According to Forbes  magazine, here are the 15 most prescribed medications in America:

  1. Hydrocodone/Acetaminophen: (Vicodin) pain
  2. Simvastatin: (Zocor) high cholesterol
  3. Lisinopril: (Prinovil, Zestril) high blood pressure, diabetes
  4. Levothyroxine Sodium: (Levothroid) low thyroid
  5. Azithromycin: (Zithromax) antibiotic
  6. Metformin: (Glucophage)  diabetes, insulin resistance
  7. Lipitor: high cholesterol (the only brand name drug on the top list)
  8. Amlodipine: (Norvasc) high blood pressure
  9. Amoxicillin: (Amoxi) antibiotic
  10. Hydrochlorothiazide: (Hydrodiuril) edema, high blood pressure
  11. Omeprazole: (Prilosec) heart burn
  12. Alprazolam: (Xanax) anxiety
  13. Furosemide: (Lasix) edema, high blood pressure
  14. Metoprolol tartrate: (Toprol) chest pain, heart failure, high blood pressure
  15. Atenolol: (Tenormin) chest pain, blood pressure, heart failure

6 of the top 15 are indicated for high blood pressure (2 of these are also for chest pain); 2 are for lowering cholesterol; 2 for diabetes; 2 are for bacterial infections; and the rest of the list is rounded out with a pain killer, thyroid medication, and heart burn.  From my perspective, most of these medications are actually for the same thing, poor carbohydrate metabolism.  I’ll explain over the next few weeks, starting this week with high blood pressure. 

Blood Pressure

When carbohydrates are eaten they attract water (an estimated 5 grams of water for every gram of carb).   This will increase the amount of fluid in the blood stream, raising blood pressure.  When eaten in excess, starches and sugars can easily contribute to hypertension- that’s fancy talk for high blood pressure.  The extra insulin that must be released to lower the blood sugar from these starchy, sugary meals essentially tells the kidneys to decrease urine output so that more fluid is available to dilute the blood sugar.  This also increases blood pressure.  So, frequent carb-rich meals and snacks provide a powerful one-two punch that keeps blood pressure elevated throughout the day.

Basically, what many people are doing is eating anywhere from 3-6 meals or snacks a day which require the body to elevate blood pressure in order to safely deal with the carbohydrate content of their food choices.  Then they take blood pressure medications which are designed to override the way the body is trying to deal with the excess carbs.  This leads to marginal pharmaceutical success and ever increasing doses and combinations of medications to get the problem under control.

If you are on blood pressure medication and would like to stop having the doses get bigger and the list get longer year-after-year, start limiting your starches and sugars.  The 2 times of the day that we are able to handle them the best- meaning we store the carbohydrate more efficiently with less insulin- are first thing in the morning and right after exercise.  The reason we are so much more sensitive to insulin at these times of day has to do with the need to replenish what has been used up. 

In the morning, we have spent (hopefully) 8-12 hrs without food.  This means the liver’s stores of carbohydrate are low since it was providing a stable supply of blood sugar throughout the night.  In the morning we are naturally a little hungrier for grains and breads because we need to restore the liver’s carb depot.  It makes sense that the body would be ready and able to handle a slightly larger amount of carbs at this time. 

Keep in mind that this is not a get-out-of jail-free card for eating carbs!  However, it makes a very nice compromise for those of you who are trying to live on low carbs and are being driven crazy by constant cravings (reminds me of a song).  Adding a few tablespoons of your favorite grain, a slice of whole grain toast, or something along those lines will cause far less of a problem in the morning.

After exercise the same thing happens, only on a grander scale.  Now, we have depleted muscle stores of carbohydrate as well as liver stores.  Our muscles are very stingy and will not help out the blood sugar during an overnight fast.  Presumably this is so that they will still have a decent energy source for getting the necessary work done to acquire food.  Physical work is the only way to access and deplete muscle stores of carbs.  If you don’t do physical work, commonly referred to as exercise, your muscles will not be hungry for carbs (known as insulin resistance).  Insulin resistance will eventually lead to diabetes but first it does fun things with your blood pressure, amongst other things! 

Immediately after exercise is actually our most advantageous time for eating starches and sugars.  If you are experiencing lots of lactic acid during your workouts, it is possible to overeat carbs after exercise but not very likely.  Less vigorous forms of exercise will improve insulin sensitivity and allow you a small grace period to eat carbs but you’ll need to be careful not to overindulge.  As an example, the typical gym-goer that spends 45-60 minutes on the treadmill and barely gets misty will be over indulging by the bottom of his/her 20oz Gatorade bottle.

By following this simple strategy of only eating starches and sugars first thing in the morning in very small amounts and in the hour after exercise in slightly larger amounts, your blood pressure will begin to respond by coming down.  Eventually, your blood pressure readings may be low enough that your doctor will want to lower your medication.  Don’t just stop taking them on your own though.  Often there is a rebound effect when these meds are stopped which can lead to dangerously high blood pressure.  Work with your doctor and with your diet to do this safely.

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