Handling Hypertension

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Karen came to see me because her doctor said her blood pressure was too high and gave her the diagnosis of pre-hypertension. “I hope the white coat doesn’t increase your blood pressure too much, especially when you think about the acupuncture needles,” I joked. Fortunately, Karen had a sense of humor.

“I never could have imagined my doctor would tell me I have high blood pressure,” Karen said. “I thought only men had trouble with that. And what’s ‘pre-hypertension’ about? He wanted to start me on medication.”

New guidelines have lowered the bar for defining hypertension, and experts have added a new category, pre-hypertension, defined as follows:

• Normal blood pressure:
less than 120/80 mm Hg
• Pre-hypertension:
120 to 139/80 to 89
• Stage 1 hypertension:
140 to 159/90 to 99
• Stage 2 hypertension: 160/100

Believe it or not, I told Karen, about 24 percent of men and 23 percent of women in the United States have hypertension (about one-fourth of all adults).

Saying that people with mildly elevated blood pressure have pre-hypertension is controversial. Some researchers and doctors believe the diagnosis will unnecessarily worry people who aren’t in any real trouble. Others say we need to alert people when their blood pressure starts trending upward and control it with medication. Hypertension can be a major risk factor for strokes, heart attacks and kidney disease.

Decrease Your Risk

As Karen and I talked, I noted a few risk factors she had that, if addressed, could help reduce her blood pressure and eliminate the need for prescription drugs. These included alcohol consumption and the 15 to 20 pounds of extra weight she carried. She told me her father had hypertension and that he had died of a stroke a few years before. “I guess I got the gene,” she said.

However, I told her that two new studies analyzed data from two huge trials, one of which followed more than 400,000 people for up to 30 years. The lead author said the studies “blow away the myth of bad genes” as a major factor in heart disease.

Because Karen’s doctor wanted her blood pressure down to about 120/80, we both wanted to see what herbs, diet and a few changes in health habits could do. Karen had read about the side effects of commonly prescribed drugs like diuretics and beta-blockers — frequent urination, fatigue and low sex drive — and she was enthusiastic to try a natural program first.

We discussed her weight, and Karen told me it had slowly come on over the last few years, right after menopause. Slimming down can provide amazing benefits for hypertension. An analysis of 25 controlled human studies by an international group of researchers showed that losing 10 pounds could result in a 4.5 mm Hg reduction in systolic pressure and 3.5 mm Hg in diastolic pressure. These results mean a pre-hypertension level of 120/80 could be reduced to a healthy level of about 116/77 by losing just 10 pounds. Larger blood pressure reductions were seen in study participants who lost more than 10 pounds.

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