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"When it comes to your heart, drinking plenty of water actually lowers blood pressure, softens and liquefies blood cells, and helps the cells move through your arteries more easily." Kenneth R. Kensey, M.D.
Iíve never considered water very interesting. I thought Iíd said all I wanted to say about it. I was wrong. There are some important new developments.
In The Lean Advantage 3, I said water is our most vital nutrient, that itís essential to the digestive as well as the elimination process, and that drinking plenty of it makes the body work more efficiently. Quoting Arno L. Jensen, M.D., I added that thereís no "metabolic magic" in water, that itís not the secret to weight loss, as some have claimed. I didnít want to encourage people to believe that drinking extra water, without cutting calories, would facilitate weight loss Ė because it wonít. Drinking lots of water will not affect your fat stores. Iíve come to discover, however, that it may do something even more important: lower the risk of heart attack and stroke.
I began thinking anew when I learned about the Adventist Health Study reported in the American Journal of Epidemiology (May 1, 2002). In this study, it was found that drinking five or more glasses of water a day, as compared to 2 or fewer, reduced the risk of fatal heart attack by about 50% (54 percent for men and 41 percent for women). The researchers believe that water helps to thin the blood, making it less likely to clot and cause blockages.
Reading The Blood Thinner Cure by Kenneth R. Kensey, M.D. (Contemporary Books, 2001), convinced me to revisit water. Dr. Kensey, a cardiologist and president of Visco Technologies, believes that damage to the arteries caused by thick, sticky blood is the primary cause of artery hardening. Most doctors recognize that thick blood is not healthy, but the idea that blood viscosity could be an important cause of artery disease is apparently new. Kensey makes a persuasive case for his view. Whatís more, I donít think many would disagree with his seven-step lifestyle plan to make the blood flow more smoothly through the body.
Most of his recommendations are mainstream: stop smoking, low-fat diet, exercise, reduce stress, and drink 10 to 12 glasses of water daily. His recommendations to take a baby aspirin each day and donate blood frequently may be slightly more controversial.
Thereís no reason to discuss each step, but Dr. Kenseyís basic theory of how artery disease develops is new and interesting; plus, it makes sense. I can only summarize here, of course. If you want more details, please read his excellent book.
Kensey believes that hardening of the arteries is a mechanical problem. Thick, sludgy blood damages the arteries causing them to harden and thicken, which eventually leads to clotting and blockage. "I believe atherosclerosis occurs because your heart has pumped thickened blood at too high a pressure for too long, which physically injures certain regions of the arterial system, making the arteries hard and inflexible," Dr. Kensey writes.
The primary cause of artery hardening and eventual clogging, according Dr. Kensey, is the way the arteries react to the mechanical injury. He says the arteries adapt in two ways, both bad.
First, the artery walls get tougher and harder to avoid further injury. The reduced flexibility makes the heart work harder pushing the blood through the vessel. The net result is higher blood pressure. Kensey says, itís a "never-ending vicious cycle." The arteries stiffen, the pressure goes up, and the cycle begins again.
Secondly, the "turbulent flow" of the blood begins to "erode" the lining of the artery. To protect itself, the artery forms a callus or plaque. "Unfortunately, when a callus forms, the Ďbumpí from the callus itself magnifies the turbulence of the blood flow, causing even more injury, so the callus gets larger," Kensey explains. "This cycle continues until finally the callus is so big that it stops blood flow altogether, causing a heart attack or stroke."
Currently there is no practical way to measure blood viscosity Ė Dr. Kenseyís company has a device which does the job in clinical trials Ė but blood pressure is a good proxy. "If you blood pressure is increasing at all, even if itís still considered under Ďnormalí limits, the disease process has begun," says Dr. Kensey. Many doctors believe itís normal for BP to rise with age, "But I donít agree," says Dr. Kensey. (I agree with Kensey. My BP has not changed over the years. Itís the same now as it was in my 20s.)
"Be obsessive about blood pressure," Dr. Kensey recommends. If it starts to go up, take action immediately. You canít do anything about your age, your family history, your gender, or your race, but there are many things you can do to keep your blood flowing smoothly and control your blood pressure. Thatís where Dr. Kenseyís seven-step plan comes into play.
The Sludge Factor
Itís important to understand that Dr. Kensey is not dismissing risk factors such as cholesterol. He believes the traditional measures of risk are important, but that they all have a common denominator: "the sludge factor."
For example, he says that the bad LDL cholesterol, which is made up of large fatlike globules, "is essentially a simple way of measuring [blood] viscosity." He believes that too much LDL cholesterol "dramatically" increases blood viscosity, "probably by causing your red blood cells to clump together."
On the other hand, he believes that HDL cholesterol, the dense good kind, "acts like a lubricant Ė like oil in your car, allowing blood to flow through the arteries without causing damage."
Homocysteine (see article #17), the amino acid that has been linked to heart disease and stroke, according to Dr. Kensey, decreases red blood cell flexibility, "thus again increasing blood thickness."
C-reactive protein (CRP) is one of the new indicators of heart attack and stroke risk. Itís thought to measure low-grade inflammation caused by injury to the lining of the arteries. Says Dr. Kensey, "A high CRP level is probably a warning that your blood is too thick, your blood pressure is too high, or a combination of both Ė and that itís time to put my seven-step blood thinning program to work." (My latest blood test included CRP for the first time; happily, mine is very low, almost undetectable.)
Water Protects Arteries
That brings us back to water.
Dr. Kensey believes that many, perhaps most, adults go through life in a basically dehydrated state. Thatís because our thirst sensation isnít a very good early-warning indicator. Thirst probably doesnít "correlate with blood viscosity any more than with dehydration," says Dr. Kensey. By the time we feel thirsty, weíre already dehydrated and our blood is already thick.
"You need to drink enough to water so that you donít get thirsty in the first place," says Kensey, "just as you should keep your car topped off with oil instead of waiting for the red oil-warning light to go on."
He recommends drinking 12 cups or three quarts of water each day, more for athletes or people who exercise.
Itís especially important to drink some water at bedtime because, according to Dr. Kensey, heart attacks often occur in the morning when we are dehydrated and our blood is thicker than during the day. "If you have dark, highly-concentrated urine when you wake up, itís a signal that your body is dehydrated," Kensey warns.
Kensey predicts that further research will show that fluids play "a far more important role in blood viscosity than we ever realized." Furthermore, he believes that drinking enough water helps to lower blood pressure. Interestingly, he says that diuretics (drugs to make you urinate), which many doctors used to prescribe to lower blood pressure, actually exacerbate the problem. "Many studies have a since shown that strokes were often the unfortunate consequence of this treatment," says Kensey.
I donít believe Iíve gone through life in a dehydrated state Ė Iíve always consumed water during the day and the fruit, vegetables and grains, which are the cornerstone of my diet, are two-thirds or more water Ė but Dr. Kenseyís book has persuaded me to pay more attention to my fluid intake. For one thing, I now have a cup of water at bedtime and again if I wake up during the night, something I never did before.
How about you? Are you drinking enough water to keep your blood flowing smoothly and your blood pressure low?
(The Blood Thinner Cure is available at your local bookstore or from Amazon.com.)
WARNING: As several readers have called to my attention, overdosing on water can be harmful to your health. It can actually kill you. You really have to work to cause harm, however.
"Overzealousness can be dangerous," says a recent piece from Reuters Health, which highlights the deaths of military recruits as a result of drinking too much water. Extreme heat and physical exertion are usually involved, but not always. A 20-year-old trainee died from swelling in the brain and lungs after drinking "around 12 quarts of water during a 2- to 4-hour period while trying to produce a urine specimen for a drug test." As I said, to do harm, you really have to try hard. Tellingly, psychiatric patients have been known to drink too much water in an attempt to purge themselves of demons.
So, use common sense. Drink plenty of water, but donít go overboard. According to Reuters, the military now sets the upper limit at 1 to 1- Ĺ quarts per hour or 12 quarts per day. They don't recommend drinking that much. Significantly, the limit or danger point set by the military is four times the amount recommended by Dr. Kensey. The 12 cups or three quarts Dr. Kensey recommends isn't likely to get anyone in trouble.
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