Conditions

Hypertension/High blood pressure

Hypertension (high blood pressure) places a strain on the arteries that can lead to serious problems throughout the body. It's one of the greatest risk factors for cardiovascular disease.

There is no single blood pressure reading that is normal for everyone. Most newborns have systolic (blood pressure when the heart contracts to push blood out) between 20 and 60, and that number generally rises progressively throughout life. For healthy adults, however, a reading of 120/80 (120 is the systolic and 80 is the diastolic ­ or pressure when the heart is relaxed) is widely considered the norm.

Blood pressure varies throughout the day in response to your level of activity, stress, and other factors. Blood pressure also normally rises somewhat with age. Tense or excitable individuals often experience a rise in blood pressure simply as a result of having their blood pressure read, which results in a false reading.

Poor dietary choices, lack of exercise, and multiple stresses are all contributing factors to hypertension. High blood pressure has also been linked to diet, alcohol consumption, smoking, the use of stimulants, drug abuse, excessive consumption of sodium and caffeine, and obesity. In some cases, women on birth control pills develop hypertension, and a rise in blood pressure is not uncommon during pregnancy.

Signs and Symptoms:

Essential hypertension has no symptoms except in extreme cases or after cardiovascular complications result. Extremely high blood pressure may cause headaches.

Severe hypertension or hypertensive crisis (usually secondary hypertension) with end-organ damage may produce headache, nausea and vomiting, seizure, retinopathy, and other symptoms.

Diagnosis:

Hypertension is diagnosed through blood pressure measurements.

Treatment Options:

The goal of treatment is to lower the risk of future cardiovascular damage by lowering the blood pressure.

Traditional Treatments:

• If lifestyle changes such as losing excess weight and restricting your salt intake do not bring your blood pressure down to 160/100 or below, your doctor will probably prescribe medication to lower the pressure.
• A diuretic is often the first drug prescribed for high blood pressure. Diuretics promote the excretion of fluids through the kidneys, thus lowering the amount of fluid circulating in the bloodstream. This reduces the pressure. The so-called thiazide diuretics are the type most commonly prescribed. Examples of this include chlorothiazide (Diuril) and hydrochlorothiazide (HydroDiuril).
  Beta-blockers are drugs that inhibit the transmission of certain nerve impulses, causing the heart to slow its rate and lower its output of blood. This in turn lowers blood pressure.
• Angiotensin-converting enzyme (ACE) inhibitors are a more recent entrant in the field of blood-pressure medication. These drugs inhibit the production of an enzyme that causes the formation of angiotensin, a hormone that is a potent blood-vessel constrictor, thus relaxing the vessels and lowering blood pressure. They also have other mechanisms of action that are not understood. Examples include captopril (Capoten), enalapril (Vasotec), and ramipril (Altace).
• Calcium-channel blockers block the transfer of calcium ions into smooth-muscle cells. This has the effect of relaxing blood vessels and lowering blood pressure. Members of this class of drug include diltiazem (Cardizem), nifedipine (Adalat, Procardia), and verapamil (Calan).
• Alpha-blockers lower blood pressure by dilating blood vessels. They may also lower total blood cholesterol and triglyceride levels. Doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin) are examples of this kind of drug.
• Central alpha agonists such as clonidine (Catapres), methyldopa (Aldomet), and guanfacine (Tenex) lower blood pressure by reducing constriction of blood vessels.
• If an individual drug proves to be inadequate, two or more different medications may be combined for greater effect.
• People with high blood pressure usually have high triglyceride and/or cholesterol levels. Unfortunately, many (if not all) of the drugs used to lower blood pressure tend to raise triglycerides and/or cholesterol. If you must take medication for high blood pressure, it is important to maintain regular, communication with your healthcare provider and undergo periodic testing to monitor the situation.

Complementary and Alternative Therapies:

Mind-body techniques (such as biofeedback, yoga, meditation, and stress management), nutritional and herbal support may be effective in improving hypertension and concurrent pathologies.

Nutritional Supplementation:

• Calcium deficiencies have been linked to high blood pressure. Take 1,500 to 3,000 mg daily with 750 to 1,000 mg of magnesium daily.
• Extra potassium is needed if you are taking cortisone or high blood pressure medication, take extra potassium to counteract depletion of this mineral.
• Coenzyme Q10 with Coenzyme A improves heart function. Follow label directions.
• Essential fatty acids are important for circulation and for lowering blood pressure. Follow label directions.
• Garlic is effective in lowering blood pressure. Take 2 capsules 3 times daily.
• L-Arginine has been shown to play an increasingly important role in heart health by lowering blood pressure and cholesterol levels.
• L-Carnitine transports long fatty acid chains. Together with L-glutamic acid and L-glutamine, aids in preventing heart disease. Take 500 mg twice daily of L-Carnitine and 500 mg each daily of L-glutamic acid and L-glutamine. Take all three on an empty stomach.
• Selenium deficiency has been linked to heart disease. Take 200 mcg daily.
• Vitamin E improves heart function. Start with 100 IU daily and add 100 IU daily each month, until you reach 400 IU daily.
  Warning: If you have high blood pressure limit your intake of supplemental vitamin E to 400 IU daily. If you are taking blood thinners, consult your doctor before taking supplemental vitamin E.
• Carnitine has a proven track record for protecting the heart, a particularly important consideration if you are taking bet-blockers, which work by interfering with the nerve and muscle actions of that organ. Take 500 mg of L-carnitine once or twice daily.
• Lecithin helps emulsify fat, and can be effective if you have a history of alcohol consumption. Take 1,200 mg two or three times daily, with meals.
• People who are deficient in vitamin C are more likely to have high blood pressure than are those who maintain an adequate intake of this important vitamin. Take 1,000 mg of each twice daily.

Alternative Therapies:

• Hawthorn berry is one of the most broadly prescribed herbal medicines in Europe. This herb brings down high blood pressure, lowers blood cholesterol, and helps regulate heart function. Choose a standardized extract containing 1.8 percent vitexin-2 rhamnosides and take 100 to 200 mg two or three times a day.
• Parsley is a natural diuretic and is also high in potassium, which is known to reduce elevated blood pressure.
• Siberian ginseng is especially helpful if you have high blood pressure and also suffer from fatigue. Choose a standardized extract containing 0.5 percent eleutheroside E and take 100 mg daily in the morning.
  Warning: Do not substitute Chinese (Korean) or American ginseng for Siberian ginseng. You should not use Chinese or American ginseng if you have high blood pressure.
• Cayenne (capsicum), chamomile, fennel, hawthorn berries, parsley, and rosemary for high blood pressure.
  Warning: Do not use chamomile on an ongoing basis, as ragweed allergy may result. Avoid it completely if you are allergic to ragweed.
• Hops and valerian root are good for calming the nerves.
• Drink 3 cups of suma tea daily.

General Recommendations:

• Follow a strict salt-free diet. Some foods and food additives that should be avoided on this diet include monosodium glutamate (Accent, MSG); baking soda; canned vegetables (unless marked sodium or salt-free); commercially prepared foods; over-the-counter medications that contain ibuprofen (such as Advil or Nuprin); diet soft drinks; foods with mold inhibitors, preservatives, and/or sugar substitutes; meat tenderizers; softened water; and soy sauce.
• Eat a high-fiber diet and take supplemental fiber. Oat bran is a good source of fiber. Always take supplemental fiber separately from other supplements and medications.
• Avoid all animal fats.
• Avoid all alcohol, caffeine, and tobacco.
• Keep your weight down.
• Be sure to get sufficient sleep.
• If you are pregnant, have your blood pressure monitored frequently by your health care provider. Untreated hypertension in pregnancy can progress suddenly and pose a serious threat to both mother and child.
• Do not take antihistamines except under a physician's directions.
• Do not take supplements containing the amino acids phenylalanine or tyrosine.
• As much as possible, avoid stress.
• Get regular moderate exercise.

Warnings:

• Avoid the herbs ephedra (ma huang) and licorice, as these herbs can elevate blood pressure.
• If you have high blood pressure limit your intake of supplemental vitamin E to 400 IU daily.
• If you are taking blood thinners, consult your doctor before taking supplemental vitamin E.
• Do not substitute Chinese (Korean) or American ginseng for Siberian ginseng. You should not use Chinese or American ginseng if you have high blood pressure.
• Do not use chamomile on an ongoing basis, as ragweed allergy may result. Avoid it completely if you are allergic to ragweed.