Did you know nearly half of adults in the United States (108 million, or 45%) have hypertension defined as systolic blood pressure ≥ 130 mm Hg or a diastolic blood pressure ≥ 80 mm Hg or are taking medication for hypertension? (1) To drop your jaw even further, high blood pressure affected only 1 percent of hunter–gatherer populations following a paleolithic diet, but its prevalence increased when those cultures adopted a Western diet and lifestyle (2) characterized by: processed and refined foods, sedentary behavior, chronic sleep deprivation, a lack of sun exposure, and excessive use of caffeine, alcohol, and tobacco.
So what is high blood pressure anyway? It is increased muscular tone inside arteries: vessels that carry blood (oxygen rich blood). See the image below for a visual 🙂 Arterial blood pressure is regulated within a narrow range to provide enough push to get blood to the ends of the body but also without causing damage to the walls of the arteries and organs. The resistance in the arteries, which is half of the equation, is dictated by the presence of compounds like Angiotensin II (more on this later); the tension in the arteries are influenced by neurological, immunological, and hormonal signals. The other half of the equation is how much blood the heart pumps out and how vigorously it does so. These two components are the mathematical pieces that elicit arterial blood pressure. Most antihypertensive drugs lower blood pressure by reducing cardiac output and/or decreasing peripheral resistance.
Hypertension is notorious for the development of heart failure and kidney disease. The excessive work demanded of the heart eventually leads to heart failure, and this chronic internal pressure also damages the filtration system in the kidneys. It’s no exaggeration in saying that learning how to keep one’s blood pressure under control is one of the most important things you can learn for longevity.
WHY IS HYPERTENSION SO PREVALENT?
If I were to bet money on a nutrient people are not getting much of, it’s potassium. The average American consumes about 2,620 milligrams of potassium per day (3) while the Institute of Medicine recommends that adults get at least 4,700 milligrams. (4) Did you know increasing potassium intake alone would decrease the number of adults with high blood pressure by 17% and increase life expectancy by five years for over 12 million Americans? (5) Potassium’s role in blood pressure explains why there is a subset of antihypertensive drugs called potassium sparing diuretics: potassium helps orchestrate relaxation of blood vessels.
On another dietary note, a low-sodium diet is also a solid recommendation but keep in mind that there needs to be an exit strategy. Low sodium diets are well established to cause insulin resistance, elevate total cholesterol, LDL cholesterol and triglycerides. When people walk into conventional medical offices with these analytes in “high” categories, the residing physician will prescribe a drug to normalize it. That is what they are taught to do, and in their defense it is the wise decision sometimes! But most of the time the conversation about lifestyle modification is delayed, and an even uglier truth is people want quick fixes. The action-oriented goal here is to PREVENT being resistant to insulin and learn the art of blood sugar management through continuous dietary counsel, and even daily blood glucose analysis in many cases.
The following may comes from left field to you, but clinics that seek to find root-causes of people’s problems oftentimes order a sleep-study. Sleep-disordered breathing is a stress that has life-long impacts if not addressed. It refers to momentary, often cyclical, cessations in breathing rhythm (apneas) or momentary or sustained reductions in the breath amplitude (hypopneas), sufficient to cause significant decrease in oxygen in arterial blood. (6) The nervous system needs fuel and activation in order to stay healthy: movement as activation, and nutrition and oxygen as fuel. It makes sense that the “fight or flight” system would be chronically activated if someone is experiencing bouts of hypoxia (low oxygen) while they are asleep. These breathing pauses can happen 5 to 30 times or more in one hour, lasting for a few seconds to a whole minute. Insane.
The goal of antihypertensive therapy is to reduce cardiovascular workload/stress and reduce further renal damage. If your arterial vessels are pulsating vigorously, the small vessels in the kidney endure damage, so it is wise to mitigate these unfavorable changes while finding the root cause of the problem. When BP is 140/90 or above, Western practice calls for 2 antihypertensive drugs to the patient. The most commonly prescribed ones for hypertension are angiotensin 2 blockers (Valsatran), Ace-Inhibitors (Lisinopril), Diuretics (Furosemide, Hydrochlorothiazide, Triamterene), Beta-adrenergic blockers (Atenolol & Metropolol), and Calcium Channel Blockers (Nifedipine). The following chart demonstrates how Medical Doctors treat their patients with concomitant diseases.
WESTERN HERBAL PRACTICE
Because diuretics are used to monitor blood pressure, it’s interesting to mention herbs that have diuretic like actions too. In Europe, phytotherapists have proposed the term aquaretic instead of diuretic. Professor Kerry Bone, one of the key icons in herbal therapy, says in his co-authored book with Rob Santich, Healthy Children:
“The thinking here is that these herbs act on the glomerulus (unlike conventional drugs which act further along the nephron) to increase water excretion from the body, but their effect on electrolytes such as sodium and potassium is largely neutral”. (7)
Kerry and Rob expand further:
“In other words, aquaretics act by increasing fluid loss from the body in a physiological manner, by increasing the formation of primary urine. The herb combination which has been most studied in this context is Asparagus Root (Asparagus officinalis) with Parsley herb (Petroselinum Crispum)… Other diuretic or aquaretic herbs include Dandelion (especially the leaf), Juniper and Horsetail”. (7)
The research in this is mostly done in Germany and was difficult for me to find (and even if I did I would need it translated). I want to leave you with some information here because there is never one right way to address a patient, and there never will be.
DOES A MISALIGNMENT IN THE UPPER NECK PRECEDE HYPERTENSION?
A Doctor of Chiropractic (DC) can play a significant role in managing hypertension. A study from the Journal of Hypertension in 2007 showed that a technique for realigning the first segment of the spinal column alone can have profound changes; this style of Chiropractic is called NUCCA (National Upper Cervical Chiropractic Association). Remember that western pharmaceutics are given two at a time in most cases, and it yields about 8 mmHg decrease in BP. At week 8 of this study, there were amazing differences in systolic BP (-17 +/- 9 mm Hg in the NUCCA group, versus -3+/-11 mm Hg for placebo; P<0.0001) and diastolic BP (-10 +/- 11mm Hg, NUCCA versus -2 +/- 7 mmHg in placebo; P< 0.002). What is crazy about these findings are the results of the placebo group (the group that the doctor intentionally did not properly correct the misalignment) STILL had improvements, highlighting the significance of this delicate area of the body known as the upper cervical spine. Most doctors of medicine haven’t observed the favorable changes the body experiences when there is an alignment in this region. In research it is referred to as the craniocervical junction.
The mechanism wasn’t explained in the study, and it’s easy to think that a decrease in the sympathetic nervous system would underlie it (the adjustment having a calming effect); turns out the heart rate didn’t change significantly during the study, which made the researchers skeptical of that. Could it be that people with a misalignment of the first segment of the spine are more likely to have hypertension due to neuroendocrine reasons? More research is necessary to know.
Hypertension is a very common problem in folks who have adopted a westernized diet and lifestyle. My best advice to you at this moment is to avoid it being a problem in the first place by eating real food (low glycemic potassium sources), adopt healthy sleep hygiene, exercise regularly, and get your upper neck aligned by a NUCCA Chiropractor. It may also be wise to monitor your blood sugar levels after eating foods you frequently eat to see which one’s are causing high blood sugar levels. Remember, a vital body can respond with the least amount of insulin! Avoiding insulin resistance is an inevitable step towards vibrant, radiating health.
My door will be open to you in Pasadena, CA if you’d like to work with me.
Direct Every Angle,
PS. If you’re interested in learning more, I wrote an e-book about hypertension that goes far more in depth. Contact me and we can figure out a way for you to get your hands on it!
(1) CDC. Hypertension Prevalence in the U.S.: Million Hearts® [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2020Jul18]. Available from: https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
(2) Lemogoum D, Ngatchou W, Janssen C, Leeman M, Bortel LV, Boutouyrie P, et al. Effects of Hunter-Gatherer Subsistence Mode on Arterial Distensibility in Cameroonian Pygmies. Hypertension. 2012;60(1):123–8.
(3) Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, et al. Origins and evolution of the Western diet: health implications for the 21st century. The American Journal of Clinical Nutrition. 2005;81(2):341–54.https://doi.org/10.1093/ajcn.81.2.341
(4) Institute of Medicine. Dietary Reference Intakes For Water, Potassium, Sodium, Chloride, and Sulfate [Internet]. The National Academies Press; [cited 2020Jul19]. Available from: https://www.nal.usda.gov/sites/default/files/fnic_uploads/water_full_report.pdf
(5) Houston MC. The importance of potassium in managing hypertension. Curr Hypertens Rep. 2011 Aug;13(4):309-17. doi: 10.1007/s11906-011-0197-8. PMID: 21403995.
(6) Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010 Jan;90(1):47-112. doi: 10.1152/physrev.00043.2008. Erratum in: Physiol Rev.2010 Apr;90(2):797-8. PMID: 20086074; PMCID: PMC3970937.
(7) Santich R, Bone K. Phytotherapy essentials: healthy children: optimising children’s health with herbs. Warwick, Qld.: Phytotherapy Press; 2008.
(8) Bakris, G., Dickholtz, M., Meyer, P. et al. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J Hum Hypertens 21, 347–352 (2007)