Ask The Professional: Hypertension

Posted by | April 22, 2010 | Blog | No Comments

Dear Dr Diana
Please tell me about natural treatments for hypertension?

Blood pressure is the force of blood pushing against the walls of arteries (blood vessels). Each time the heart beats, it pumps blood through blood vessels, supplying the body’s muscles, organs and tissues with the oxygen and nutrients that they need to function. Over the course of a day, an individual’s blood pressure rises and falls transiently many times in response to various stimuli. Elevated blood pressure over a sustained period of time is a condition referred to as hypertension

Obesity: Individuals with a body mass index (BMI, or body fat content) of 30.0 or higher are more likely to develop high blood pressure. An individual is considered underweight if their BMI is less than 18.5. A BMI of 18.5 to 24.9 is considered a “normal” weight. A BMI of 25 to 29.9 is considered overweight. Individuals who fall into the BMI range of 25-34.9 begin having some health risk concerns, such as the development of diabetes, hypertension (high blood pressure), and heart disease. Specifically those who have a waist size of more than 40 inches for men, or 35 inches for women, have a higher risk for obesity-related health problems. A BMI of 30 or more qualifies as individual as obese. A BMI over 40 indicates that a person is morbidly obese. The greater the number, the greater the chances of developing health concerns.

Salt sensitivity: Salt (or sodium chloride) contains sodium, which may cause fluid retention and thereby cause pressure around the blood vessels which can lead to hypertension. It is noted that approximately 60% of the essential hypertension population may decrease blood pressure (BP) by decreasing sodium (salt) intake.

Drinking too much alcohol: Chronic (long-term) use of alcohol can increase blood pressure dramatically by placing stress on the heart and blood vessels.

Lack of physical activity: An inactive lifestyle makes it easier to become overweight and increases the chance of high blood pressure. Physical inactivity increases the risk of hypertension by 30%.

Smoking: Cigarette smoking can repeatedly produce a temporary rise in blood pressure (BP) of approximately 5-10mmHg. This effect may be most prominent with the first cigarette of the day in habitual smokers. However, research indicates that habitual or chronic (regular) smokers in general have lower BP than non-smokers, possibly due to weight loss associated with smoking. Experts agree that smoking should be avoided in any person with high blood pressure because it can substantially increase the risk of secondary cardiovascular complications such as atherosclerosis (hardening of the arteries) and appears to enhance the progression of kidney disease. Cigarette smoking also increases the chances of men having erectile dysfunction (ED), or the inability to get or maintain and erection.

Stress: Stress is a normal part of everyday life. Responses to stress vary from person to person, but chronic (regular) stress can lead to an increase in the release of the stress hormone cortisol from the adrenal glands (above the kidneys). Cushing’s disease can also cause too much cortisol to be released. Scientists think that excess cortisol can lead to an increase in blood pressure, an inability of insulin to control blood sugar (insulin sensitivity), inflammation, and weight gain.

Ethnicity (race): African Americans develop high blood pressure more often than Caucasians, and it tends to occur earlier and be more severe. Compared to other groups, African Americans tend to get high blood pressure earlier in life, usually have more severe high blood pressure, and have a higher death rate from stroke (lack of blood and oxygen to the brain), coronary heart disease CHD, or the lack of blood and oxygen to the heart), and kidney failure.

Heredity: Having a parent or other close blood relatives with high blood pressure increases the chances of developing it.

Age: In general, blood pressure increases with age, occurring most often in people over age 35. Men seem to develop it most often between age 35 and 55. Women are more likely to develop it after menopause. Over half of all Americans aged 60 and older have high blood pressure.

Diet: A diet poor in fruits, vegetables, and whole grains and high in sodium (salt), high fat foods such as dairy (milk, cheese, sour cream), animal fat, and fried foods (potato chips, French fries, fried chicken) can lead to high cholesterol levels in the blood, which can lead to high blood pressure.

Strong scientific evidence:

Magnesium: Intravenous magnesium sulfate (MgSO4) is commonly administered in cases of preeclampsia and eclampsia. MgSO4 is a superior drug for the prevention of the recurrence of seizures in eclampsia and in seizure prevention in preeclampsia.

A common but not serious side effect of MgSO4 therapy is flushing. Use cautiously in patients with bleeding disorders, or in those taking anticoagulants or antiplatelet agents, antidiabetic agents, or antihypertensive agents. Use intravenous magnesium sulfate with extreme caution in patients with eclampsia. Avoid in patients with atrioventricular heart block, renal failure, or severe renal disease. Avoid intravenous magnesium in women with toxemia during the first few hours of labor.

Omega-3 fatty acids: Omega-3 fatty acids are essential fatty acids found in some plants and fish. There should be a balance of omega-6 and omega-3 fatty acids for health. Multiple human trials report small reductions in blood pressure with intake of omega-3 fatty acids. DHA, or docosahexaenoic acid, may have greater benefits than EPA, or eicosapentaenoic acid. However, high intakes of omega-3 fatty acids per day may be necessary to obtain clinically relevant effects, and at this dose level, there is an increased risk of bleeding. There is strong scientific evidence from human trials that omega-3 fatty acids from fish or fish oil supplements significantly reduce cholesterol levels, which may also help patients with hypertension.

Omega-3 supplements can cause an increase in bleeding in susceptible individuals including those taking blood thinning medications such as warfarin (CoumadinĀ®). Avoid if allergic or hypersensitive to fish, omega-3 fatty acid products that come from fish, nuts, linolenic acid, or omega-3 fatty acid products that come from nuts. Use cautiously before surgery. Pregnant and breastfeeding women should not consume doses that exceed the recommended dietary allowance (RDA).

Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy over 2,000 years ago. Several human studies support the use of yoga in the treatment of high blood pressure (hypertension) when practiced for up to one year. It is not clear if yoga is better than other forms of exercise for blood pressure control. Yoga practitioners sometimes recommend that patients with high blood pressure avoid certain positions, such as headstands or shoulder stands (inverted asanas), which may increase blood pressure.

Yoga is generally considered to be safe in healthy individuals when practiced appropriately. Avoid some inverted poses with disc disease of the spine, fragile or atherosclerotic neck arteries, extremely high or low blood pressure, glaucoma, detachment of the retina, ear problems, severe osteoporosis, cervical spondylitis, or if at risk for blood clots. Certain yoga breathing techniques should be avoided with heart or lung disease. Use cautiously with a history of psychotic disorders. Yoga techniques are believed to be safe during pregnancy and breastfeeding when practiced under the guidance of expert instruction. However, poses that put pressure on the uterus, such as abdominal twists, should be avoided in pregnancy.

Good scientific evidence:

Calcium: Calcium is the most abundant mineral in the human body. Several studies have found that calcium may have hypotensive (blood pressure lowering) effects. These studies indicate that high calcium levels lead to sodium loss in the urine, and lowered parathyroid hormone (PTH) levels, both of which result in the lowering of blood pressure. However, one study found that these results did not hold true for middle-aged patients with mild to moderate essential hypertension. In the DASH (Dietary Approaches to Stop Hypertension) study, three servings per day of calcium enriched low-fat dairy products reduced systolic and diastolic blood pressure. This research indicates that a calcium intake at the recommended level may be helpful in preventing and treating moderate hypertension. Treatment of hypertension should only be done under supervision of a qualified healthcare professional.

Avoid if allergic or hypersensitive to calcium or lactose. High doses taken by mouth may cause kidney stones. Avoid with high levels of calcium in the blood, high levels of calcium in urine, hyperparathyroidism (overgrowth of the parathyroid glands), bone tumors, digitalis toxicity, ventricular fibrillation (rapid, irregular twitching of heart muscle), kidney stones, kidney disease, or sarcoidosis (inflammatory disease). Calcium supplements made from dolomite, oyster shells, or bone meal may contain unacceptable levels of lead. Use cautiously with achlorhydria or irregular heartbeat. Calcium appears to be safe in pregnant or breastfeeding women. A healthcare provider should be consulted to determine appropriate dosing during pregnancy and breastfeeding.

Coenzyme Q10 (CoQ10): Coenzyme Q10 (CoQ10) is produced by the human body and is necessary for the basic functioning of cells. CoQ10 levels are reported to decrease with age and to be low in patients with some chronic diseases such as heart conditions, muscular dystrophies, Parkinson’s disease, cancer, diabetes, and HIV/AIDS. Some prescription drugs may also deplete CoQ10 levels, such as HMG Co-A inhibitors, or statin drugs, for high cholesterol. Preliminary research suggests that CoQ10 causes small decreases in blood pressure (systolic and possibly diastolic). Low blood levels of CoQ10 have been found in people with hypertension, although it is not clear if CoQ10 deficiency is a cause of high blood pressure. Well-designed long-term research is needed.

Allergies associated with Coenzyme Q10 supplements have not been reported in the available literature. However, rash and itching have been reported rarely. Stop use two weeks before and immediately after surgery/dental/diagnostic procedures with bleeding risks. Use cautiously with a history of blood clots, diabetes, high blood pressure, heart attack, or stroke. Use cautiously if taking anticoagulants (blood thinners) or anti-platelet drugs, blood pressure drugs, blood sugar drugs, cholesterol drugs, or thyroid drugs. Avoid if pregnant or breastfeeding.

Hibiscus: Hibiscus (Hibiscus spp.) has been used for centuries by Ayurvedic (Hindu) and Chinese medical practitioners. Human studies have shown that extracts of hibiscus may lower systolic and diastolic pressure. In one study, hibiscus standardized extract worked as well as captopril (CapotenĀ®), a commonly used angiotensin converting enzyme (ACE) inhibitor, in lowering blood pressure. Additional high-quality studies comparing hibiscus to placebo are needed to confirm these results, although the use of hibiscus for hypertension looks promising. Caution is advised when taking hibiscus, as numerous adverse effects including diuresis (increased excretion of fluid) can occur.

Avoid if allergic or hypersensitive to hibiscus, its constituents, or members of the Malvaceae family. Use cautiously with hypertension or hypotension. Hibiscus rosa-sinensis has exhibited antifertility activity, and the benzene extract of the flower petals may suppress implantation. Use cautiously if pregnant or trying to get pregnant, or breastfeeding.

Meditation: Various forms of meditation have been practiced for thousands of years throughout the world. In general, it appears that regular practice of meditation may promote relaxation and reduce blood pressure. More research is needed before recommendations can be made. However, meditation can be recommended, in addition to healthy diet and exercise, for the prevention (versus treatment) of hypertension.

Use cautiously with underlying mental illnesses. People with psychiatric disorders should consult with their primary mental healthcare professionals before starting a program of meditation and should explore how meditation may or may not fit in with their current treatment plans. Avoid with risk of seizures. The practice of meditation should not delay the time to diagnose or treat the condition with more proven techniques or therapies. Meditation should not be used as the sole approach to illnesses.

Qi gong: Qi gong is a type of Traditional Chinese Medicine (TCM) that is thought to be at least 4,000 years old. There are two main types of Qi gong practice: internal and external. Internal Qi gong is a self-directed technique that involves the use of sounds, movements, and meditation. Internal Qi gong actively engages people in their own health and well-being, and can be performed with or without the presence of a Master instructor. It may be practiced daily to promote health maintenance and disease prevention. Several human trials suggest benefits of Qi gong in the treatment of high blood pressure, particularly when added to conventional treatments such as prescription drugs. There is early evidence that there may be lower death rates in people with high blood pressure who practice Qi gong. Some studies report that high blood pressure associated with pregnancy may be partially controlled through internal Qi gong relaxation exercises. Although this research is promising, a major problem is that the way Qi gong is practiced is not always clear in these studies, and may not be similar to the way Qi gong is practiced in the community.

Qi gong is generally considered to be safe in most people when learned from a qualified instructor. Use cautiously with psychiatric disorders.

Stevia: Stevia (Stevia rebaudiana) standardized extracts are used as natural sweeteners and dietary supplements. Stevioside is a natural plant component isolated from stevia that has demonstrated blood pressure lowering effects. Despite evidence of benefits in some human studies and support from laboratory and animal studies, more research is warranted to compare stevia’s effectiveness for hypertension with the current standard of care.

Dr Lorenzo Diana ND
Doctor Of Naturopathic Medicine

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