Hypertension

Emily Kane N.D.

Hypertension
Hypertension is defined as a repeated blood pressure (BP) reading of greater than 150/90 mm Hg (mercury). There are two types of hypertension: primary (aka essential or idiopathic, which means no particular cause can be identified) and secondary, which means due to some definable cause such as kidney failure or atherosclerosis.

About 89% of cases are considered to be primary hypertension, and while no specific cause can be singled out as the culprit, many factors are implicated in the development of primary, or essential hypertension. Some of the recognized risk factors include family history, environment (family size, crowding, eating patterns, occupation, obesity), salt ingestion and sensitivity (there is controversy over whether the sodium or chloride part of the salt molecule is the principal factor), race (blacks have more primary hypertension and more morbidity and mortality than whites), hyperlipidemia, smoking, and diet.

Secondary hypertension accounts for only a small minority of patients with hypertension, but must be ruled out in all cases, as discovery and treatment of the cause will cure the hypertension. Causes of secondary hypertension include:

• sympathetic nervous system compensation in response to pancreatic hypoglycemia which usually will fluctuate; in the morning it will be better and in the afternoon it will be worse.
• epinephrine compensation in response to severe pancreatic hypoglycemia: the patient will seem like they are calm outside but really tense inside. They will tend to have increasing hypertension as the day goes on.
• obese hypertension: may be hormonal, hormonal with adrenal compensation, or hormonal with liver compensation.
• renal hypertension: divided into renovascular hypertension (pre-eclampsia and eclampsia, usually seen in pregnancy), and renal parenchymal hypertension (stenosis of a renal artery causing decreased renal perfusion which results in the kidneys activating the renin-angiotensin pathway)
• endocrine hypertension: this includes adrenal hypertension (primary aldosteronism, Cushing's syndrome, and pheochromocytoma), acromegaly, hypercalcemia, and oral contraceptives (probably the most common cause of secondary hypertension).
• coarctation of the aorta

Signs and symptoms of hypertension are as follows:
In primary hypertension patients are often asymptomatic until late in the disease, and frequently hypertension is discovered during routine physical examination.

• occipital headache: seen only with severe, advanced disease; worse in the morning on rising, and better as the day goes on
• dizziness
• palpitations
• blurred vision
• epistaxis (nosebleeds)
• hematuria (blood in the urine)
• abnormal sounds over the renal arteries, possibly due to abdominal aorta aneurysm
• no fall in BP from supine to standing. Blood pressure should normally drop slightly with position changes just momentarily, then calibrate.

In secondary hypertension the same symptoms as primary hypertension are seen, plus symptoms or history related to whatever is the inciting cause. In addition:

• blood pressure falls during orthostatic measurement (sitting to standing)
• sympathetic nervous system compensation may cause BP fluctuations with a better BP reading in the morning and worse in the evening. The individual will appear calm but experiences internal tension.

To treat hypertension from a physical medicine standpoint, the first order of business is to assess cardiovascular fitness with a submaximal stress test. This is something typically done in a hospital or sports medicine setting, by a qualified exercise physiologist. Your aerobic condition is calculated, compared to normal for your age and other factors, and then an aerobic exercise program tailored to your needs can be designed. Typically heart patients need to work out in the range of around 40% of their maximum target heart rate, sometimes for only 10 minutes a day at first. Don't overdue. Consistency, and slowly building up as your condition improves is the key. Severe hypertension patients may be advised to do NO aerobic exercise at first. Isometrics are strongly contraindicated because they can unduly stress the venous system. A system of slow, standing Chinese exercise movements called Qi Gong have helped many people and are widely practiced in China not only as therapy but treatment of many diseases, including cardiovascular problems.

Physical medicine therapies using water may also provide great benefit. Some of these include:

• hot baths: to promote sweating
• peroxide baths: to greatly stimulate skin circulation
• constitutional hydrotherapy
• for acute hypertension : enema, then full body hot bath with cold compress to head and neck
• foot baths: alternating between tubs of hot and cold water.

Stress is an important complicating factor in hypertension, so you may benefit from stress reduction techniques. One of the oldest and best beloved stress management technique is treating yourself periodically, as your budget allows, to a gentle, full body massage.

The importance of nutrition and diet cannot be overemphasized in disease control, and hypertension is no exception. In general, attempt to adhere to the following eating principles:

• low sugar, especially refined, white sugar and products which contain it.
• low fat diet of unsaturated fats -- no more than 15% is optimal, and try to avoid saturated fats (meat fat) altogether.
• your daily food intake should provide calories in the following percentages: 70% complex carbohydrates, 12-15% protein and 10-15% fat .
• high fiber, such as the good old apple a day, and whole grains
• low cholesterol (avoid animal fat).
• low Sodium/Sodium-restricted diet . Take the salt shaker off the table.
• 1-2 week fast on alkaline juices or watermelon fast, followed by a vegetarian diet .
• if overweight, reduce weight to normal range.

Foods that can provide specific therapeutic benefit in hypertension include:

• high Potassium foods such as millet, buckwheat, oats, rice, raw goat's milk, raw leafy vegetables, watermelon, garlic, onions, rutin-rich foods, cornsilk tea, garlic, broccoli, celery, cherries, nectarines, pineapple, kumquats, watermelons, squash, pomegranate, guava, parsley, cucumber, dandelion greens, cornsilk and white mushroom soup. If you are taking diuretics as part of your plan to control or reduce your hypertension, replacing Potassium is especially important.
• increase omega-3 and omega-6 fatty acids. These high quality oils are found in vegetable, nut, and seed oils (particularly good is flaxseed oil), salmon, herring, mackerel, sardines, walnuts, evening primrose oil, and black currant oil.

Therapeutic foods used in Oriental cultures for hypertension include:

• mung bean soup
• chrysanthemum and spinach tea
• persimmon
• radish
• cucumber vine tea

Other specific food-based remedies include:

• take 60 g of banana skins or stems, steam in water and eat three times daily
• one cup of grape juice and celery juice each, taken with warm water three times daily for 20 days. After one 20-day course of treatment, a 5-7 day rest, then resume another course.
• drink the decoction of 10 water chestnuts and 25 g each of kelp and corn silk. This means bring 1 quart of water to a boil, add the ingredients and simmer for about 20 minutes on a low heat.
• soak peanuts in vinegar for 5 days, then eat 10 peanuts every morning.
• take a handful of sunflower seeds every morning and evening with 1/2 cup of celery juice (an effective, potassium-sparing diuretic) for one month.
• drink one small "wine glass" of freshly pressed turnip juice morning and evening for 10 days
• soak 6 g black fungus in water overnight; steam for one hour; sweeten with sugar to taste. Take one time per day in evening before bed until the symptoms and blood pressure have improved.
• for constipation caused by hypertension take 500 g of peeled banana and mash together with 15 g black sesame seed. Eat daily.
• take 60 g of water chestnuts and 30 g of fresh orange peel. Add water, steam until cooked and eat this dish 2 or 3 times daily.
• take 30 g dried green peach (pitted young green fruit left to dry in the sun) cover with water and simmer until cooked and drink in place of tea.

Avoid:

• allergenic foods
• salt, salty foods: pickles, olives, chips, packaged snacks, meat, (especially ham, frankfurters, bacon, bologna, corned beef, lunch meats, frozen fish fillets, sardines, herring, caviar, anchovies, shellfish), dairy products, spicy foods: salsa, white and black pepper, mustard, ginger, hot foods, canned tomato juice, V-8 juice, processed cheese, canned, dried or instant soups, frozen peas and beans, most processed and refined foods, MSG, mayonnaise, salad dressings, gravies, ketchup, food with Sodium benzoate as a preservative, Sodium proprionate in cheese and bread, baking powder, baking soda, ice cream, milkshakes, soft drinks, smoked meats and fish, Jello, pretzels, potato chips, salted nuts, candy, rennet tablets, pudding mixes, beverage mixes, spicy foods, alcohol, fried foods, fatty foods, pork, overeating, low levels of Calcium
• alcohol, sucrose, caffeine
• trans-fatty acids, hydrogenated oils (margarine, vegetable shortenings, imitation butter spreads, most commercial peanut butters) oxidized fats (deep fried foods, fast food, ghee, barbecued meats)

Supplements that may be additionally helpful, because it is sometimes impossible to get therapeutic levels of certain nutrients through diet alone. Please contact a qualified health care provider for specific dosages.

• Vitamin A
• Vitamin B-complex
• Vitamin B3
• Vitamin C
• Vitamin D
• Calcium 1-2 grams
• Magnesium 500 mg daily
• Potassium 100 mg daily
• Coenzyme Q10 60 mg daily
• omega-3 fatty acids 10-15 g daily
• omega-6 fatty acids, especially evening primrose oil (EPO)

The world of plant medicine has much to offer for controlling or even reducing chronic high blood pressure. Please consult with a qualified herbalist or naturopathic doctor to find out about specific dosages, or the form in which to take the herbs. The following list will provide a guideline.

• Achillea millefolium (Yarrow) for essential hypertension
• Allium sativum (garlic)
• Apium graveolens: juice and seeds
• Arctium lappa (Burdock)
• Arnica spp. (toxic)
• Berberis vulgaris (root bark of Oregon Grape Root)
• Cimicifuga spp. (Blue cohosh)
• Crataegus oxyacantha: cardiotonic, stabilizes heart (Hawthorne berries)
• Fagopyrum esculentum (buckwheat) with vitamin C for raised arterial tension with capillary bleeding
• Ginkgo biloba (standardized extract)
• Hamamelis virginiana (Witch Hazel)
• Olea europaea (olive oil)
• Rauwolfia serpentina (toxic):primary hypertension
• Scutellaria lateriflora (Skullcap) to soothe the nervous system
• Taraxacum officinale (Dandelion), useful as a diuretic and to tone the vasculature
• Tilia platyphyllos for hypertension associated with atherosclerosis
• Valeriana spp. (Valerian root)
• Viscum album (Mistletoe). Beware! this plant is toxic in relatively low doses but useful for high blood pressure which presents with headache, dizziness, loss of energy, and irritability

Chinese herbs:

• Coptis and Scute (Huang Lian Jie Du Tang) (or if constipation, Coptis and Rhubarb C. (Xie Xing Tang)); Jiang Ya Wan (patent); Uncaria 6 (patent): Liver Fire Blazing Upward: irritability, dry mouth, insomnia, dark urine, red tongue with yellow coat, forceful pulse
• Bupleurum and Dragon Bone (Chai Hu Jia Long Gu Mu Li Tang): Gall Bladder Phlegm: irritability with occasional attacks of palpitations, constipation, heavy sensation in the body, wiry rapid pulse , greasy tongue coat
• Zhen Gan Xi Feng Tang; Tianma Chu Feng Pu Pien (patent); Jiang Ya Wan (patent); Uncaria 6 (patent): Liver Wind Arising from Liver Yang Rising: dizziness, headache, irritability, flushed face
• Ban Xia Bai Zhu Tian Ma Tang: Spleen Qi Xu (Deficiency) causing Phlegm and Liver WInd Stirring: vertigo, headache, nausea/vomiting · Major Bupleurum C. (Da Chai Hu Tang): Liver Qi Stagnation in obese or strong constitution patients
• Rehmannia Six F. (Liu Wei Di Huang Wan): Kidney Yin Xu (Deficiency)and Liver Yin Xu (Deficiency): low back pain, tinnitus, night sweats
• Linking Decoction (Yi Guan Jian): Kidney Yin Xu (Deficiency) and Liver Yin Xu (Deficiency) with Liver Qi Stagnation: hypochondriac and chest pain/tightness, acid regurgitation
• Tang Kuei and Gambir C.: Kidney Yin Xu (Deficiency): Weaker patients with chronic hypertension, including due to kidney disease · Yao Qin
• Qing Dan Tang: Gallbladder Damp-Heat: alternating fever and chills, chest pain/tightness, nausea, bitter taste in mouth, acid regurgitation
• Gentiana C. (Long Dan Xie Gan Wan) (available as patent); Gentiana 12 (patent): Liver and Gall Bladder Invaded by Damp-Heat
• Xue Fu Zhu Yu Tang: Xue (Blood) Stagnation and Liver Qi Stagnation: chest and hypochondriac pain, chronic fixed piercing headache, depression, insomnia, irritability
• Si Sheng Wan: Xue (Blood) Heat: dry mouth, nosebleeds · Er Xian Tang: Kidney Yin Xu (Deficiency) with Empty Fire Blazing and Kidney Yang Xu (Deficiency): menopausal hypertension
• Vitality C. (Zhen Wu Tang); Du Zhong Pian (Compound Cortex Eucommia Tablets) (patent): Kidney Yang Xu (Deficiency)and Spleen Yang Xu (Deficiency) with Water Stagnation: primary hypertension: edema, loose stools, dizziness, pain worse with cold
• Tienma and Shou Wu (patent); Uncaria 6 (patent): Liver Xue Xu (Blood Deficiency) with Liver Yang Rising.
• Wan Shi Niu Huang Qing Xin Wan (patent): Pericardium Invaded by Heat Bupleurum and Gambir F.

Acupuncture point combinations:
After assessing the person and palpating, consider these patterns:

• Flourishing of Fire of Liver and Gall Bladder
• Liver Wind Stirring
• Liver Yang Rising
• Liver Fire Blazing Upward
• Upward Attack of Qi and Xue (Blood)
• Gall Bladder Phlegm
• Liver and Gall Bladder Invaded by Damp-Heat
• Xue (Blood) Stagnation and Liver Qi Stagnation
• Liver Xue Xu (Blood Deficiency) with Liver Yang Rising
• Pericardium Invaded by Heat
• Xue (Blood) Heat
• Xiao Yang imbalance in the Windows to the Sky
• Spleen Qi Xu (Deficiency)
• Excessive secretion and obstruction by Wet Phlegm
• Wind-Phlegm Obstruction
• Liver and Kidney Yin Xu (Deficiency), esp. with Empty Fire Blazing
• Xu (Deficiency) of both Yin and Yang
• illustrative combinations:
• Stomach-9, Large Intestine-11 and Stomach-36 for hypertension
• Liver-3, Urinary Bladder-18, Stomach-36 and Large Intestine-11 for primary hypertension; also consider Heart-7 and yin tang (extra point between eyebrows) with dizziness; Pericardium-6 and Urinary Bladder-15 with palpitation; Heart-7 and Spleen-6 with insomnia
• Gall Bladder-20, Large Intestine-11, Stomach-36 and Liver-3 for hypertension; also consider Liver-2, tai yang (extra point at lateral edge of eyebrows), Triple Warmer-7, Heart-7, an mian (extra point behind ear), Spleen-6, Kidney-3, Gall Bladder-34, Spleen-9, Stomach-40, Pericardium-6, Conception Vessel (CV)-4 and CV-6

Homeopathy is another form of "energy" medicine, which like Traditional Chinese Medicine uses substances to stimulate your own innate power to heal. Homeopathic medicine is often touted as the "medicine of the 20th century" by its proponents because it uses minute doses of plants, minerals or animal parts to produce "remedies" with very little resultant environmental damage. The remedies to consider in hypertension are:

• Aurum metallicum if the presentation is violent palpitation; orthopnea (difficulty breathing while lying down), fullness in the heart region, with symptoms worse at night
• Baryta carbonicum is you are chilly, physically and mentally compromised, have palpitations which are worse while you're lying on your eft side; vertigo in the morning, fainting with nausea
• Conium maculatum for vertigo which comes on with the slightest motion of head or lying down, if you feel better closing your eyes or if you have an occipital headache on rising in the morning
• Kali iodatum for hypertension with a past history of syphilis or Mercury poisoning; for hypertension with bleeding problems; for chronic, burning nasal discharge and pain in the frontal sinus
• Lachesis for left-sided heart failure, hemorrhagic tendencies, with angina, and in a hot patient
• Natrum muriaticum for headache and vertigo, throbbing, one-sided symptoms if you're also a hot patient; have vertigo with nausea and tendency to fall forward and to the left
• Picric acid for hypertension due to enlarged prostate, renal conditions; with occipital headache that feels better when a tight bandage is applied to the head
• Plumbum metallicum with atherosclerosis; nephritis; mental depression; when symptoms are worse at night, worse from mental exertion; for dark, hard stools
• Secale cornutus is the remedy for you if you feel internal heat with external coldness, and you feel better uncovering bedclothes or clothing; if you have a bleeding tendency; with palpitation and a boring pain in chest.
• Strontium carbonicum with flushed face and threatened apoplexy; vertigo with headache and nausea; chilly, better immersing hands in water.

Another popular, new to the West, type of plant medicine makes use of specially prepared flower "juices" whose essences are extracted in alcohol, usually. The flower essences to consider in hypertension are:

• willow
• honeysuckle
• gentian
• dill
• mallow

Yet another form of "vibrational" medicine consists of the use of various colors for the specific therapeutic properties these colors emit. There are different ways to apply color therapy, including wearing clothing of a certain color, or assuming a relaxed or meditative state then imagining the color seeping into your body, or using thin colored pieces of plastic ("gels") over a light source in the home or office, such as a lamp. Colors reputed to benefit hypertension are:

• lemon (helps to dissolve blood clots) and purple (helps to lower blood pressure by three pathways: vasodilation, slows heart rate, and helps to calm kidney and adrenals)
• magenta (a cardiotonic; helps to build up and balance the functional activity of kidneys and adrenals) on chest and kidneys
• indigo (an astringent, antipyic, antiemetic, and hemostatic) on whole body if tumors found in chromaffin system, or on kidneys if found in kidneys or adrenals
• blue or green
• green on top of head
• indigo, blue, green, and orange

Other people like to use "healing rocks," or semi-precious stones to help with physical, emotional or spiritual complaints. Gems that have been reported to be helpful in hypertension are:

• Sapphire
• Coral
• Pearl
• Pearl, Sapphire, Emerald, Diamond combination
  Emerald, Sapphire, Cat's Eye combination

As with most diseases, hypertension is likely to have mental and emotional correlates, that may even be part of the causation of the trouble. When exploring who to best treat your hypertension, open you mind to the following concepts. They may help!

• Do you have a mainly type A behavior pattern?
• Could you describe your personality as dynamic, maybe even hyperactive? Do you work with a large steady output of energy. Are you sensitive and quick tempered, but without serious mood fluctuations?
• Do people tell you exhibit too much anxiety, ambition, and anger?
• Can you relate to feeling that your blood and anger are boiling over and need to be cooled?
• Do you feel suppressed rage, fear or repressed hostility resulting from frustration or resentment? Do you have inhibited aggressive impulses and hostile tendencies?

Hypertensive patients are like overreactive sounding boards and often display increased anxiety, inappropriate coping behaviors in socially distressing situations or exaggerated dependency needs.

Treatment procedures derived from a cognitive-behavioral base and consisting of training experiences for coping effectively with stress may produce significant decreases in your state of anxiety and your systolic blood pressure. High diastolic blood pressure is more dangerous, and more difficult to treat with psycho spiritual approaches.

The heart represents your center of love and security. Heart problems are thus logically associated with long standing emotional problems such as lack of joy or belief in strain and stress. If you are a person who feels threatened with being harmed by an ever-present danger you will constantly feel the need to be on guard, as though you need to be prepared to meet all conceivable threats. This stance is exhausting, especially to the heart! A suitable psycho spiritual approaching to treating hypertension must be geared towards resolving residual anger, fear or frustration in your life

Consider this quote: "The blood pressure is an expression of a person's general dynamism. It arises out of the mutual effects of the behavior of the liquid blood on the one hand and the behavior of the limiting walls of the blood vessels on the other. When considering the blood pressure we always need to bear in mind these two mutually contradictory components: the fluid and the flowing on the one hand, and the limitation and the resistance on the other. To the extent that the blood corresponds to our own inner being, the walls of the vessels correspond to the limits that the unfolding personality sets upon itself and the resistances that stand in the way of our development.

In the case of hypertension, the circulatory system maintains a long term excitation in the expectation that it will eventually be translated into action. If the action fails to materialize, the patient stays 'under pressure'. Of even greater importance is that the same relationship applies where conflict is concerned. These patients take refuge in superficial 'busy-ness', attempting through great external activity to divert both themselves and others from the challenge to come to grips with their conflict." People with hypertension have a good deal of aggression which they repress by exercising self-restraint. (Dethlefsen, p. 195-197, 201)

Here are some specific therapeutic ideas towards using the power of your loving mind to heal hypertension:

• Any relaxation techniques such as meditation, Transcendental Meditation, yoga, progressive relaxation, autogenic training will be beneficial.
• Qigong (Chinese breathing exercise) treatment indicates that breathing exercises may reliably regulate the internal autonomic functioning, and thus signal the nervous system to slow down.
• Relaxation techniques may fail if underlying behavioral factors are not addressed. In other words you can meditate all you want but it won't help if you're still really angry at your mother/father/lover/ boss.
• One study using relaxation and meditation aided by biofeedback reinforcement showed significant reduction in both systolic and diastolic blood pressure in 77% of patients. In 50% of patients it was also possible to reduce antihypertensive medications. Biofeedback-assisted training showed a significantly greater fall in blood pressure (11mm systolic and 9mm diastolic) than other combinations. Results were maintained eight months after the training.

Creative visualization is a type of meditation technique where you find a quiet, comfortable place and gently focus you mind on an image you want to hold there for a time. Don't be discouraged if other thoughts keep popping up. This is natural. The quieting of the mind takes practice, practice, practice. Try these specific visualizations:

• Visualize anything because the best treatment is relaxation.
• reducing blood flow to the coronary arteries.
• cooling down with ice cubes.

Prayer, in whatever form seems genuine to you, is also helpful, for similar reasons outlined above. One form of praying is to consciously recognize the God-self that you are by reciting affirmations, either out loud, looking at yourself in the mirror, or quietly before sleep. Here are several suggested by Louise Hay:

• I joyously release the past. I am at peace.
• I bring joy back to the center of my heart. I express love to all.
• Joy, joy, joy. I lovingly allow joy to flow through my mind and body experience.

With heart disturbances and heart conditions, the following questions are possibly worth exploring:

• Are my head and heart, my intellect and feelings, in harmonious balance?
• Am I giving enough scope to my feelings and trusting myself to express them?
• Am I living and loving 'heartily', or only 'halfheartedly'?
• Is my life borne along by a living rhythm, or am I subjecting it to a rigid way?
• Does my life still contain enough combustible materials and explosives?
• Am I listening to, seeing, feeling, moving my heart?