Body Size and Blood Pressure

I wrote this up a few months ago. I've posted it a couple other places. Seeing Baby1's post about the possibility of a general Health forum reminded me to post this. Hope you like it.
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I wanted to address the issue of hypertension (high blood pressure) as it relates to increased body size and the health complications that can result from hypertension (HTN).

Most of us already know that being fat generally equals high blood pressure. The truth is the HTN caused by obesity isn’t merely a product of a sedentary lifestyle. It’s a byproduct of increased body size. For every kg of body fat that a person packs on, they grow an extra ~400 miles of blood vessels [2]. This obviously includes capillary beds.

So what does this mean for the heart? Well, basically you have a pump and some hose. You’ve just added an extra 400miles of hose to the same pump. This means the heart in essence has to pump the blood farther. There are a couple of ways it can do this. It can either speed up the heart rate, or it can constrict the blood vessels. Think about it. If you turn on your garden hose, how far does the water squirt? A couple feet? Then put your thumb over the end, increasing the pressure. How much farther does the water go now? The principle is the same when applied to the circulatory system. This is how the heart compensates.

So here’s the issue as it relates to us. It’s not just fat that adds miles of blood vessels to your circulatory system. I don’t have the exact numbers on a kilo of muscle, but it can’t be too far behind the vasculature needed for fat. I’m not saying don’t put on muscle. Far from it. Put it on, but be aware of what’s going on with your body and do what you have to do to prevent (or at least minimize damage).

Before we talk about damage control, lets talk about some of the complications associated with HTN. The list goes on forever, so I’m only going to hit some big ones. Hemorrhagic stroke, arteriosclerosis (not to be confused with arthrosclerosis), kidney damage (I could write a whole paper on that one) and last but not least Left Ventricular Hypertrophy (LVH), which leads to left sided heart failure… which leads to right sided heart failure.

LVH
Okay, so the heart is pumping faster, our arterioles have constricted. This means that the heart must has a higher pressure to overcome each time it beats (called afterload). The heart compensates for this added strain like any other muscle tissue, it grows.

“Great so my heart just gets stronger.” – Incorrect. This compensation backfires in a serious way. Lets look at what happens when the left ventricle enlarges:

http://i979.photobucket.com/albums/a...ans7_lvh-1.jpg

http://i979.photobucket.com/albums/a...rtrophy_sa.jpg

As you can see by these pictures, as the cardiac muscle gets thicker, the size of the lumen (interior opening) gets smaller. So this becomes a vicious cycle. The heart gets bigger to compensate, and thus it pumps less blood with each contraction, so it increases pressure even more so that each contraction sends that blood farther, so it increases in size to deal with the added pressure… you see how this works.

This eventually leads to heart failure. The left side of the heart enlarges, becomes less efficient and eventually can’t keep up with the right side. This leads to pulmonary edema and eventually right sided heart failure. If you want I’ll go into how that takes place. But for now lets just leave it at that.

So increased body size leads to increased BP which leads to LVH which leads to heart failure, which leads to a slow death.

How do we prevent this?
Well, we all know cardio is a good place to start. I won’t go into that any further.

I’m not going to talk about supps either, expect to say that they most effective supplementation you can do is to avoid stimulants. Personally I’ve never seen results from an ECA stack that justify it IMO. If you’re doubling down on clen and ECA you’re probably doing more damage than getting a little fat while bulking.

Now let’s talk about medication options:

Beta Blockers:
From what I’ve seen, beta blockers get a bad reputation in BBing. People say you don’t want a beta blocker, it will make you tired. Okay, so get one that doesn’t last for 24hrs and take it at night. That would be an ideal time to be tired don’t you think?

Basically a beta blocker slows your heart rate, it can also cause some vasodilation. The slower heart rate is going to lower blood pressure. The reason it can make you tired is A) your body has become used to having HTN. B) If you’re doing cardio, beta blockers put a cap on how high your heart rate can go.

Beta blockers also can normalize your heart rhythm [1]. I’ve read that high dose test can act as a pro-arrhythmic, so this may be an added benefit to beta blockers.

ACE inhibitors and ARBs:
If y’all want I’ll go into more depth about these. They are a good option. They inhibit aldosterone to some extent, and they inhibit the creation of (or action of) Angiotensin II, a potent vasoconstrictor.

Calcium channel blockers:
Some of these sound promising to me. I’ve never personally known anyone who uses them though so I don’t know how they may make you feel. They make the heart constrict less forcefully and they cause vasodilation, particularly of the coronary arteries [1]. They are particularly useful in lowering systolic blood pressure.

But make sure you stay away from amlodipine. Gynocomastia is one of the potential side effects. So if you’re prone to gyno, and you’re on cycle, and you’re on amlodipine… do the math.

Nitrates:
We’ve all heard of nitro for treating angina. These are purely vasodilators. There are such things as nitro pastes and patches that will keep you dilated throughout the day. There are also oral nitrates that will do the same. You probably won’t be getting a prescription for these kinds of drugs though. Generally this is prescribed for angina.

WARNING: if you do use nitrates. DO NOT take any Viagra, ciallis, levitra etc with them. This will send you into irretrievable hypotension. Basically it can make your BP drop so low it will kill you.

There are others (Diuretics deserve mentioning, but I'm going to go take a nap now). I’ll go into more depth on any of them if you want. Feel free to ask questions.

All info came from one of the following books, or lectures at school:
1. http://www.amazon.com/Saunders-Nursi...8128365&sr=8-3

2. http://www.amazon.com/Principles-Ana...8126944&sr=8-3

3. http://www.amazon.com/Nancy-Caroline...8126968&sr=8-1

4. http://www.amazon.com/Medical-Surgic...8&sr=1-1-spell

Thanks for reading,
TC

Okay I'm not seeing an "Edit" button so I can make that picture smaller. If a mod can delete this I'll fix it. Or if someone can just fix it that'd be great. Or maybe I'll find the edit button... we'll see.

Nice post bro.

Great info and great job!!!

One of those ACE inhibitors (Lisinopril) is available at Walmart as a $4 prescription for 30 tabs. A cheap price to pay to stop HBP, because it can destroy your kidneys.

I know all about this shit as an MA and RN in training