Hypertension, defined as blood pressure greater than or equal to 140/90 mm Hg, is very common. About one in three Americans have hypertension and only about 60% of these have their blood pressure under control. Hypertension increases the risk for stroke, heart attack and kidney failure. There are many factors that contribute to the development of hypertension. Examples include: poor diet, genetics, inadequate physical activity and too much stress. In addition, blood pressure tends to increase as we age. The good news is that there are many steps you can take to control your blood pressure.
As an integrative cardiologist, I often see patients with hypertension who are looking for natural and alternative therapies and who wish to stop their medications. When I first evaluate a patient with hypertension, or pre-hypertension (130-139/81-89 mmHg) I review their medical history, family history, physical activity, work and home environment, sleep, medications and psycho-social factors. I partner with the patient in their treatment plan - which often includes modifications to diet and exercise, supplementation with micro-nutrients and stress reduction techniques. I also recommend frequent measuring of blood pressure out of the office. This is easy to do and there are many simple, affordable devices available for home use.
There are simple steps you can take right now to optimize your blood pressure:
1. Medications. Take your medications as prescribed and never stop or reduce them without your doctor’s approval. Stopping an anti-hypertensive medication suddenly can cause a “rebound” where your blood pressure rises to dangerous levels. Even if you are unhappy about needing medication, develop a gratitude practice for them. Before taking your pill, invite a smile on your face and look at it with gratitude. This causes your brain to release hormones that recruit the relaxation response. Your blood pressure will lower naturally allowing your medication to work better. Over time you may be able to reduce the amount of medication that you need.
2. Nutrition. Eat a DASH (Dietary Approaches to Stop Hypertension - https://www.nhlbi.nih.gov/health/health-topics/topics/dash/) or Mediterranean style diet (http://www.mediterraneandiet.com/). This eating pattern is high in fresh vegetables and whole grains and low in processed foods, salt, saturated and trans fats, and sugar. Too much sugar causes increased levels of the stress hormone, cortisol that increases blood pressure.
3. Relaxation. All of us have stressors. The stress response is a protective mechanism that gets our body ready to flee or fight danger. The problem is that we often view minor stressors as major catastrophes. Too much stress causes an increase in blood pressure, damages blood vessel function over time, causes dangerous changes to the brain, and destroys our mood. There are simple steps to reduce stress. Try the 4-7-8 breathing technique (Inhale through your nose to the count of 4; hold your breath for a count of 7; exhale through your mouth to the count of 8) or learn how to elicit the relaxation response.
4. Biofeedback. There are several devices on the market that can help reduce blood pressure. One that is specifically approved for blood pressure reduction is RESPeRATE (http://www.resperate.com/shop-resperate). This is an easy to use breathing assisted device that uses a 2 tone melody that causes breathing to become slower and deeper. When used for 15 to 20 minutes most days of the week, BP can be reduced by up to 10 mm Hg!
5. Supplements. Although there are several supplements that can help reduce blood pressure, it is best to discuss these with your integrative practitioner to see what is best for you. Beware that taking too many supplements can cause dangerous interactions. And some supplements such as ephedra, licorice, ginseng, yohimbine, and kola nut can raise blood pressure.
6. Exercise. I cannot say enough good things about exercise. Any increase in physical activity will help reduce blood pressure, improve sleep, increase well-being and reduce risk for most chronic diseases including some cancers.
7. Sleep. Like physical activity, sleep is necessary for health. Practice good sleep hygiene. Stop looking at TV and all devices at least an hour prior to going to bed. Develop relaxing night time rituals such as meditation or breath work, read relaxing material or write in a gratitude journal. Go to bed when you are sleepy. And develop a regular bedtime schedule. If you suffer from excessive snoring, daytime sleepiness and insomnia, get help from a sleep specialist.
8. Excessive alcohol. Drinking more than two alcoholic drinks daily for men or one daily for women can increase blood pressure.
9. Prescription and over the counter drugs. Tell your doctor EVERYTHING you are taking. Oral contraceptives, steroids, ibuprofen and decongestants for example increase blood pressure.
What can you do right now? Put a smile on your face. Your brain will think you are relaxed even if you are not. The relaxation response will be activated, lowering your blood pressure and improving your health.