Hypertension: What Your MD May Not Tell You
By Dr Ingrid Pincott, ND
Blood pressure is the pressure of circulating blood on the walls of large arteries of the systemic circulation. Blood pressure is usually expressed in terms of systolic pressure (maximum during one heart beat) over diastolic pressure (minimum in between two heart beats). If your blood pressure is higher than normal (140/90), your heart is working harder to force the blood through the arteries. The major cause is narrowing arterial channels caused by hardening of the arteries or by cholesterol plaques obstructing the arteries. Other common causes are water retention, stress, family history, obesity, kidney disorders, diabetes, the use of oral contraceptives, overactive thyroid, and adrenal tumors.
The first question to confirm about hypertension is “do you have white coat syndrome”—that is being tense in the doctor’s office. Up to 40% of hypertensive patients are diagnosed incorrectly because the blood pressure is only high in a clinic! A good idea is to own a BP unit and check your pressure at home. The best time to measure is first thing in the morning. If someone wakes up with high blood pressure this could indicate an increased risk of stroke. Documenting your results is helpful for your health care provider.
The next question is what is the ideal blood pressure reading? A detailed article on the Cochrane Group is available HERE.
There is good information at the link on what all the numbers mean. In the end, the authors conclude that lowering BP targets below 140-160/90-100mmHg does not reduce mortality or morbidity. However, for groups of patients who have diabetes mellitus or chronic renal disease there are guidelines for even lower targets–and reviews in the medical literature of this specific population have not been published.
In general if the blood pressure readings are over 140/90 treatment is recommended.
Nitric oxide (NO) plays a significant the role of cardiovascular disease including hypertension. NO is a free radical gas produced in the cells that line the blood vessels, nerve cells and white blood cells; NO relaxes smooth muscle in the arteries, decreases platelets from clotting and regulates fat metabolism. Individuals with low levels of NO may have signs and symptoms of hypertension, coronary artery disease, stroke and atherosclerosis. In my practice, I recommend a number of NO friendly nutrients and herbs to my patients such as folic acid, L-arginine, vitamin B6 and B12, folic acid, vitamin E, garlic, resveratrol, quercetin and green tea.
A typical naturopathic anti-hypertensive treatment protocol may include the following:
-A recommendation to reduce weight by reducing carbohydrate intake. Keeping the waist circumference for women below 35 inches and for men below 40 inches is a good way to monitor oneself.
-Increasing exercise to get 10,000 steps per day (or at least three times per week), increases NO production and lowers hypertension.
-Fish oils: these are anti-inflammatory as well as antithrombotic (anti-clotting) and lower blood pressure, triglycerides and LDL cholesterol. Therapeutic dosages range from 1800 to 3000mg per day of both EPA and DHA essential fatty acids.
-Increase specific mineral intake such as calcium, magnesium and potassium, all of which have shown efficacy in the management of hypertension.
-Vitamin D is measured to maintain blood levels of 150nmol/l. Often over 3000IU’s of vitamin D per day are required.
-Hawthorne, gingko, CoQ10 are all useful for lowering blood pressure.
-A Mediterranean diet, high in vegetables, olive oil and fish improves NO levels in the arteries and can help reduce weight. Salt excess is a controversial contributor to hypertension. Naturopathic physicians address a lack of potassium as an underlying cause. Celtic grey salt contains trace minerals and is recommended over simple iodized table salt.
If you are already taking a blood pressure medication, I recommend a thorough discussion with your naturopathic doctor first, before beginning any alternative treatments.
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