What to do if you have the 'Three Highs'? A Comprehensive Guide to Managing Blood Pressure, Blood Sugar, and Cholesterol

Hypertension

Hypertension refers to abnormally high blood pressure against the arterial walls, usually       expressed as two values: systolic and diastolic pressure. Normal blood pressure is   generally around 120/80 mmHg. According to the 2017–2020 National Nutrition and Health Survey,   the prevalence of hypertension among adults in Taiwan is 26.8%, meaning that about one in four adults has high blood pressure.

In its early stages, hypertension often presents no noticeable symptoms, and regular monitoring  is required to track blood pressure levels. A normal reading should be at or below          120/80 mmHg. Readings of 130/85 mmHg indicate slightly elevated blood pressure, while 140/90 mmHg or higher signifies hypertension.

Hyperglycemia

Diabetes can generally be divided into three types

  • Type 1 Diabetes (Insulin-Dependent Diabetes Mellitus, IDDM)

1.Occurs at any age, but mostly diagnosed before the age of thirty

2.Insulin deficiency occurs when the body’s immune system destroys the pancreatic β-cells.

  • Type 2 Diabetes

Type 2 diabetes is usually found in adults and is often related to diet habits, lack of   exercise, and being overweight. Nowadays, with the increased consumption of          refined foods, diabetes is appearing at younger ages. In addition, people with a          family history of diabetes have a higher risk of developing the disease than others.

Type 2 diabetes is caused by insulin resistance, leading to a relative insufficiency of   insulin secretion. In the early stages, blood sugar can be controlled with medication   without insulin supplementation. In the later stages, when insulin secretion is also      impaired, insulin injections may be required to manage blood glucose.

  • Gestational Diabetes Mellitus (GDM)

Pregnant women who are overweight or obese are at a higher risk of developing       gestational diabetes. Those who experienced GDM in a previous pregnancy or have a family history of diabetes should pay more attention. GDM is defined as diabetes    diagnosed either prior to pregnancy or first recognized during pregnancy.

 

Diabetes Diagnosis Criteria

·         Random plasma glucose ≥ 200 mg/dL in the presence of classic symptoms of hyperglycemia, such as poor wound healing, polyphagia (increased appetite), polydipsia (increased thirst), polyuria (frequent urination), and unexplained weight loss.

·         Fasting plasma glucose ≥ 126 mg/dL on at least three separate occasions

·         Two-hour plasma glucose ≥ 200 mg/dL during a 75-g oral glucose tolerance test    (OGTT)

·         Glycated hemoglobin (HbA1c) ≥ 6.5%

Hyperlipidemia

High cholesterol means having too much fat in the blood, including cholesterol and triglycerides. Cholesterol is divided into LDL (low-density lipoprotein, often called “bad cholesterol”)     and HDL (high-density lipoprotein, often called “good cholesterol”). Normal levels are generally: total cholesterol below 200 mg/dL, LDL below 100 mg/dL, and HDL above 60 mg/dL. Having high cholesterol increases the risk of heart disease and stroke.

A Hidden Threat Deadlier than Cancer

Based on the statistics from the Ministry of Health and Welfare, the heart disease has           remained the second leading cause of death in Taiwan for several years. If deaths from        three-high-related chronic diseases are counted, such as cerebrovascular disease, diabetes, and hypertension, the combined number of deaths exceeds that of cancer.

Among hypertension, hyperglycemia, and hyperlipidemia, hyperlipidemia is the most easily  overlooked. In Taiwan, about 40% of adults have high cholesterol, yet because it is often     with out symptoms in the early stages, only one in four people are aware of their condition,  even when tests reveal elevated cholesterol.

When excessive amounts of “bad cholesterol” (LDL) build up along the walls of blood           vessels, the vessels gradually narrow and blood flow becomes obstructed. This can result in poor circulation, leading to symptoms such as fatigue and dizziness. More seriously, if a       plaque ruptures, it may cause a blood clot, which can trigger acute events such as myocardial infarction (heart attack) or stroke.

Bad cholesterol,” also known as low-density lipoprotein (LDL), carries cholesterol from the     liver into the bloodstream. In contrast, high-density lipoprotein (HDL) transports cholesterol   from the blood back to the liver for metabolism. Because of this role, HDL cholesterol (HDL-C) is often referred to as “good cholesterol” and considered the scavenger of the blood vessels.

Standard Blood Lipid Range

項目: Item

正常值: Normal Value

高危險群(極須盡速保養Urgent need of care): High-Risk Group

極高危險群(極須盡速保養及檢查Urgent need of care and check-up): Very High-Risk Group

備註: Remark

High cholesterol combines with other substances in the blood to form plaque, which over      time can lead to atherosclerosis and may result in coronary artery disease, narrowing or       even blocking the arteries.

High triglyceride levels, also known as hypertriglyceridemia, are commonly referred to as    “blood turbidity.”

Low-density lipoprotein (LDL), commonly known as 'bad cholesterol,' is primarily responsible for transporting cholesterol. Excessive levels can lead to plaque buildup in the arteries.

High-density lipoprotein (HDL), commonly known as 'good cholesterol,' transports  cholesterol from the body back to the liver, where excess cholesterol is removed.

What to do with “Three Highs”?

  • Balanced Diet

Reduce the intake of foods high in cholesterol, such as organ meats, crab roe, fish eggs,      cheese and butter. Instead, cultivate the habit of eating more vegetables, fruits and whole    grains. For daily cooking, choose plant-based oil, such as olive oil or sunflower oil and limit   the use of animal fats

  •  Reduce Salt Intake

Excessive intake of salt may lead to high risk of heart disease and stroke. According to the Ministry of Health and Welfare, the recommended daily sodium intake should not exceed     2400mg, which is about 6g of salt. In Taiwan, younger age groups tend to consume even    more sodium. For example, male junior and senior high school students consume more than twice the recommended daily amount, while young adult males (ages 19–30) consume about 1.9 times the recommended daily intake.

Excessive sodium intake is one of the main causes of high blood pressure. According to the 2007 Taiwan Survey on hypertension, hyperglycemia, and hyperlipidemia conducted by the National Health Administration, one in every twelve young adults (ages 20–39) has high       blood pressure. On average, three out of four young adults with hypertension are unaware of  their condition. If young people do not change their habit of consuming highly salted foods,   the future risks of heart disease and stroke could become even more severe.

For people with three highs, experts suggest doing daily aerobic exercise for 30~60 minutes  gradually buliding up intensity, such as brisk waliking or swimming.This not only helps the body sweat and metabolize, but also activates large muscle groups. Most importantly, it turns exercise into a daily lifestyle habit.

  • Stay Away from Alcohol

Most people enjoy drinking alcohol aftet work or on weekends. However, when alcohol is    metabolized into acetaldehyde in the body, it can affect the contraction of blood vessel walls,     leading to fluctuations in blood pressure. Therefore, long-term improper drinking can              increase the risk of high blood pressure. Even drinking cocktails or beer can put a burden on the body, often because they are consumed along with large amounts of fats or                    carbohydrates.

  •  Look after your body, mind, and spirit

The factors of “Three Highs”are closely linked to long-term stress from work and daily life  or often having irregular schedules, not getting enough sleep, or experiencing poor sleep     quality. Stress management plays an important role in controlling blood pressure. Therefore, to prevent the three highs, maintaining a regular daily routine, engaging in moderate             exercise, and keeping a positive mood can help promote overall health.

Besides age and genetics, the main risk factors for the three highs include diet, sleep, and   daily habits. Consuming sugary drinks or high-fat foods, sitting for long periods, and not       exercising regularly are all key contributors to these chronic health problems. If blood           pressure, cholesterol, and blood sugar levels are all abnormal, the risk of developing heart   and vascular diseases like heart attack, heart failure, or stroke, diabetes, kidney problems,   and related complications, is higher compared to most people. Chronic conditions usually     require long-term medication, which can affect daily life and overall quality of life. The three   highs are preventable, and people should start from the source. By regularly monitoring your health, maintaining a regular daily routine, and following a light, balanced diet, you can help keep your body healthy and full of vitality. It is important to remind everyone that if you are at high risk for the three highs, regular health check-ups and consulting a healthcare  .

FAQ

Do three highs (high blood pressure, high blood sugar, and high blood lipids) always require medication?

The three highs are chronic conditions that are not easily noticeable in daily life. However,   once they lead to cardiovascular complications, they can become a serious health threat. Therefore, regular health check-ups and self-monitoring are essential. If test results exceed the normal range and affect health, medication is often required. In mild cases, improvements   may be achieved through dietary adjustments, exercise, weight management, food therapy, and lifestyle modifications. Traditional Chinese Medicine (TCM) emphasizes the regulation of “body constitution.” By identifying imbalances in the organs and meridians, TCM applies        targeted treatment. Common therapeutic approaches include strengthening the spleen and  kidneys, soothing the liver and regulating qi, and promoting blood circulation to resolve         stasis.    Acupuncture may also be used to help regulate qi and blood, thereby maintaining   balance in the three highs. For patients already taking Western medication, it is important not to stop the medication on their own. Under integrated treatment combining Chinese and Western medicine, adjustments to prescriptions should only be made once the condition is stably controlled and under a doctor’s evaluation, with medication gradually tapered when appropriate.

How TCM controls blood pressure, blood sugar, and  blood lipids?

Three highs are considered as metablic disease. In Traditional Chinese Medicine (TCM),  they are thought to result from imbalances in the internal organs (the five zang and six fu)    and blockages in the meridians and qi and blood circulation, leading to a combination of      wind, fire, phlegm, blood stasis, and deficiency. Besides clearing metabolic waste, TCM       emphasizes treating both the root and the symptoms. Treatment often begins with improving spleen and stomach function, soothing the liver and reducing internal heat, and tonifying the kidneys and strengthening the heart. Methods such as herbal medicine, acupuncture, dietary therapy, and Qi Gong exercises are used to regulate body functions. Clinically, treatment      recommendations and strategies are tailored according to the patient’s individual constitution.

For hyperglycemia: Corn silk, bitter melon, and Gymnema leaves can be used as dietary       therapy support. These may be combined with herbal prescriptions that regulate the spleen and tonify the kidney, such as Liuwei Dihuang Wan. If there are signs of qi and yin deficiency,such  as dry mouth and thirst, Yu Qian Wan may be modified accordingly.

For Hyperlipidemia: TCM approaches high blood lipids by supporting liver and gallbladder     function and regulating digestion. Herbs such as hawthorn Shan Zha, Jue Ming Zi, red yeast rice, Yi Yi Ren, and Chai Hu can help with digestion and lower cholesterol. These are often  combined with formulas that promote blood circulation and resolve blood stasis, such as Xue Fu Zhu Yu Tang and Dan Shen. Additionally, phlegm-resolving herbs like modified Er Chen Tang may be included, depending on the individual’s condition.

Red yeast rice capsules, commonly used to lower cholesterol, may have contraindications - what are they?

Red yeast rice (also known as hongqu mi, danqu, or chiqu) is produced by fermenting      steamed rice with Monascus yeast. It contains natural Monacolin K, which can help lower     cholesterol. However, the following individuals should use it  with caution:

  • People taking statins lipid-lowering drugs(eg., statins): Red yeast rice extracts are     structurally similar to these medications. Concurrent use may increase drug levels in the blood, placing extra strain on the body.
  • People taking anticoagulants (e.g., warfarin): Red yeast rice supplements may          enhance the effects of these drugs, impacting blood clotting.

How to choose red yeast rice products for lowering cholesterol?

With so many cholesterol-lowering products available, it is hard for consumers to judge their quality based on appearance alone.

Safety: When purchasing, make sure the products contain Monascus pirpureus, the red       yeast strain approved as safe by the Ministry of Health and Welfare. In addition, red yeast     rice is a natural fermentation product of rice. If the fermentation or storage conditions are       improper, it may produce citrinin, a harmful mycotoxin. Therefore, when purchasing,             consumers should check whether the product has undergone safety testing for pesticides,      heavy metals, and microbial contamination.

Efficacy: According to the Ministry of Health and Welfare, the recommended daily intake of monacolin K is 4.8–15 mg. Consumers are advised to choose products that provide an         adequate amount of this active ingredient.

Comprehensive formulation: Some products include additional beneficial ingredients such as nattokinase and coenzyme Q10. Since red yeast rice may reduce the body’s natural             production of CoQ10 during the cholesterol-lowering process, a complete formulation           containing CoQ10 is important to support antioxidant protection and cellular energy             maintenance to promote overall health.

Can cholesterol-lowering products be used in  combination with Western medications?

Red yeast rice and cholesterol-lowering Western medications (e.g., statins) work through     similar mechanisms of action. Concurrent use is not recommended, as it may increase liver strain or cause side effects such as muscle pain. If combining with other herbal remedies or  supplements, such as Jue Ming Zi (cassia seeds) or San Zha (hawthorn), professional medical consultation is advised to ensure safety.

 

Dr. Jun Ying Zhu, Attending Physician, Yue Zhan TCM Clinic

  • Areas of Expertise:

General Internal Medicine
Gynecology
Dermatology
Constitutional Health/Tonic Therapy
Acupuncture

  • Education & Training:

Master’s Degree in Chinese Medicine (in progress), Tzu Chi University
Post-Baccalaureate Chinese Medicine, China Medical University
Bachelor’s Degree in Chemistry, National Taiwan University

TOP