Hypertension

Definition:

• Hypertension (HTN) means elevated blood pressure and can be defined as systolic blood pressure (SBP) higher than 120 mg and diastolic blood pressure (DBP) higher than 80.
• There are 3 different stages of hypertension described, depending on the degree of blood pressure elevation and the corresponding treatment recommendations. Pre-hypertension is described as SBP of 120-139 and DBP of 80-89; stage 1 is described as SBP 140-159 and DBP 90- 99; Stage 2 SBP greater than 160 and DBP greater than 100.
• HTN is considered the most important risk factor for cardiovascular morbidity and mortality in industrialized countries others include smoking and elevated cholesterol.
• Risk factors for developing HTN may include male gender, genetic predisposition, and aging. It is estimated that more than 65% of persons 65 years old or older are hypertensive.
• Even a small reduction of 5 mm Hg of SBP is shown to reduce mortality by 7%.
• HTN is frequently asymptomatic and does not cause discomfort thus may not seem significant to patients.

Treatment:

Rule out medical conditions:

• During the workup process for HTN, the following medical conditions should be checked and treated – if necessary:
• Insulin Resistance
• Apnea
• Nutritional deficiencies
• Toxins
• Inflammatory/autoimmune conditions
• Gut issues

Lifestyle:

• Some lifestyle changes may make a big difference in the treatment of HTN such as:
• Eat whole foods, mostly plant-based and do not overeat
• Increase soluble fiber intake, oily fish, 70% cacao dark chocolate
• Reduce unhealthy fats including hydrogenated vegetable oils, unhealthy sugars including high-fructose corn syrup, alcohol, caffeine, sodium
• Exercise at least 30 minutes a day at least 4 days per week.
• Do not smoke.
• Try DASH diet
• Lose weight, if overweight

Mind-body:

• Mind-body techniques have proven effective in the treatment of HTN including:
• Relaxation techniques such as breathing techniques and biofeedback
• Daily meditation, start with 10-15 minutes and then expand to longer periods.
• Yoga and tai chi

Supplements can be helpful when used under the care of your provider.

Medications are the standard therapy for HTN and may be used selectively if required.