Preventive Med Associates offers alternative treatments for hypertension.

Everyone's blood pressure varies during the course of the day. As you'd expect, it's lower when you're resting or relaxed and higher after activity, especially a sudden burst of activity. Some people have what's referred to as "white coat syndrome," which simply means that the experience of having their blood pressure taken in a doctor's office will boost their reading. For this reason, most prudent doctors will not prescribe pressure-lowering medication after the first high reading; they'll wait until they've seen a pattern of several high readings before thinking about medication.

Before you begin to worry about your blood pressure reading, be sure that you're getting a number that reflects your real pressure. Certain drugs can elevate your pressure. For example, phenylpropanolamine (PPA), an ingredient which is commonly found in many over-the-counter medications including cold remedies, decongestants, and appetite-suppressants, can elevate your pressure, as can caffeine. An alarmingly high reading can result from taking a decongestant and two cups of coffee an hour before a reading.

The big questions today are determining when hypertension needs to be treated with medication and how much the pressure should be reduced by means of medication. There's been considerable controversy about this. Years ago researchers linked hypertension with an increased rate of heart attack and stroke. Yet studies that tried to demonstrate the value of reducing blood pressure produced a decrease only in the number of strokes while the number of heart attacks remained the same. The key seems to be that if the pressure is reduced either too much or too little, the danger of heart attack is still present. The latest studies recommend moderate reductions in the range of 7 to 17 mmHg for people with mild to moderate hypertension. This provides yet another incentive to avoid medication, as blood pressure controlled naturally is less likely to be reduced either too much or too little. If you've got severe hypertension, you will no doubt need drug therapy. But if your diastolic pressure is between 90 and 104, you may well be able--depending on your family history and other lifestyle factors--to avoid drugs and rely on natural means to get your pressure under control.

If you already know that you have high blood pressure and are on medication, you should not stop taking it. Instead, after consultation with your doctor, adopt the measures I recommend, and then after a sufficient trial period--say a month or two--get a pressure reading that will indicate if the new steps you're taking are having an effect. It's quite likely that your pressure will be lower and you'll be able to reduce your medication.

If you have a "high normal" pressure reading, you're in a great position to profit from the help that natural medicine can offer. By adopting the suggestions below, you'll probably be able to lower your pressure naturally and avoid medication entirely. While we don't know precisely what causes hypertension, we do know that it's primarily a lifestyle disease that's found almost entirely in developing nations. People who live in remote areas of the globe including parts of China, the Solomon Islands, and New Guinea, for example, show virtually no evidence of hypertension, nor do they have a rise in blood pressure as they age.

The first step in reducing blood pressure is changing your diet, particularly if you are overweight. In one study where various means of treatments were tried in an effort to lower pressure, weight loss was by far the most effective. Some people are discouraged when they hear this because they've tried dieting and found it difficult. But you don't have to get down to your ideal weight in order to reduce your pressure. If you're overweight, even a small drop can lower your pressure significantly. So don't feel overwhelmed by having to lose twenty or fifty pounds: Just aim for five or ten pounds. You may well want to go on and lose additional weight, if need be, once you achieve this goal.

A vegetarian diet has been shown to be prophylactic against hypertension. Most vegetarians enjoy lower blood pressure readings than meat eaters. The reason is that the components of a vegetarian diet--more fiber, vitamin C, vitamin E, magnesium, calcium, potassium, and significantly less salt and less total fat, saturated fat, and cholesterol--help to fight hypertension. I don't advise my patients to become vegetarians. Many people don't do well as vegetarians; they feel tired and run-down on a vegetarian diet, especially if they have been eating sugars and have low blood sugar. And for many people it's impractical to go a strictly vegetarian diet. But some of my patients are vegetarians and are quite robust and healthy. While strict vegetarianism may not be sensible for many patients, I do advise them to adopt as many of the aspects of a vegetarian diet as possible, particularly the reduction of saturated fat and cholesterol. Studies have been done with Finns, who eat more saturated and less polyunsaturated fats compared with Americans, and who have a higher incidence of hypertension. When their saturated fat intake was decreased, despite the fact that their sodium intake was unchanged, they experienced an average pressure drop of 7.5 mmHg systolic and 2.8 mmHg diastolic. When their previous, high saturated fat intake levels were resumed, their pressure once again went up.

Sodium or salt has always been an issue for people with hypertension. In the past it was assumed that if you had high blood pressure you had to eliminate salt from your diet. Today we know that not everyone with hypertension is salt sensitive. In fact, only about 30 to 40 percent of the population is sensitive to salt. If you have heart or kidney problems in addition to high blood pressure, you should definitely avoid salt, because your body doesn't properly eliminate sodium. But if you're restricting sodium solely for hypertension, you might want to test yourself to see if sodium restriction is doing you any good. After having your pressure taken, follow a diet that is as sodium-free as possible for two weeks.

Have your pressure taken again. You can do the opposite if you've been avoiding salt: Try two weeks of a diet that does include salt and see what effect, if any, it has on your blood pressure reading.

If, however, you are salt sensitive, you should probably restrict your salt intake and increase your potassium intake. Many people who are salt sensitive not only consume too much salt but also get too little potassium in their diet. This causes an increase in fluid volume and an impairment of the blood pressure regulating mechanism. You can either rely on potassium supplements or you can make a concerted effort to get it from food sources. In one study, people were able to reduce medications for hypertension by half simply by consuming a diet rich in potassium. Particularly good sources are fresh fruits and vegetables such as potatoes, peas, peppers, eggplant, pears, squash, lima beans, tomatoes, and bananas.

A diet that is low in fiber will promote hypertension as well as a host of other chronic ailments. The benefits of a high-fiber diet are dramatic in someone whose pressure is high. I don't recommend taking fiber supplements, but I do think an emphasis on fresh vegetables, fruits, and whole grain cereals, breads, and pastas is important. Another good way to increase your fiber intake, which I recommend to my patients, is to have a bowl of oat bran cereal or other high-fiber cereal for breakfast.

Recent research has proven that celery can have a beneficial effect on hypertension. It lowers the blood pressure by relaxing smooth muscles in the blood vessels themselves. Despite the fact that celery is often forbidden to people with hypertension because of its high sodium content, its benefits are now recognized. Four stalks of celery daily will provide sufficient amounts of the active chemical that causes the desired effect. Don't overdose on celery because it can be toxic in extremely large amounts. And don't take it if you are sodium sensitive. But I think it's worth trying a week of three or four daily stalks of celery before a pressure reading to see if it works for you.

If you drink alcohol, you're much more likely to suffer from hypertension. In men, 5 to 11 percent of hypertension has been attributed to alcohol. One hospital survey showed that over half of the admitted men whose daily alcohol consumption exceeded the equivalent of four pints of beer, had hypertension. Despite the reports that "moderate" alcohol intake has a certain protective effect, I tell patients with any degree of hypertension that they should completely eliminate alcohol from their diet. I believe that the alcohol's possible protection from coronary artery disease isn't worth the definite myocardial damage and risk of hypertension. Fortunately the negative effects of alcohol on your blood pressure will disappear when you stop drinking.

There are also a number of supplements that can be helpful. The first pair to look at are calcium and magnesium. I mention them together because they work together in the body and because low levels of both these minerals have been found to be associated with high blood pressure. We know that there's a relationship between calcium and blood pressure, though there is some controversy about exactly what the relationship is. It may be calcium's interaction with magnesium and particularly sodium that affects the pressure. In any case, some studies have shown definite benefits for some patients who take calcium and magnesium, and no change in others. I suggest that you take both calcium and magnesium supplements on a trial basis for two months. If you see a reduction in your pressure, you should continue with the supplements; if not, discontinue.

Coenzyme Q10 is a supplement that's been extremely helpful for many people with cardiovascular disease, including hypertension. It's believed that CoQI0 improves the function of the blood vessel wall and thus helps regulate blood pressure. In one ten-week trial, hypertensive patients taking CoQI0 experienced a mean systolic and diastolic pressure reduction of 10.6 and 7.7 mmHg, respectively, during their treatment, while the group taking a placebo had no change.

We know that there's a connection between fish oil and the omega-3 fatty acids in fish oil and regulation of blood pressure. Many studies have shown reduction of pressure when taking fish oil either in the form of a supplement, an increase in fish consumption, particularly mackerel (which is high in omega-3 fatty acids). I think the best way to supplement with omega-3 fatty acids is through MaxEPA (a trade name for a fish oil preparation), which is available at health food stores.

Garlic has been shown to decrease the systolic pressure by 20 to 30 mmHg and diastolic pressure by 10 to 20 mmHg. I tell my patients to enjoy garlic in food as often as possible. As you need to take two to three cloves of fresh garlic daily to get a therapeutic benefit, many people prefer to take supplements, available in an odor-free form at health food stores.

Vitamin C, so useful for so many metabolic functions, has also recently been found to help regulate blood pressure. While studies haven't yet shown it effective at reducing diastolic pressure, it definitely can help reduce the systolic reading.

Exercise can be extremely effective in treating hypertension. In one recent study, people with moderate hypertension lowered their pressure using only exercise. These people adhered to a six-month program of a half-hour of aerobic exercise three or four times a week. After this regime, their average systolic drop was 5 mmHg and the average diastolic drop was 8 mmHg. Exercise not only has a physiological effect but also reduces stress and therefore is of enormous benefit to the cardiovascular system. 1 tell all my hypertensive patients that they must make a commitment to exercise, even if they only walk briskly for a half hour three or four times weekly. If you are under a doctor's care for hypertension, review your exercise program with your physician to be sure that it's safe for you. Avoid exercises such as weight lifting, which causes a temporary rise in blood pressure.

Stress control can make a big difference in lowering high blood pressure. One study, which used a controlled trial of yoga and biofeedback, demonstrated a highly significant reduction in blood pressure with stress control treatments.

Smoking is very closely associated with hypertension as nicotine stimulates the adrenal glands, which ultimately act to increase blood pressure. If you smoke, add hypertension to all the diseases you're promoting.

NATURAL TREATMENTS FOR HYPERTENSION: