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 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 psychospiritual 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
psychospiritual 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?
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