High Blood Pressure (Hypertension)

Introduction

High blood pressure (hypertension) is an often insidious disease that may not present with symptoms. The most common type of hypertension is called "Essential Hypertension" for which there are many theories as to the cause. This site is designed to provide treatment options for this category of high blood pressure. If you are unsure about the type of hypertension you have, please consult with your physician. As well, it is important to discuss any changes you may wish to make to your current treatment plan with your physician.

Hypertension is diagnosed when your blood pressure is found to be consistently greater than 140/90, or greater than 135/80 if you are a diabetic.

Lifestyle considerations

LIfestyle modification is not only essential for adequate blood pressure control, but obviously the safest therapy. It should be considered as the initial approach the majority of the time. Often it is possible to normalize blood pressure with a change in lifestyle alone. There are, however, situations in which this alone would not be appropriate - such as in life or organ threateningly high pressure. There are also systemic disease processes that preclude adequate control without medical or surgical intervention.

Essential hypertension is the most common form of high blood pressure, the cause of which is rather ill defined. This is the type of high blood pressure for which lifestyle changes can result in the greatest change. It often exists with other "disease processes" becoming part of a syndrome called "Syndrome X", a diet-related phenomenom.

Diet

Diet is an often ignored part of the treatment of hypertension. But this is an unfortunate mistake. Though you may still need medication to keep your blood pressure in the desired range, the proper diet may decrease the amount of medicaion you need. The concept is relatively simple, as your weight creeps above your optimum, the potential for elevated blood pressure increases. A diet (I prefer to refer to this as a nutritional plan) that is high in vegetables and proteins relative to highly processed carbohydrates will not only help keep your weight at an optimal level, but will also provide the necessary nutrients for optimal health in general. Hypertension is NOT a consequence of aging - a life long unhealthy diet is often a major contributing factor.
Obesity
Excessive weight can contribute to elevated blood pressure. By following the general dietary concepts as outlined, and excercising regularly, your baseline weight can easily be controlled. See the section on Syndrome X for more information.
Caffeine
Caffeinated beverages including coffee, tea, and sodas can significantly raise blood pressure. If you already have high blood pressure, you should avoid ALL caffeinated products, including caffeine in pill form.
Alcohol
Chronic alcohol intake, beyond moderate intake (greater than two drinks per day) can also result in elevated blood pressure. If you have high blood pressure, it is worth a trial of abstinance to evaluate its effect on you.
Tobacco
Tobacco affects all aspects of your health, including blood pressure.
Medication
Certain medications contain compounds that acutely raise blood pressure. Generally, decongestants are notorious for this. A common medicaion in over-the-counter (OTC) preparations for colds and allergies is pseudoephederine (Sudafed). The herbal equivalent is ephedra (Ma Huang)- commonly found in diet and enegry boosting preparations. Carefully discuss all OTC medication and herbs with your physician as there are other medications and herbs than raise your blood pressure.
Exercise
Exercise can lower your blood pressure by increasing your cardiovascular health.
Relaxation techniques
Techniques such as meditation, yoga, deep breathing techniques, and biofeedback all have a role in helping to not only lower your overall stress level but also your blood pressure.

Dietary Considerations

See general dietary recommendations

In general, it is better to obtain necessary nutrients from your diet than from supplements. Your diet should therefore include the suggested groups of food. If there is still a deficiency, supplements may then be beneficial.
 
Potassium to Sodium radio

The average American has a potassium to salt ratio of less than 1:2. Resarch has shown that a ratio of at least 5:1 is necessary to maintain adequate health. This is ten time the average. It is not only necessary to monitor your intake of salt, but to ensure adequate potassium intake as well. Most vegetables and fruits have a K:Na ratio of at least 50:1. See the list of foods high in potassium.
Celery
A compound in celery, 3-n-butyl phthalid has been shown to reduce blood pressure.
Garlic and Onion
A diet liberal in garlic and onion may help lower blood pressure. Therapeutic doses (below) can result in a 5-10% decrease.
Nuts and seeds - For their essential fatty acids.
Cold water fish - Omega 3 content
Green leafy vegetables - Source of calcium and magnesium
Whole grains and legumes - For their fiber content.
Foods rich in vitamin C

Supplements

Garlic
 

Studies have shown that garlic can lower blood pressure levels about 5-10 percent.

Dose: 900 mg daily, standardized to contain 1.3% alliin (12,000 mcg alliin).
 

Coenzyme Q10

Several studies have shown CoQ10 to lower blood pressure. The effects are slow in becoming apparent however, taking four to twelve weeks. A reduction as much as 10 percent is typical. The mechanism for lowering blood pressure is poorly understood, but may lowering cholesterol levels and stabilizing the vascular system by its antioxidant properties.

Dose: 30-100 mg three times daily.

Fish oil

Fish oil is rich in the omega-3 fatty acids eicosapentanoic acid (EPA) and doscosahexaenoic acid (DHA). There are mixed studies regarding its effectiveness in lowering blood pressure, but some studies have shown a mild effect.

Dose: 3 to 9 mg per day.

Flaxseed oil

Flaxseed oil also has omega-3 fatty acids, though they are not the same as those in fish oil. While fish oil contains EPA and DHA, flaxseed oil contains alpha-linolenic acid (ALA). Studies for lowering blood pressure have concentrated on the omega-3 fatty acids in fish oil.

Dose: 1 to 2 teaspoons per day, in oil or capsule form.
 

Other Vitamins/Minerals
 
Calcium, magnesium, and potassium are all important for adequate blood pressure control. If there is a deficiency, supplementation may be of greater benefit. A daily dose of 750 mg of calcium and 350 mg of magnesium should be sufficient. Caution should be exercised with kidney disease.

Herbal Treatments

Hawthorn (crataegus oxyacantha)
 

Widely used in Europe for congestive heart failure, may have a mild blood pressure lowering effect. The effects may take up to four weeks to be apparent.

Dose: 100-300 mg three times daily. Extract standardized to 2-3% flavonoids or 18-20% procyanidins.

Conclusion

Hypertension is usually a progressive disease that may not have symptoms. The most common type, essential hypertension, can be treated with lifestyle modifications such as a change in diet, weight loss, abstinence from caffeine, alcohol, and smoking. Your diet should ensure a high potassium to sodium ratio, liberal use of onions, garlic and celery, plenty of nuts and seeds, cold water fish, green leafy vegetables, whole grains and legumes, and foods rich in vitamin C.

Supplements that may help lower blood pressure:

Garlic: 900 mg daily, standardized to contain 1.3% alliin (12,000 mcg alliin).
Coenzyme Q10: 30-100 mg three times daily.
Fish Oil: 3 to 9 mg per day.
Flaxseed oil: 1 to 2 teaspoons per day, in oil or capsule form.
Calcium: 750 mg
Magnesium: 350 mg
Potassium:

Herbal Treatments

Hawthorn: 100-300 mg three times daily. Extract standardized to 2-3% flavonoids or 18-20% procyanidins.

 

See information about atherosclerosis for more.