Robert E. Kowalski was 35 when he had a major heart attack and multiple-bypass surgery. He'd inherited the tendency for heart disease from his father, who died too young several years before. He now describes the year of his heart attack, 1978, as the "Dark Ages of Cardiology." The doctor assured him the problem was fixed. He could forget it ever happened.
So he lit a cigarette, celebrated with a drink and got on with his life — briefly. Back then, he says, no one exercised. "If someone ran, it was because the cops were chasing him." His diet leaned heavily toward junk food. As a capper, for pleasure he cooked rich, delicious meals that were not necessarily what modern wisdom would recommend.
Within six years, he was back on the operating table for another set of bypasses, following yet another major heart attack.
This time, he promised himself he'd do things differently. And he has. He quit smoking and started exercising. He also hit the medical literature, undertaking a serious search to see what he could learn about heart disease, because he wanted to see his children grow up. Soon, he was normal weight, with great blood pressure readings — and a cholesterol level that was a disastrous 269. Woops.
His research and how he lowered that number was fodder for his first best seller, "The 8-Week Cholesterol Cure," and his new book, "The Blood Pressure Cure" (April 2007, John Wiley and Sons, $24.95).
Kowalski last week spent an hour chatting with the Morning News about his books, his heart — he now plans to see his grandchildren grow up — and what he's learned. His personal experience, while dramatic, is not singular. An estimated one-third of adult Americans — about 65 million — have mild hypertension or worse.
He starts with disclaimers. Some people have blood pressure so high they cannot avoid prescription drugs. His tips, he says, will help. They'll keep the needed doses as low as possible. For some, they may be enough. They'll help head off problems for those who are marching toward heart disease. But he's adamant that you not go off on your own without medical guidance.
"Some people are really sick with malignant hypertension, and it's highly dangerous. They're not going to be able to use natural approaches and get rid of their prescriptions. Not a chance. I am serious about this. But if you're hypertensive, start doing some of these other things. Don't stop taking the drug. If the doctor starts seeing results, he may reduce the dosage of the drug or cut you from two prescriptions to one."
He touts, among other things, several dietary supplements. And he's quick to point out that they come in different brands and he doesn't make a penny off any of them. He documents each suggestion with research studies by others published in prestigious medical journals. He notes that his suggestions are not controversial in the medical community, although when he first started publishing on the subject 20 years ago, "doctors were ready to crucify me." Their own profession's work has lent his ideas credibility and leading heart experts have praised his conclusions. One wrote the foreword to the new book.
His bag of tricks includes natural supplements, a rare form of pine bark, the perennial favorite cocoa, and an enzyme that helps keep veins and arteries supple.
He was the first to promote the idea to the general population that oat bran is heart-friendly, after finding a "gem of a study" comparing cereals for diabetic patients. Oatmeal stabilized blood-sugar levels, but why? He found in his review of research that is it the soluble fiber of bran, which works by binding onto bile. He studied some more and found dried beans and peas, figs, raisins, barley and other soluble fiber all lower cholesterol, especially when combined with niacin.
He reduced his saturated fat, not then widely believed to be a factor, and dropped his cholesterol to 184. Even his cardiologist, who had first laughed at him, was impressed and launched a study to see if it was a Kowalski-specific effect or would help others. It did. That was the foundation of the cholesterol book.
It helps that Kowalski was skilled at reading medical research. He'd studied medicine briefly, before deciding he didn't want to be a doctor. He chose to write about medicine and science, backed by a dual major in biology-chemistry and a journalism degree, then a master's in journalism and physiology. He completed the course work for a doctorate in physiology but didn't finish his dissertation. He was already busy writing about medicine.
"The Blood Pressure Cure" is Kowalski's eighth book, prompted when a new set of guidelines for blood pressure was issued to practitioners. "It was a quantum change, being told to deal with blood pressure sooner. What was normal to high-normal left people to develop full-blown hypertension," Kowalski says. The area between 120/80 and 140/90 was, in fact, a potentially dangerous span ripe for lifestyle changes.
People were not taking their prescriptions because of unpleasant side effects, including dizziness, chronic cough, morning headaches and loss of libido. He wondered if most people could simply change their habits. He offers a "Chinese menu," where you pick and choose depending on how "hungry" you are. Do you need a dramatic change or a small one?
Some advice is now perennial: Quit smoking, lose weight, exercise and reduce salt intake. Some who do all those things, though, get limited results. Barring a salt-free diet, only those who are sodium sensitive see much difference from that, Kowalski says. His own theory says the electrolytes sodium and potassium need to be in balance. So instead of focusing just on reducing sodium, he started promoting fruits and vegetables such as sweet potatoes, honey dew melon, bananas and oranges that are rich in potassium. "If you on a daily basis hit about 4,000 milligrams a day, you'll see a significant drop in blood pressure."
It's not easy to get that much potassium, so he uses a "salt substitute," potassium chloride, although not in place of salt. He doesn't like the taste. He adds it as he cooks, adding a tablespoon to the pasta as it boils, for instance.
He loves the blood-pressure-lowering qualities of cocoa. Kuna Indians off the coast of Panama used it, a practice their descendants still embrace. They use it in mole sauce and other foods. They drink it. And they live long, without high blood pressure. But if they move away and stop using it, their blood pressure goes up like everyone else's.
He's not talking about candy bars, filled with saturated fat and calories. He drinks unsweetened cocoa a half hour before bed. Do that every day for six weeks, he says, and your blood pressure will drop 11 points. Use the darkest unsweetened, rich cocoa you can find.
His research led him to the enzyme L-arginine, which helps the process that relaxes blood vessels and keeps them supple. Getting the building block wasn't very doable until a couple of supplement manufacturers figured out how to offer sustained-release arginine. "You see nice blood-pressure reduction, especially if you combine it with tomato extract." He looks for that in products marketed as containing "Lyc-O-Mato" — a "secret weapon" found in "tons of different brands." A cardiologist first documented the effects in the American Heart Journal.
He loves the origin of heart-friendly grape-seed extract. Two large wine producers wanted to see if they could feed leftover grape seed to animals as a way to rid themselves of the waste. Veterinarians noted their blood pressure went down, which led curious chemists to an isolate within the grape seed that is responsible for the effect. Clinical trials on people just identified with elevated pressure and in others with metabolic syndrome found in both an average 10-point drop. Add it to arginine and you get even better results, Kowalski says.
Don't want to take a supplement and just need a little help? Try deep breathing. "Take three or four mini-vacations every day, close your eyes, sit down with your back supported, feet on the floor and picture a balloon in your chest, inflating and deflating. Retention of carbon dioxide raises blood pressure, so get rid of it. It's a very relaxing habit. Do it regularly and you'll drop 10 bp points."
The bark that helps, he says, comes from a French maritime pine tree that grows only on one coast in France, and the efficacy of the substance, called Pycnogenol, is well documented now in medical literature. But it's fairly expensive, he notes, and does about the same thing his other suggestions accomplish.
He doesn't forget the staples, either, starting with not smoking. Moderate activity is better than strenuous exercise for blood pressure. "A brisk walk," he says. But the more strenuous activity will strengthen the heart muscle and lower the heart rate, which is what heart drugs like beta blockers do.
E-mail: lois@desnews.com