragm toward your feet, expanding your abdomen so that  it arches upward. You’re expanding the lower lobes of your lungs. You’re not finished yet. Now breath in even further expanding your chest. When this part of the breath has ended, breathe in further and expand your chest. Slowly, gradually you will fill your lungs entirely.

You will soon find out that this is not easy. Just take your time and practice this exercise three times a day for five minutes. It is best to begin by lying down, but as you progress, you can do this exercise sitting or standing. Be sure there is plenty of fresh air. And remember to breathe in through your nose and out through your mouth.

You can measure how well you are doing by humming as you exhale. Time it. When you can exhale/hum for 20 seconds, you’re doing fabulous. Once you can do this, start taking your blood pressure and watch it drop.

Deep Breathing Technique #2

This one I think comes to us from Dr Andrew Weil. My psychologist introduced me to it to handle some PTSD issues and anxiety attacks. I’ve found that, since I’ve started monitoring my blood pressure at home, this technique has helped to lower my blood pressure. It’s especially useful if you have “white coat hypertension.” If you are not aware of this, it’s simply a phenomenon where your blood pressure goes up when you visit a doctor’s office. Quite a few people experience this, so you might want to incorporate this technique into your next office visit.

From Medical News Today, we find how to do it:

• empty the lungs of air
• breathe in quietly through the nose for 4 seconds
• hold the breath for a count of 7 seconds
• exhale forcefully through the mouth, pursing the lips and making a “whoosh” sound, for 8 seconds
• repeat the cycle up to 4 times

According to Dr Weil, this technique will help reduce anxiety, help you get to sleep, manage cravings, and control or reduce anger responses. As I’ve said, it’s also helped me to manage my blood pressure.

Additional Therapies & Supplements for Hypertension

First and foremost we would be remiss not to shine a light on meditation, yoga, qigong and tai chi, and martial arts in general. There’s a reason they word “art” is in there.

If you suffer from high blood pressure (or any cardiovascular problem), you are not your disease. You are body/mind/spirit, and you must care for all three of you. Find a teacher who can teach you one or two of these wonderful healing modalities, healing arts. All of these have proven to reduce blood pressure and heal the heart.

As for supplements, we’ve mentioned it once and need to mention it again: Arjuna. It’s an Ayurvedic herb that truly works miracles, and we have personally used it with great results. It’s located at our best affiliate program’s website: Swanson’s Health.

Shang Gardens, Minnesota’s own ginseng farm (we grow some of the best ginseng in the world here in Minnesota and next door in Wisconsin), told us that Soviet and German physicians discovered that ginseng helps to reduce high blood pressure. They also learned that American ginseng was best at lowering cholesterol levels in animal studies and produces better circulation, with the side effect of cleaner metabolism. (We called Swanson and were told that their American ginseng comes from our farms here in the Midwest.)

In Medicinal Herbal Therapy – A Pharmacist’s Viewpoint by Steven Ottariano (a practicing clinical pharmacist at the VA Medical Center in Manchester, New Hampshire), we learned that the hawthorne berry has angiotensin-converting enzyme (ACE) inhibitor activity. ACE inhibitors have been used by physicians to treat hypertension, but there are many undesirable side effects. The hawthorne berry doesn’t have these side effects, and, as Steven points out, in some cases works better than the prescribed medications.

Clinical studies on CoQ10 [Langsjoen P. H., Langsjoen P. H., Willis R., Folkers K. (1994) Treatment of essential hypertension with coenzyme Q10. In: Eighth International Symposium on Biomedical and Clinical Aspects of Coenzyme Q (1994) Littarru G.P., Battino M, Folkers K. (Eds) The Molecular Aspects of Medicine, Vol. 15 (Supplement), pp S287-S294] showed that by using CoQ10 in conjunction with conventional antihypertensive drugs, 51% of those studied were able to stop between one and three antihypertensive drugs just 4.4 (avg.) months after starting the CoQ10 therapy. Another similar study showed the same thing, except that the number was 43% of the patients. So, as you can see, this is not a 100% of the time sort of therapy. Each individual is just that: an individual.

Since writing the above paragraph, Ubiquinol has come to the forefront, upstaging CoQ10. They’re both great, but Ubiquinol is the active form that’s a bit more advanced than CoQ10 because it’s an antioxidant too. The best form we’ve found at Swanson’s, the most bioavailable is Quinogel – Hydrosoluble Ubiquinol CoQ10. It’s a bit spendier than the others, but you’ll like it.

Both Drs Cayenne (Dr Christopher and Dr Schulze) swear by cayenne pepper. I’m sure most of you have heard of the heart-healthy benefits of cayenne pepper, but few of you take a teaspoon of it in a cup of water, up to three times a day. Taking cayenne pills is quite different from taking it in water, like tea. For one thing, you have to take the pills with food and never on an empty stomach. The tea form can, and should be taken on an empty stomach, for it is absorbed quicker and is not an irritant as most of us suspected (it has been known to reverse ulcers). Both Dr Christopher and Dr Schulze have had hundreds of patients stabilize their blood pressure with cayenne pepper, whether it was low or high to begin with.

Now, for both herbalists (Master Herbalists, I should add), the standard treatment was one teaspoon of very hot cayenne pepper in water, three times a day. However, Dr Schulze’s best high (and low) blood pressure recipe is: 2 parts Garlic bulb, 1 part Cayenne, 1 part Ginger root (making a tincture is even better). Take this three times daily. You should see results before a month is up.

When and if these fine United States allow us to use marijuana legally, you’ll find new antihypertensive drugs hitting the market. Studies done in the thirties (not to mention thousands of testimonials) show it lowers blood pressure. And the science is out there. It is both an anti-inflammatory and anti-hypertensive. There are over a thousand studies at www.ncbi.nlm.nih.gov. Places that sell CBD oil (and medical marijuana) provide tons of information. And you know something is fantastic when pharmaceutical companies are trying to make synthetic versions of the original that was found growing in your back yard.

Note: Simply the Best has access to the most potent CBD oil on the planet, 24,000 mgs per ounce. However, it’s expensive as hell: sells for over $200.00 per ounce retail, and they have to order nearly $2,000.00 worth to get it wholesale. If you are interested, write to them because they will not order if it’s just going to depress their cash-flow. Write here: [email protected].

The Journal of Cardiovascular Pharmacology [92;20 Supplement 12:S196-7] reported that intravenous L-arginine lowered blood pressure, decreased resistance in the blood vessels and increased heart output. Orally it lowers cholesterol levels. However, in middle-aged men, it has only detrimental effects and should be avoided, especially in large doses.

This is from our article: Nitric Oxide Revisited:

The L-arginine pathway has been found to lose its effectiveness in middle-aged men (when hypertension and heart disease really starts taking its toll), and even worse: it can do damage. People who’ve had heart attacks get no NO from this particular pathway, and people with heart disease can be pushed over the edge taking L-arginine supplements. We found a study in which six subjects died while taking large doses of L-arginine that is no longer on the web thank you very much!

With the above in mind, we present you this:

L-arginine: is an essential amino acid that body builders discovered to be a wonderful supplement for building muscle, while it is also the “relaxing” factor of your blood vessels. It decreases tension in the arterial wall thus lowering blood pressure. L-arginine will also allow the smaller arteries to open up and flush more life-sustaining blood through an area. Opening up an artery just a small amount can make a huge difference in the amount of blood flow. Note: Toxicity to L-arginine is around 40 grams or more a day. Also, if you have herpes, you’ll want to increase this slowly as it can stimulate an outbreak, so be careful.

But keep in mind our warning above concerning Arginine. If you’re middle age, keep your intake low.  And consider the following:

Taking Siberian ginseng (180 to 300 milligrams) will increase the conversion of L-arginine to nitric oxide and can improve blood flow to the muscle in times of low oxygen. Nitric oxide is a potent antioxidant that combats free radical injury to the heart muscle.

But again, if you’re over 40, you might want to stick to beet juice for your nitric oxide, or supplement with L-citrulline.

L-citrulline is a non-essential amino acid that your body turns into L-arginine and nitric oxide. If over 40, you might want to get your L-arginine from your foods or from L citrulline. Watermelon is the richest known source of L-citrulline, though the yellow and orange watermelon “meat” contains the highest amount of L-citrulline.

Eggplant: let your food be your medicine. Eggplant contains scopoletin and scoparone, two phytochemicals that calm the nerves that control the muscles in your arteries. And should you eat a diet high in cholesterol, a little eggplant will bind with the cholesterol and keep it from being absorbed in the colon.

We received the following folk remedy for lowering your blood pressure, but be warned: you must have your blood pressure monitored daily, because low blood pressure is dangerous too. Do not attempt this without supervision from your doctor or health care professional.

Cut up a medium sized unpeeled, organic eggplant into small pieces and put them into a quart jar. Add filtered water, not tap or distilled, till the jar is full and cap it. Store it in the refrigerator for 4 days. Then, starting on the fifth day, drink one ounce of the liquid each day. When your diastolic pressure (the bottom or lower number) drops to 80, stop. If you are on blood pressure medication, have your doctor take you off when your pressure first starts to drop. It can take up to two weeks for your pressure to start dropping. There are no side effects.

DMG: dimethylglycine. From Russia we learned some time ago of their use of DMG to detox radiation poisoning in the victims of the Chernobyl disaster. It is an amazing supplement, though there are very few studies done here in the US. There was one study that reportedly repudiated Russian claims that athletes benefit from it, though still, many athletes use it because it allows tissues to absorb more oxygen. It is immuno-restorative in that it brings up T-cell counts and increases the production of interferon. Amazingly, at 175 mg per day it reduces cholesterol and triglyceride levels, lowers high blood pressure, and reduces or eliminates angina pain. It must be continued daily, and it has no known side effects, especially at this small dosage.

A study in India showed that people eating 3.5 ounces of guava fruit a day lowered their cholesterol and triglyceride levels while increasing HDL levels. Even more important, blood pressure levels dropped (9 points systolic and 8 points diastolic). Guavas are high in vitamin C and beta-carotene. In the Annals of Internal Medicine we discovered a study in Italy that showed that a diet rich in potassium lessens the need for hypertension drugs. We should all know by now that increasing our calcium, magnesium and potassium will help to lower blood pressure, and now your doctor will find out. Foods high in potassium are strawberries, cantaloupes, oranges, bananas, and potatoes. Additionally, Celtic Sea Salt contains potassium, and the sodium/potassium ratio could not be any more perfect for your health.

And one more thing, Celtic Sea Salt has micronutrients your body needs. Throwing out your mineral-depleted salt in your house can be the best thing you’ll ever do for your heart. You can read about Celtic Sea Salt by clicking on that link.

Prescription Drug Warning

As always, when you are taking prescription drugs, beware of drug interactions, even with standard OTC (over-the-counter) drugs. Additionally, many over-the-counter drugs can exacerbate your current condition. A good example here is OTC decongestants: if you have hypertension, ask your doctor before taking a decongestant containing pseudoephedrine, because that medicine can raise blood pressure.

When battling stubborn hypertension, most of the time it’s “hit or miss,” trying this and that and the other. Well, after researching for years and finding all of the above information, we suddenly stumbled across the work of Dr Rath. He has a theory as to the many causes of hypertension and is, in fact, reversing it in case after case, no matter how stubborn, using nutrition. All we have mentioned above is still valid (with some overlap as you shall see) and it leads right to the work of Dr Rath.

The main cause of hypertension is (from Dr Rath’s book, Why Animals Don’t Get Heart Attacks — But People Do, which we highly recommend): “… a chronic deficiency of essential nutrients in millions of artery wall cells.” According to his research, essential nutrition begins with his Basic Cellular Medicine Program.

Since we learn through repetition, to normalize our blood pressure we will want to add the following supplements to our regimen. Dr Rath has created a special formula containing the some of the supplements we’re about to mention called Relacor, which is a daily dietary supplement designed to support the normal process of blood pressure that you can find at our best affiliate program: Swanson Health.

Vitamin C: You might consider taking one to two thousand milligrams of a good, vitamin C complex daily.  The reason (certain) animals don’t get heart disease is that their bodies create vitamin C. However, with today’s toxic world, their bodies might not create as much as is needed and supplementing vitamin C in animals has been proposed by many veterinarians.

Additionally, a study out of John Hopkins showed that supplementing with at least 500 mg of vitamin C lowered blood pressure and redused the number of people having strokes. [Source: American Journal of Clinical Nutrition, 2012; 95: 1079-88]

Our favorite vitamin C is Ultra C from Swanson. Besides 500 mg of ascorbic acid, there are 50 mg of bioflavonoids or as we sometimes call them, co-factors: acerola, citris bioflavonoid complex, hesperidin complex, rose hips, and rutin. Rutin, by the way, repairs blood vessels and capillaries which will heal and prevent varicose veins and hemorrhoids.

Sadly, animals are beginning to get heart disease because the amount of vitamin C their bodies manufacture is not enough to counter the toxins in the environment and your pets too can benefit from additional vitamin C.

Vitamin E: We’re told that the dry kind is more bioavailable (your body absorbs it better), but the best in our books is one of mixed tocopherols and mixed tocotrienols. Since this is an oil, for better bioavailability, take it with other supplements with oil, or just a bit of fat (butter, cream, coconut oil). Our favorite is Swanson’s Vitamin E with Tocotrienols – Full Spectrum.

Foods high in vitamin E are,  wheat germ, nuts, seeds, and avocados. And there is one fruit with vitamin E, and that’s a kiwi. But you have to eat the skin. This antioxidant protects your arteries and your blood. It is also a blood thinner.

Now again, we have to tell you that all vitamin E is a complex. The FDA would have you believe that alpha tocopherol (synthetic, at that) is vitamin E, but it is a complex as surely as I’m writing out these words right now.

From our book Bypassing Bypass:

A European study released by the World Health Organization and published in the Jan 1991 issue of The American Journal of Clinical Nutrition states emphatically that a low concentration of vitamin E in the blood is more of a risk factor for dying from heart disease than high cholesterol or hypertension (high blood pressure).

Eight hundred IU/day is a good solid dose that clearly prevents oxidation of cholesterol  [Med Tribune, Jan 20, 1994] For many menopausal women this is a very good dosage for hot flashes. This dosage also helps to thin the blood.

Magnesium: This is the agent responsible for all the TV commercials recommending the use of aspirin for heart disease and heart attacks. In all the aspirin studies, plain aspirin never worked as well as buffered aspirin. Magnesium is the buffering agent. Your body needs magnesium. It doesn’t need aspirin. Aspirin use over a period of time can be deadly. Aspirin actually increases the chances of hemorrhagic stroke in 40% of the people using it to prevent these diseases.

Another study showed that people with high blood pressure (hypertension) and coronary artery disease increase their risk of dying by 47 per cent when they take aspirin and other NSAIDs (non-steroidal, anti-inflammatory drugs). [Source: American Journal of Medicine, 2011; 124: 614]

Magnesium is, in our opinion, the single most important supplement for the prevention of CVD (Cardiovascular Disease). It relaxes the blood vessels and that is a good thing.

Calcium: increase your intake for maximum metabolism of your various minerals. Bone Calcium has always been our favorite form, since it contains everything for healthy bones and teeth. Vegetarians don’t take bone calcium, so they’ll have to get all the factors they need separately. Your arteries need calcium too. A good solid level is 1,000 mg daily. For absorption, however, you might need to take additional stomach acid and enzymes. We will talk about digestive aids later, but know this: stomach acid is needed to break down and absorb calcium and if you’re using a daily antacid, well, you’re not getting the calcium and other minerals you need.

Bioflavonoids: We cannot overstress the fact that in nature, vitamins are complexes and not singular chemicals. Vitamin C is found in plants that also contain copper and bioflavonoids. Vitamin C is a complex of all these things and if you are taking vitamin C alone, you will require bioflavonoids to improve and potentiate the effect of your vitamin C. It is now known that resveratrol is one of the factors behind what 60 Minutes termed the French Paradox: the fact that the French diet is filled with fats (that we assume clog arteries) and yet they have the lowest heart disease rate among developed nations. It’s the wine, everyone agreed. But what was it in the wine? Resveratrol, a bioflavonoid from the skin of grapes. You don’t need to drink wine to get the benefits of resveratrol; grape juice is just as effective. Resveratrol can also be found in supplements at your health food store and in your fruits (mostly berries). It is also good protection against cancer.

The best form we’ve found, and we take it with Quercetin for the most efficient uptake, is Pterostilbene Plus with Resveratrol (at Swanson Health).

The American Heart Association

Many of the early foundations to promote a healthy heart were funded by the food industry. Hoping to get their products approved and promoted as “heart healthy,” these companies sank millions of dollars into creating these organizations. Today, drug companies are among the largest funding agencies for the various heart foundations and the American Heart Association itself.

In 1996 the American Heart Association released this: “From 1982 to 1992 death rates from CVD [Cardiovascular Disease] declined 24.5 percent. Later they stated, in a press release published by Reuters, “Treatment of people who already have coronary heart disease (CHD) is a bigger factor in the steady decline in cardiac deaths than preventive efforts aimed at getting healthy people to adopt heart-safe lifestyles, a new study shows.”

In November of that year, they elected a new president, Dr Jan L. Breslow. Being new to the job, he didn’t know he was supposed to continue these lies. At a big get-together in New Orleans where most of the speakers continued promoting the party line, Dr Breslow stood up and told the audience that “Americans have been seriously misled into thinking that heart disease is on the decline.” He preached against the claim that drugs were more important than diet and lifestyle and even intimated that too many heart patients were dying from adverse reactions to their drugs rather than from their actual disease.

In the New England Journal of Medicine, the January 2002 issue, they finally came out and admitted that though drugs are a needed intervention at times, only proper nutrition will reverse heart disease.

If You Cannot Lower Your Blood Pressure With Nutrition, Supplements, and Exercise: SEE YOUR DOCTOR

There is nothing wrong with reaching out for help. Just make sure that you are fully informed about the drugs you’ll be prescribed. And fully informed means also knowing the nutritional cost . . . what they block or use up or what you’ll run short of. Work with your doctor, and keep up the diet and exercise. Take your blood pressure daily.

Sure, you’ve suffered a setback. But you’re still above ground and still able to fight and live your life to the fullest.