B.S., C.N.C.

Hypertension is not to be considered a diagnosis, like diabetes, but rather a description. It is an elevated reading on a blood pressure cuff that could be the result of one or many different causes. Some of those causes, such as an elder person with arteriosclerotic vasculature, are actually beneficial. In such a person, the higher blood pressure is necessary in order to keep the blood flowing adequately. If an elder person is put on drugs to lower their blood pressure, the results could drastically lower their quality of life. This is another example of the need to treat every person as an individual. Keep in mind, also, that no randomized clinical trials have ever proven that lowering an elevated systolic blood pressure to 140 reduces the risk for death due to coronary disease.

A good example of this was the multicenter Multiple Risk Factor Trial (MRFIT) designed to demonstrate that reducing hypertension, high cholesterol and smoking would lower coronary mortality. 13,000 middle-aged men who had these "risk factors" were put into either a treatment group or a control group. After 10 years, although the treatment group substantially achieved their objectives, they fared no different than controls who received usual care. In fact, a subset of the treatment group treated with diuretics had the highest mortality rates, probably due to potassium depletion. This trial was very instrumental in showing that in order to successfully treat a disease, it is necessary to remove or reduce its cause rather than its manifestations or markers. There are over 300 risk factors for heart attacks........attempting to treat or remove such markers will accomplish nothing since they do not "cause" coronary disease. The same can be true for lowering an elevated systolic or diastolic blood pressure unless the treatment is directed at what is "causing" the problem, which is usually not clear.

Following a diagnosis of high blood pressure (usually after it has been found to be high on three separate occasions), your doctor will probably prescribe an ‘anti-hypertensive’ drug. There are a number of drugs that fall under this category. They include beta blockers, which lower your heart rate; vasodilators (such as calcium channel blockers and ACE inhibitors), which widen your blood vessels; and diuretics (‘water tablets’), which reduce the volume of your blood by removing water from your body. Unfortunately these drugs all come with unpleasant and sometimes dangerous side effects – ranging from muscle aches, fatigue and nausea to breathing difficulties, impotence and heart failure.

As a prelude to discussing holistic remedies for hypertension, it may be a good idea to simply mention some of the more common risks or "causes" of hypertension, and the adverse effects of heart medications. The "causes" can vary greatly, from being overweight to drinking excess alcohol (which is known to be one of the most common causes of hypertension, recognized as long ago as 1915, with sufficient epidemiologic, clinical, and laboratory evidence providing a link only recently), or smoking (which is known to cause increased blood coagulability and endothelial damage. These are excellent articles concerning smoking. These causes or risks are, in most cases, able to be completely corrected with a little patience and guidance. For more extensive information on the relationship between alcohol and hypertension, please refer to this link. One other risk not often caught could be an undiagnosed thyroid condition.

It is well known, or should be, that problems with the thyroid gland can lead to abnormal heart rhythms, high blood pressure, chest pain and more. The thyroid controls the pace at which your body runs, and the heart is especially sensitive to it's signals. That means, simply put, that a malfunctioning thyroid can cause problems that may appear to be heart disease or make existing heart disease worse.

Some particular cardiovascular influences of thyroid hormone are:

The volume of blood circulating through the heart and blood vessels
The force of heart muscle contractions
The relaxation of heart muscle between beats The heart rate
The flexibility and elasticity of small arteries
The ability of blood and other fluids to leave and enter the smallest blood vessels (capillaries)

Abnormal heart rhythms, high blood pressure, and chest pain are often a result of hyperthyroidism or an over active thyroid. A slow heart rate, or bradycardia (resulting in a diminished pumping ability),and high cholesterol and homocysteine levels are common with hypothyroidism or an underactive thyroid. One thing to remember is that it is not always simply a thyroid disorder being responsible for cardiovascular problems. A heart attack or heart failure can disrupt the function of the thyroid gland - which can cause further cardiovascular problems.

If you have cardiovascular disease or a familial risk of heart disease — a heart rhythm problem, high blood pressure, high cholesterol levels, atherosclerosis, or chest pain — a thyroid check is always in order. For that matter, medical organizations such as the American Thyroid Association and the American College of Physicians recommend that all adults, especially older women, get regular checks for thyroid disease. In addition to palpating the neck area, most open-minded physicians will order diagnostic thyroid blood tests such as TSH, Free T3, Free T4, and anti-thyroid antibodies in addition to the exceptionally diagnostic cardiovascular blood tests C-Reactive Protein, Homocysteine levels, apo-lipoprotein-B, apo-lipoprotein-A1 and the apo-B/apo-A1 ratio, triglycerides, and fasting plasma insulin levels.

Without going into extensive detail at this point, I do want to point out that despite the lower normal values for the TSH, in both men and women values above 1.0 are known to be indicative of a failing thyroid. People have often remarked of an increased feeling of wellness when their levels are at the very low end of normal (0.3). Women should also take note that it may often be the case where they have perfectly normal TSH results (less than 1.0) and are still experiencing a decreased quality of life with many cardiovcascular symptoms. This is known to be a result of estrogen dominance. Estrogen dominance is very prominant; hence, so is hypothyroidism and more often cardiovascular problems such as hypertension.

In addition to that, never let a physician tell you that you have a high cholesterol if your fasting test result is between 200 and 240. That is very outdated thinking. Doing a cholesterol panel is actually not as diagnostic as it was once considered. Today, it is known that apo-B/apo-A1 tests and ratio are much more indicative a test, as is the homocysteine level, and C-Reactive protein. Always keep in mind the fact that cholesterol is responsible for the integrity of the vasculature. If the total cholesterol level goes much below 180, the risk of hemorrhagic stroke drastically increases. I am going to include a very good web page that gives a more holistic list of test results if you scroll down the page a way to the "Causes, Risk Factors, Prevention" section. The name of the article is entitled "How to Determine Your Cardiovascular Health" by Brian Vonk. The entire webpage is VERY good, so please read some of the other articles. The webpage is located here.

Stress is often mentioned as a "cause" of hypertension. However, unless there are other mitigating factors that correlate to high blood pressure, it should not be considered a "cause". With that in mind, though, know that stress of any kind drastically influences the thyroid gland... often resulting in the gland totally shutting down. The thyroid plays a very important part in the health and well-being of the entire body. Yes, stress can cause an elevated blood pressure in and of itself, but, it is not a sustained, physiological elevation unless the thyroid is involved. If we are talking about sporadic, short-term, periodic stressful situations and a resulting high blood pressure reading, this could be considered more a psuedohypertension. In a case such as that, it has often been found that those people (inadvertantly being treated for essential hypertension) can stop their medication without any adverse effects. Other instances where this may be possible might be admission to the hospital for surgery or an unrelated condition where the hypertension drugs are discontinued.

"White coat" hypertension is also very common. In one study published in the Journal of the American Medical Association, more than one in four patients with elevated blood pressures in the doctor's office were found to have normal values on ambulatory monitoring. All were taken off drugs with no adverse effects.

Some other sources of "psuedo" hypertension that should be mentioned might be - the size of the blood pressure cuff, the time of day, room temperature, a full bladder, eating, drinking or smoking within the past hour, standing, sitting or supine... all can influence the measurements. Concerning the size of the cuff: This can be very significant in giving false high readings in fat arms. Due to the large number of obese people, on one end of the spectrum, to extreme body builders, on the other end of the spectrum, the cuff size should always be considered.

Hypertension is very treatable holistically; however, it is best to prevent it instead. The goal is to address the various factors that contribute to it. As mentioned, hypertension is not a disease (unless caused by renal failure), it is a symptom of an underlying disorder or dis-ease... address that disorder, and the hypertension is corrected.

Authoritative advice for treating blood pressure has changed dramatically over the years. Forty years ago, the chapter on hypertension in Harrison's Textbook of Medicine it was noted that "the physician who treats hypertension is treating the patient as a whole, rather than the separate manifestations of a disease." Remember the words of the Hippocratic oath: "Above all, DO NO HARM".

One of the first methods of prevention or treatment of hypertension should be nutritionally. It's not that specific nutrition in and of itself will prevent it, but, rather specific or "good" nutrition will prevent the occurrence of obesity and the accumulation of abdominal or visceral fat. Based on population studies, risk estimates indicate that at least two-thirds of the prevalence of hypertension can be directly attributed to obesity Weight loss is associated with a significant reduction of blood pressure and has beneficial effects on the associated risk factors. Even modest weight loss of 5–10 percent of body weight is associated with clinically significant reductions in blood pressure.

One of the first nutritional guidelines that should be employed is the reduction of, or in some cases the elimination of, refined sugars, fruit juices, and starchy vegetables. These all contribute to the production of excess insulin. Insulin is not a good hormone to have an excess of... aside from the cardiovascular risks. By ingesting an over-abundance of these types of carbohydrates, not only does the body produce excess insulin, but, the body eventually becomes insulin resistant. This means that the body will then produce even more insulin than before. Studies have found that approximately 50 percent of persons with hypertension can be considered to have insulin resistance and hyperinsulinemia (Geriatrics 2000;55(6):28-32, 35)”. Current research and documentation is finding that the "age old" recommendation that a high-fiber, low-fat diet will be of benefit in cardiovascular disease is not necessarily the case. The contrary is now known to be true: good protein (preferably organic), adequate amounts of beneficial fat (including highly beneficial saturated fat from coconut oil and organic meats), and non-starchy vegetables are the best way to eat to maintain or regain health. The theory that high fat increases cholesterol levels is false. I have known many people who eat good quality meat, and twenty or so eggs a week along with organic olive oil, ghee, butter and coconut milk. Their cholesterol levels actually were too low. As I mentioned, cholesterol levels much below 180 may give an increased risk of hemorrhagic stroke or even spontaneous subdural hematomas, in some cases.

Other beneficial foods to consider when combating hypertension might be:

Onions and garlic, which may act like natural blood thinners - discouraging clotting. Allicin is the primary component that has been found to benefit blood pressure. Garlic was also found to work by influencing the concentration of nitric oxide – a substance that reduces blood pressure by widening the arteries – in the blood (Al-Qattan KK, et al. J Nutr. 2006;136(3 Suppl):774S-776S).

Celery contains a blood pressure lowering compound called 3 n-butyl-phthalide. Eating 2 to 4 stalks a day is the amount found to help lower blood pressure.

According to a study in Hypertension, eating approximately 3 ounces of dark chocolate (which contains flavonols) on a daily basis helps in a small but significant degree to combat high blood pressure, insulin resistance, blood vessel dilation, and LDL cholesterol in individuals with “essential” hypertension. The researchers referred to prior research that demonstrated the same effects in healthy individuals.

Increase your dietary intake of magnesium and potassium. Both have been found to be extremely effective in lowering high blood pressure. Magnesium-rich foods include green leafy vegetables, whole grains, nuts, seeds, dried peas and beans. Scientists began studying the effects of potassium on high blood pressure as early as 1928. Now a major study of 300 nurses shows that potassium can lower your blood pressure even if it's in the normal range. Good sources of potassium are dried apricots, avocados, dried figs, acorn squash, baked sweet potatoes (with skins), kidney beans, cantaloupe, citrus fruits, raisins and bananas. If you're taking a diuretic, your body is getting rid of potassium along with fluid. Research has found it most beneficial to eat a sodium-to-potassium ratio of at least one to four. Another suggestion to combat over-consumption of sodium (NaCL)is to use a potassium-salt combo in place of regular table salt. In place of regular salt, mix three parts potassium chloride (Nu-Salt or Morton’s Salt Substitute) with one part sodium chloride (table salt). Few people can tell the difference.

Another important cause of heart disease is eating food under stress. If you eat whilst under physical or mental stress, you will be producing stress hormones: cortisol, adrenaline (epinephrine), glucagon and growth hormone. These are all powerful insulin antagonists. The antagonism from these hormones during a meal will lead to spikes of blood sugar, insulin and triglyceride (to name but three factors) as insulin, the anabolic hormone, battles against the catabolic stress hormones. Which is why a country such as France — which has the same level of ‘classical’ risk factors as the USA — has a low rate of death from heart disease. The French spend a long time eating their meals, so they give their metabolism a chance to absorb and digest food properly, rather than set up a metabolic battleground with stress hormones.

If you need a little more help than what adjusting your diet offers, then there are many options in the supplement category that are highly beneficial in lowering blood pressure. Some of the most important might be:

Co-enzyme Q10, which has been found to be as effective as many anti-hypertensive drugs, but without the side effects. In a double-blind clinical trial, a group of 76 patients with hypertension took 60mg.per day of CoQ10 or a placebe for 12 weeks. At the end of the study, the CoQ10 group had an average reduction of 18 points in their blood pressure, leading the researchers to conclude: "CoQ10 may safely be offered to hypertnsive patients as an alternative treatment option" (Southern Med J 2001; 94(11): 1112-7). The optimal dosage of CoQ10 has been found to be 60mg to 120mg a day.

Blood pressure reduction via Bonito peptide therapy has come to the forefront and is based on a broader thesis that certain bioactive peptides are able to prevent and/or reverse certain health conditions, especially if the conditions are caused by lifestyle choices. Several human trials have been completed that address the blood pressure lowering properties of bonito fish peptides. The cumulative data gathered from these double-blind, randomized, crossover studies supports the following:

Approximately 2/3 of borderline or mildly hypertensive persons experienced significant blood pressure lowering effects when engaged in bonito fish peptide therapy. This is especially impressive when compared to the relatively low success rate of 34% associated with mass-prescribed ACE inhibitor drugs.

Bonito fish peptide therapy typically reduces systolic pressure by 10 mm Hg while simultaneously reducing diastolic pressure by 7 mm Hg.

One point five (1.5) grams per day of bonito peptides are considered an optimal amount for the effective treatment of hypertension.

No side effects have been observed or reported concerning bonito peptide therapy for the treatment of high blood pressure.

Bonito peptides will not reduce the blood pressure of individuals with normal blood pressure.

With abrupt bonito peptide therapy termination, no reverse effects, no rebound effects and no abnormally high blood pressure resulted.

Ongoing clinical research continues to strongly support that bonito fish bioactive peptides are more beneficial for the treatment of hypertension than are ACE inhibitor drugs. Further, they demonstrate no adverse side effects. Because the peptides are naturally strong vasodilators, they are the targets of any angiotensin converting enzymes that may be present. With the peptides taking the attention of the ACE, angiotensin II is prevented from being produced. The result is a relaxation (dilation) of the vascular system, and in turn, reduced blood pressure.

Hawthorn (Crataegus oxycantha) is a plant with proven heart benefits. It is known to strengthen the force of the contractions without increasing blood pressure. Hawthorne has a normalizing effect on the heart, and it's primary use is the treatment of high blood pressure, angina pectoris, and arteriosclerosis. UK scientists from the University of Reading recently found that 1,200mg of hawthorn extract taken each day for 16 weeks was effective at lowering blood pressure in diabetic patients (Walker AF et al. Br J Gen Pract. 2006;56(527):437-43). This is just above the currently recommended dosage for hawthorn, which is 1,000mg a day.

Vitamin D3 (cholecalciferol),has been available as long as there's been a sun in the sky. Studies have shown Vitamin D3 is absorbed faster than D2, which comes from milk or cereals. Statistics have shown for years that the prevalence of hypertension rises for all ethnic groups the farther away from the equator they are. Researchers have long suspected that vitamin D – which is produced by the body following exposure to the sun – is behind these positive results, and now there’s a study confirming those suspicions. In 2002, the Journal of Clinical Investigation published a detailed explanation of exactly how vitamin D helps to lower blood pressure. Basically, here's how it works: Without adequate vitamin D, one of your genes (a tiny part of your DNA) initiates the formation of excess quantities of a molecule called renin. Renin breaks down another molecule, called angiotensinogen, into angiotensin I. Angiotensin I is converted into angiotensin II by a substance known as angiotensin converting enzyme (ACE). The end result – angiotensin II – is the “bad stuff” that (in excess amounts) causes high blood pressure. Most popular patented antihypertensive drugs are ACE inhibitors and angiotensin II receptor blockers (ARBs). Vitamin D does a better job than these drugs because it targets the problem at the most basic genetic level. In its fully activated form, vitamin D persuades the gene that controls renin production to become less active, and the end result is less angiotensin II and lower blood pressure (J Clin Invest 2002:110;229-238; Intern Med 1999;38:31-35). Studies have found it most beneficial to take at least 1,000iu of vitamin D3 a day. However, I have known many people that took 5,000iu daily with no adverse effects at all.

Taurine is a sulfur-containing amino acid-like endogenous compound found in substantial amounts in mammalian tissues. It exerts a diverse array of biological effects, including cardiovascular regulation, antioxidation, modulation of ion transport, membrane stabilization, osmoregulation, modulation of neurotransmission, bile acid conjugation, hypolipidemia, and antiplatelet activity. A review of the literature generally indicates that taurine exerts vascular effects by acting at different target sites and by various mechanisms. Oral taurine supplementation improves vascular relaxation, intimal thickening, oxidative stress and inflammation associated with various related vascular disorders. It has also been found to increase NO generation. Oral taurine supplementation alleviates the symptoms of hypertension in hypertensive human patients and reverses arterial stiffness. The most frequently recommended dosage is 3g. per day.

A relatively new method for reducing high blood pressure is a small machine called RESPeRATE. RESPeRATE is the only non-drug solution for lowering blood pressure with an extensive amount of clinical support. The clinical studies have proven the effectiveness of RESPeRATE on lowering blood pressure, and have been published in reputable journals such as the American Journal of Hypertension and Journal of Human Hypertension. Resperate is a portable electronic device that promotes slow, deep breathing. It is approved by the Food and Drug Administration for reducing stress and lowering blood pressure, and it's available without a prescription. Resperate uses chest sensors to measure your breathing, and then a computerized unit creates a melody for you to use to synchronize your breathing. The melody is supposed to help you slow your breathing with long exhalations. Resperate is intended to be used at least 15 minutes a day, three to four days a week. Within a few weeks, the deep-breathing exercises can help lower both systolic and diastolic blood pressure — the top and bottom numbers in a blood pressure reading. You need to keep doing the breathing exercises to maintain the blood pressure lowering benefits.

Always stay hydrated. Being dehydrated essentially makes your blood thicker; when your blood's thicker, the heart has to work harder to get the blood out of the aorta, down to the feet, then back again. The muscles (in addition to the heart) that take on this extra work eventually increase the pressure inside the blood vessels causing increased or high blood pressure. Using Chinese medicine to explain the situation, the heart is referred to as wood that is burning. If a wood fire is burning too high (the heart working too hard), you put water on the fire. In the same way, you would drink more water to slow the burning of the wood or, in other words, lower the blood pressure. Western medicine views it this way - When a person has high blood pressure, they are often given diuretics to make them urinate. Drinking more water will make you urinate. They are also given blood thinners. Drinking more water will thin your blood. Finally, they are often given calcium channel blockers to prevent the muscles from squeezing the blood vessels. Drinking the water to thin the blood will prevent the need for these muscle to squeeze. Please know that this does not mean that you should drink lots of water and stop taking your high blood pressure medicine (if you are already on these). High blood pressure is known as the silent killer because it kills without notice. Therefore, keep taking your medicine until your physician tells you that you do not need it anymore. Increase your water to the proper amount. Tell your physician what you are doing and that you want him/her to be on alert that your pressure should be monitored closely and that your medicine may need to be decreased. As time goes by, your pressure should keep dropping too low and, unless you are one of the few that has additional reasons for your high blood pressure, your physician may, eventually, take you off of all of your high blood pressure medicines.

Exercise is known to be a drug-free approach to lowering high blood pressure. Even though your risk of high blood pressure increases with age, getting some exercise can make a big difference. If your blood pressure is already high, exercise can help to control it. Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure. Becoming more active can lower your systolic blood pressure — the top number in a blood pressure reading — by an average of 4 to 9 millimeters of mercury (mm Hg). That's as good as some blood pressure medications. For some people, getting some exercise is enough to reduce the need for blood pressure medication. But to keep your blood pressure low, you need to keep exercising. It takes about one to three months for regular exercise to have an impact on your blood pressure. The benefits last only as long as you continue to exercise. Researchers and exercise physiologists have found that flexibility and strengthening exercises such as lifting weights are an important part of an overall fitness plan, but it takes aerobic activity to control high blood pressure. Any physical activity that increases your heart and breathing rates is considered aerobic exercise, including:

Household chores, such as mowing the lawn, raking leaves or scrubbing the floor
Active sports, such as basketball or tennis
Climbing stairs
Walking
Jogging
Bicycling
Swimming

One thing I would like to mention concerns weight training and high blood pressure. It is known that weight training can cause a temporary increase in blood pressure during exercise. This increase can be dramatic, depending on how much weight you lift. However, weightlifting can also have long-term benefits to blood pressure that outweigh the risk of a temporary spike for most people. If you have high blood pressure and want to include weight training in your fitness program, remember:

Learn and use proper form when lifting to reduce the risk of injury.
Don't hold your breath. Holding your breath during exertion can cause dangerous spikes in blood pressure. Instead, breathe easily and continuously during each lift.
Lift lighter weights more times. Heavier weights require more strain, which can cause a greater increase in blood pressure. You can challenge your muscles with lighter weights by increasing the number of repetitions you do.
Listen to your body. Stop your activity right away if you become severely out of breath or dizzy or if you experience chest pain or pressure.

Exercises such as yoga and tai chi, which teach specific relaxation and breathing techniques, have been researched and used to lower high blood pressure and stress levels, regulate your heart rate and improve the health of your arteries. For example, the Harvard Health Publications website claims that tai chi can improve symptoms of arthritis, high blood pressure and Parkinson's disease. Similarly, MayoClinic.com claims that a regular yoga practice can reduce heart rate, lower blood pressure, relieve physical pain across the body and alleviate the symptoms of depression. When done regularly, both practices can improve the quality of life among patients with cancer and heart disease. People with mild hypertension who practiced these healing techniques daily for two to three months experienced significant decreases in their blood pressure, had lower levels of stress hormones, and were less anxious.

One last technique I'd like to mention in the quest to lower hypertension is that of meditation. Several studies on elderly adults (Hypertension, 1999) have demonstrated that high blood pressure is reduced even after only a few months of twice-daily practice of the Transcendental Meditation technique. The need for antihypertensive medication is reduced and sometimes eliminated. Scientific research has found that stress has been implicated in the development of hypertension. This has been documented through epidemiological blood pressure studies; naturalistic studies of the relationship among blood pressure, psychology, and everyday life events; and experimental studies of cardiovascular and neuroendocrine responses to behavioral stimuli. The mind and body are very intimately connected. The subjective experience of the Transcendental Meditation technique is one of mental relaxation and peacefulness combined with inner wakefulness. The meditation response is very rapid, and the most clear-cut effects have been seen after 15-30 minutes of practice. The mental relaxation elicits physiological relaxation; that is, when the mind settles down, the body gains deep rest.

Please email me if you have any questions.