Overview 

The term blood pressure refers to a measurement of the amount of pressure in the arteries as blood is taken away from the heart and circulated throughout the body. This rate is measured in two phases: systolic pressure, or the peak of pressure in response to the initiation of the cardiac cycle when the heart is contracting, and diastolic, or when the heart is briefly at rest between beats. Most often determined through the use of a stethoscope and a sphygmomanometer reading, blood pressure is expressed as millimeters of mercury and written with the systolic rate over diastolic. Since the normal blood pressure for an adult is at or below 120 millimeters of mercury systolic and 80 millimeters of mercury diastolic, the rate would be abbreviated as 120/80 mm Hg and presented verbally as simply ‘one twenty over eighty.’ 

Blood pressure is not a fixed value. In fact, blood pressure readily changes throughout the day in response to normal circadian rhythm, in addition to other factors such as physical exertion or stress. Blood pressure can also be an indication of general health status, which is why it is considered one of the vital signs to be taken upon physical examination. For instance, the presence of certain diseases, such as kidney disease, can cause blood pressure to escalate. 

High Blood Pressure 

When there is an increase of pressure exerted upon arterial walls, the patient is said to be suffering from hypertension, or high blood pressure. Hypertension affects more than 70,000,000 million people over the age of 20 in the US, the equivalent of one on three adults. Of this number, the population with the highest rate of incidence of hypertension is the African-American community. However, while certain risk factors may increase the chance of developing hypertension, up to 95% of all cases of high blood pressure, regardless of race or gender, are of unknown origin. 

Risk Factors for High Blood Pressure 

As previously mentioned, most cases of hypertension cannot be attributed to any specific cause. In addition, hypertension has no symptoms and roughly one-third of those currently affected are unaware that they even have the condition. Yet, according to the American Heart Association, high blood pressure is the 13^th-leading cause of death in the US and the risk increases with age. In fact, the Framingham Heart Study concluded that a person over the age of 55 has a 90% chance of developing hypertension over the course of their remaining lifetime. 

While the exact cause of high blood pressure is not currently well understood, researchers do know that there are certain specific risk factors that may contribute to its development, such as: 

Age  Until the age of 45, men have a greater likelihood of developing high blood pressure. However, between 45 and 54, the ratio of incidence between men and women equalizes. After age 55, women are more likely to develop high blood pressure than men. 

Genetics  A person who has a close relative with hypertension has a greater chance of developing the condition. 

Race  African Americans are more susceptible to this condition, with its incidence tending to occur earlier in life and with more complications. Researchers suspect this may be do to low levels of nitric oxide, which is needed for blood vessel dilation. 

Obesity  Being overweight increases the risk, especially when combined with a sedentary lifestyle and a diet high in saturated fats. 

Excessive alcohol consumption 

Smoking 

Certain medications  Many types of medications can negatively impact blood pressure, including monoamine oxidase inhibitors, diet pills, decongestants, allergy medications, nonsteroidal anti-inflammatory drugs, oral contraceptives  and steroids. 

Pregnancy  It is not uncommon for a woman to experience high blood pressure during pregnancy, particularly during the third trimester. 

Symptoms and Diagnosis of High Blood Pressure 

Generally, there are no symptoms. Contrary to popular belief, people who may be described as being hyperactive, nervous or ‘high-strung,’ are usually no more vulnerable to developing hypertension than a person who always appears to be in a relaxed, calm state. Similarly, having high cholesterol isn’t necessarily a precursor to hypertension. However, certain lifestyle habits that help contribute to high cholesterol may increase the risk of developing high blood pressure, such as a sedentary lifestyle, poor diet, tobacco use and excess alcohol consumption. In addition, while it is true that the risk for hypertension increases with age, high blood pressure can occur at any age, even in a very young child. 

The only way to determine the existence of high blood pressure is to have the blood pressure checked. According to the American Heart Association, a healthy adult should generally have their blood pressure checked by a physician a minimum of every two years. However, the frequency of screenings may increase if there are certain risk factors present, such as a family history of hypertension. 

A one-time high reading doesn’t necessarily indicate the presence of high blood pressure, although it may suggest that the blood pressure should be check more often. In addition, there is a phenomenon known as ‘white coat syndrome,’ which results in a person having a high blood pressure reading while at the doctor’s office due to slight nervousness or anxiety over the examination. Usually, the physician or other medical staff will take the blood pressure again once the patient has had a few moments to relax and feel more comfortable in the medical setting. 

Dangers and Complications of High Blood Pressure 

Hypertension is categorized as being either essential (primary) or secondary. Essential hypertension accounts for most cases and is of no specific cause. On the other hand, secondary hypertension can be attributed to a variety of other conditions, such as: 

Diabetes

Central nervous system or spinal cord damage

Kidney disease, or excessive secretion of the hormone aldosterone

Cushing’s disease

Sleep apnea

Endothelium dysfunction (i.e., atheriosclerosis) 

High blood pressure is also linked to an increased risk for serious complications, such as heart attack, stroke, renal failure, blood clots and damage to the blood vessels in the eyes. Since high blood pressure forces the heart to work harder than it normally would, there is increased stress put upon arterial walls, leading to an increased incidence of blood clot and plaque formation. In addition, organs may suffer due to an impaired blood supply. Even the heart itself can become enlarged, leaving it susceptible to further damage or complete failure.

Conventional Treatment of High Blood Pressure 

Conventional treatment of high blood pressure varies according to severity and classification (i.e., prehypertension, or only slightly elevated blood pressure, versus secondary hypertension). In the absence of a secondary condition, such as diabetes or kidney disease, treatment nearly always consists of a combination approach of lifestyle and dietary modifications. In short, this translates to adhering to a balanced, low-fat diet, maintaining a healthy weight, getting regular exercise and limiting salt and alcohol consumption.  

Many physicians treat hypertension with one or more antihypertensive drugs, of which there are six different classes: 

Alpha blockers to inhibit the uptake of catecholamines produced under times of stress and to improve the dilation of blood vessels. Side effects include a sudden drop in blood pressure and dizziness, particularly upon standing after sitting or lying down. 

Beta blockers are sometimes used to prevent a recurring heart attack in a patient that has already had a heart attack. However, these medications can interfere with glucose utilization and healthy lipoprotein and triglycerides levels. 

Calcium channel blockers (CCBs) help to promote increased blood vessel dilation and oxygen transport by improving the delivery of calcium to the heart. However, this class of antihypertensive is not recommended for people with heart disease or who have previously had a heart attack. Adverse effects include swelling of the lower legs and headache. 

Angiotensin-converting enzyme (ACE) inhibitors inhibit the production and release of angiotensin from the kidneys, which causes blood pressure to increase. 

Angiotensin II receptor blockers (ARBs) block the action of angiotensin at receptor sites. Side effects include dizziness, headache and diarrhea. 

Thiazide diuretics increase water and salt elimination by decreasing blood volume and increasing urine flow. However, these medications can sometimes cause sexual dysfunction, excessively low sodium levels, potassium retention, or glucose intolerance. 

Unfortunately, several studies have shown that treatment with these drugs does not guarantee success in reducing blood pressure. In fact, the American Heart Association recognizes that many people treated with antihypertensive medications continue to display high blood pressure readings. Furthermore, the Journal of the American Medical Association reported that 77% of women over the age of 80 with high blood pressure do not achieve adequate control of their condition despite receiving standard treatment from their physicians. 

Natural Management of High Blood Pressure 

Since hypertension is a complex disease, most physicians today agree that a comprehensive, integrated approach to managing high blood pressure is the best prescription compared to medication with antihypertensive drugs alone. In addition to diet and lifestyle modifications, this course of treatment encompasses several complimentary therapies, including meditation, yoga and biofeedback, as well as nutritional and botanical therapy. 

The Mind-Body Connection 

The practice of meditating is well known as a technique to induce relaxation and reduce stress, and its physiological benefits are proven. Of particular interest to researchers is Transcendental Meditation (TM), the effects of which have been studied and published in literally hundreds of peer-reviewed journals since the early 1970s. In fact, the National Institutes of Health has contributed more than $20,000,000 to fund research on the impact of TM on heart disease and high blood pressure. This research has confirmed that TM reduces blood pressure, lowers serum cholesterol, and regulates the production and release of the stress hormone cortisol while increasing serotonin production. Numerous studies cite that hypertensive adults who practice TM at least once per day experience not only lower blood pressure, but also a reduction in hardening of arterial walls. Furthermore, TM has been found to be an effective long-term therapy for the group most frequently and severely affected by high blood pressure—African-Americans. 

Yoga, which literally translates from Sanskrit to mean ‘union,’ is an ancient system of specific stretches and poses (called asanas) that promote strength and flexibility, but does not necessarily require strenuous effort. In fact, this is what makes yoga so attractive to many walks of life—anyone of any age or levels of fitness can practice it. A yoga program may also incorporate meditation, breathing exercises, or chanting, depending on individual preference or style of an instructor. 

In itself, yoga can greatly enhance a feeling of well-being and promote stress reduction. However, studies have also shown that yoga can significantly reduce high blood pressure. 

Recommended Supplements to Treat High Blood Pressure 

Casein Peptide 

Casein peptide or, more specifically, the isolated C12 peptide, is a protein derived from milk that is currently receiving much attention for being a natural and fast-acting ACE inhibitor. One small US study involving 10 hypertensive men and women aged at or near 50 years showed that this substance had a significant impact on blood pressure after a single dose. A later Japanese study had similar results and also found that the beneficial effects of C12 peptide were observed two weeks after treatment was discontinued. The Japanese considered these findings so encouraging that the Japanese Ministry of Health and Welfare approved the manufacture and sale of a C12 peptide-containing commercial beverage. 

Omega-3 

Omega-3 fatty acids deliver eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), which can help reduce blood pressure levels. Several clinical studies indicate that these essential fatty acids naturally promote blood vessel dilation, in addition to improving endothelial function—two factors that help to reduce the risk of heart disease and stroke. 

Coenzyme Q10 (CoQ10) 

CoQ10 is used by cells for energy production. In the treatment of hypertension, CoQ10 is of benefit due to its antioxidant qualities that help to inhibit oxidative stress, in addition to increasing nitric oxide transport and utilization. Some studies indicate that the blood pressure lowering effect typically takes 4-12 weeks to become apparent. In one study involving 109 subjects with essential hypertension, CoQ10 supplementation resulted in a reduced need for antihypertensive medications within six months, while more than half of the study group were able to completely discontinue medications within four to five months. 

Magnesium and Calcium 

Magnesium deficiency is frequently seen in hypertensive patients, yet this mineral is necessary for the correct ratio and utilization of calcium needed to promote vascular dilation and reduce the risk of high blood pressure. Low magnesium levels also negatively impacts the balance of potassium and sodium, resulting in the latter gaining ground. Magnesium supplementation has the added benefit of helping to reduce cholesterol and improving endothelial function. 

Calcium supplementation is also beneficial since it stimulates muscle contraction. However, since magnesium promotes muscle relaxation and vessel dilation, these two supplements compliment each other and are best taken together. In fact, the National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that are struggling to control their high blood pressure increase their intake of these minerals. (Note that potassium supplementation should be supervised by a physician due to its potential action on the kidneys in these individuals.) 

L-arginine 

This amino acid is a precursor to nitric oxide and necessary for proper endothelial function. Several studies have shown that L-arginine supplementation increases nitric oxide levels, thereby promoting blood vessel dilation and reducing blood pressure.

Herbs Used in the Treatment of High Blood Pressure 

Grape Seed 

Grape seed extract is high in polyphenol content with potent antioxidant effects. The action of grape seed extract is to help minimize oxidative stress and preserve endothelial function, thereby improving vessel dilation, blood circulation and lowering blood pressure. Several studies have shown its effectiveness in maintaining endothelial function and reducing blood pressure. 

Hawthorn 

Hawthorn berries have a long history of use in the treatment of heart disease. More recently, researchers have found that hawthorn extract helps to improve blood vessel dilation and blood flow, in addition to lowering diastolic blood pressure. Studies have also confirmed that hawthorn is well-tolerated and safe, even for patients with congestive heart failure. 

Olive Leaf 

Olive leaf extract contains oleuropein that has vasodilative qualities, as well as cholesterol-reducing properties. Research also indicates that oleuropein relaxes arterial walls to improve blood flow and reduce blood pressure. 

Pomegranate 

Punicalagins, the main constituent of pomegranate juice and skin, is rich in ellagic acid, a powerful antioxidant that is currently being studied for its anticancer value. However, the collective phytonutrients found in standardized pomegranate extract also exhibits potent vasodilating properties in addition to blocking oxidative stress. Several studies indicate that this extract is a natural ACE inhibitor and there is evidence to show that it may promote normal endothelial function and lower blood pressure.

Safety Precautions 

Omega-3 

Do not take EPA/DHA if combination with warfarin (Coumadin) due to an increased risk of bleeding. 

Coenzyme Q10 (CoQ10) 

There is evidence to suggest that CoQ10 may improve glycose metabolism in type II diabetes. However, be sure to monitor glucose levels carefully. 

Statin drugs often counteract CoQ10, decreasing serum levels of this nutrient. 

Magnesium 

Do not take if you have myasthenia gravis or kidney or renal disease. 

Magnesium inhibits the absorption of tetracycline antibiotics. 

Magnesium inhibits the absorption of folate or iron supplements. Therefore, the latter should be taken either two hours before or after magnesium. 

Calcium 

Do not take calcium if you have kidney disease. 

L-arginine 

Supplementation should be supervised by a physician if you have liver disease, kidney disease, or herpes simplex. 

This nutrient can stimulate growth hormone and should be avoided by cancer patients. 

Do not take if you have argininemia (a rare genetic disorder). 

Grape Seed 

Do not take if you are currently taking warfarin (Coumadin) or other blood thinners. 

Hawthorn 

Do not take in conjunction with heart medications, such as digoxin.

Large doses may cause an unsafe drop in blood pressure. 

Olive Leaf 

Avoid if you have a history of gallstones. 

Pomegranate 

Due to sugar content, supplementation in diabetics should be monitored by a physician.