Hypertension/High Blood Pressure

High Blood Pressure – Symptoms, Causes & Natural Treatment

Hypertension, in short High Blood Pressure is defined as a sustained rise in resting blood pressure above 140/90 mmHg. Blood pressure that is persistently between 120/80 and 140/90 is known as pre-hypertension and increases the risk of hypertension.

Hypertension significantly increases the risk of atherosclerosis, coronary heart disease, left ventricular hyperplasia, stroke, aneurysm and damage to the retina and kidney.

Generally people with hypertension are four times more likely to experience a major cardiovascular event. Also, it is believed to contribute to 75% of all strokes and heart attacks.

Hypertension may be classified as:

• Primary (or essential) hypertension: accounts of 90-95% of cases. Orthodox medicine defines this as idiopathic (no known cause); however, a complementary medicine approach considers a number of risk factors (see below)
• Secondary hypertension: most commonly caused by kidney disease; other causes include endocrine disorders and pregnancy

Causes & Risk Factors of High Blood Pressure / Hypertension

Primary (essential) hypertension

• Genetic predisposition
• Increasing age (due to stiffening of blood vessels): more prevalent in men and post-menopausal women
• Obesity: highly correlated with hypertension
• Stress, anxiety, repressed anger: increases sympathetic nervous system activity
• Poor diet: for instance, high sodium, high sugar, and/or low fibre, low potassium intake
• Excessive alcohol or caffeine intake (> 5 cups /day)
• Smoking
• High homocysteine levels: an independent risk factor for increased systolic pressure
• Excessive or lack of exercise
• Insulin resistance and diabetes
• Low levels of nitric oxide (NO in the endothelium needed for vasodilation)
• Heavy metal toxicity or toxic chemical exposure

Secondary hypertension

• Chronic kidney disease
  • Renal artery stenosis
  • Adrenal disorders (Cushing‘s syndrome)
  • Hyperparathyroidism
  • Pregnancy (pre-eclampsia)
  • Sleep apnea
  • Alcoholism
  • Long term use of NSAIDs, especially in the elderly
  • Certain medications e.g. OCP/ HRT, pseudoephedrine, steroids, diet pills, licorice
  • Recreational drug use e.g. cocaine, amphetamines, nicotine

Signs & symptoms of High Blood Pressure

• Mostly asymptomatic
• Very severe hypertension (malignant hypertension) may give rise to headaches, dizziness, nausea and vomiting, confusion, vision changes and nosebleeds

Treatment Strategy for High Blood Pressure

• Identify / address underlying risk factors:
  • Bacterial overgrowth of the gut
  • Methylation and MTHFR polymorphism
  • Dietary factors
  • Insulin resistance
  • Obesity
  • Sedentary lifestyle
  • Alcohol, tobacco & caffeine consumption
  • Stress
  • Homocysteine levels
• Enhance vasodilation and arterial elasticity
• Reduce stress

Diet plan guidelines 

Dietary changes are essential for achieving and maintaining normal blood pressure.

• Fresh, whole food, low-GI diet high in fibre, fruits and vegetables, fish, plant proteins and healthy fats:
  • The Mediterranean Diet has been shown to significantly improve dyslipidaemia, blood pressure and CHD risk.  A Paleo diet and other whole food diets are also indicated.  Meat should be from a grass fed source and ideally organic.
  • Salt reduces activity of nitric oxide (NO) synthase in the arteries, causing a reduction in elasticity and an increase in blood pressure. Sodium also causes the kidneys to retain more water, which raises the levels.
  • ought to be more beneficial than table salt as it retains other minerals such as magnesium, potassium and calcium, which help to offset the effects of sodium.
  • The NHMRC has set the Adequate Intake of salt at 1.15-2.3 g/day. The average Australian consumes around 10 g of salt per day with 75% coming from processed foods with added salt.
  • Individuals with hypertension should limit salt intake to 1.5 g/day and be educated to read labels carefully

• Increase potassium-containing foods:

  a diet high in potassium is important as potassium reduces the effects of sodium. Potassium-rich foods, for instance, green leafy vegetables, sweet potato, potato, legumes, avocado, bananas, rockmelon, mango and papaya.

• Increase magnesium-containing foods:

  magnesium is important for relaxing smooth muscle, including that in arterial walls. Magnesium rich foods include green leafy vegetables, whole grains, nuts and seeds and cocoa.

• Increase calcium-containing foods:

  low calcium intakes have been linked to higher blood pressure, especially in salt-sensitive individuals. Ensure adequate calcium intake through dairy (if tolerated), green leafy vegetables, nuts and seeds, bony fish, tofu, tahini.

• Increase fibre intake:

  fruits and vegetables, whole grains if tolerated, legumes, psyllium, oat bran

• Low GL diet:

  high insulin levels cause rises the levels. Therefore,
• a diet low in sugars and refined carbohydrates and high in fibre and healthy fats can assist with lowering blood pressure

• Dietary bioflavonoids:

  enhance nitric oxide status and improve endothelial function; found in green tea, citrus fruits, onions, dark chocolate, red wine.

• Include garlic, onion and ginger in the diet:

  reduces blood viscosity

• Avoid excessive alcohol consumption:

  more than 3 drinks in one session temporarily increases blood pressure and repeated binge drinking can lead to long-term increases. Hence, alcohol should be consumed in moderation

• Avoid excessive caffeine:

  the effects of caffeine are considered temporary, but caffeine appears to cause an increase in average blood pressure in some people. This effect appears to be most pronounced in men over the age of 70 or who are overweight. It is recommended to limit caffeine consumption to no more than 2 cups of coffee per day

• Weight loss diet:

  obesity and hypertension are highly correlated. If obesity is a factor, a weight loss diet is essential.

Supplements that support High Blood Pressure / Hypertension

• Enhance vasodilation / reduce blood pressure
  • Magnesium
  • Potassium
  • CoQ10
  • Arginine – needed for nitric oxide production
  • Omega-3 fatty acids
  • Taurine: lowers blood pressure via renin-angiotensin system
  • Vit D3 (depending on status) – regulates blood pressure via renin- angiotensin system

Reduce blood viscosity

• Vitamin E – start with low dose and monitor BP; slowly increase

Herbal medicine Treatment that supports High Blood Pressure

– Licorice is contraindicated in hypertension.

• Hypotensives – hawthorn, mistletoe, motherwort, olive leaf, astragalus, coleus, cramp bark
• Peripheral vasodilator – hawthorn, lime flower, mistletoe, yarrow
• Blood-thinning – gingko, ginger
• Diuretics – dandelion leaf, bear berry, celery, cleavers
• Relaxing nervines -valerian, passionflower, chamomile, scullcap, hops, motherwort, lime flowers

Lifestyle / Physical measures

• Regular aerobic exercise 30 mins daily: important to lower blood pressure
• Relaxation: massage, yoga, deep breathing, qi gong
• Acupuncture or chiropractic spinal manipulation may be useful
• Quit smoking
• Lose weight if necessary

FUNCTIONAL MEDICINE TREATMENT OF HIGH BLOOD PRESSURE

High blood pressure is a very common condition that affects many people as they age.  Therefore understanding what mechanism is driving the hypertension is important in order to permanently reduce the levels as there are many factors contributing it.   Addressing methylation, nutrient insufficiencies such as riboflavin, folate and B12, methylation imbalances, gut dysbiosis, SIBO and dietary and lifestyle measures are vital in improving a stubborn high blood pressure. 

At our Perth clinic of Advanced Functional Medicine we have experience with patients that have had long standing issues with blood pressure.  

If you or a family member are suffering from high blood pressure we would love to hear from you.  What measures have you taken to reduce your blood pressure and what has worked the best for you?  Have you improved your gut health and methylation status and seen great results?  We would love to hear your story, please leave a comment below. 

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