Naturopathic Medicine and High Blood Pressure

Naturopathic Medicine and High Blood Pressure
By Brooke Campbell
Brooke Campbell is a fourth-year naturopathic medical student at the National University of Natural Medicine in Portland, Oregon. She believes in an integrative approach to care and she is passionate about helping others optimize all aspects of their health, with a special interest in cardiology.

What is high blood pressure?

High blood pressure, or hypertension, is one of the most common conditions in the United States. Almost half of all adults in the US have hypertension. It is one of the most common reasons for doctors’ visits and prescription medications. Unfortunately, only about 1 in 4 adults with high blood pressure have their condition well-controlled on their medications. This means that many people with hypertension may be taking medications, but their blood pressure is still too high, which can lead to health complications. 
Certain groups of people are more likely to have a high blood pressure than others. It is more common in men than women, and in non-Hispanic black adults than non-Hispanic white adults, non-Hispanic Asian adults, or Hispanic adults. 
Approximately 1 in 5 people have high blood pressure and do not know. This is because high blood pressure usually does not have any symptoms, so you need to have your blood pressure checked by your health care provider. For adults, ideally, your blood pressure should be at or below, 120/80 mmHg. Hypertension is defined as a blood pressure higher than 130/80 mmHg, typically measured at the doctor’s office on at least 2 different visits.

Are there different kinds of high blood pressure?

There are two main types of high blood pressure that you may hear your doctor mention: Primary and Secondary Hypertension. There is also a third type called “White Coat” hypertension, which is less common. 

1. Primary hypertension often called essential hypertension, is the most common type. This type of high blood pressure typically develops over time with age. It may be caused by multiple factors such as salt intake, obesity, inflammation, stress hormones, and more. For this type of high blood pressure, patients have commonly prescribed medications like Hydrochlorothiazide, Lisinopril, Losartan, or many others.
2. The second type is called secondary hypertension, which means that the high blood pressure is due to an underlying cause. Possible causes of Secondary Hypertension include kidney disease, obstructive sleep apnea, and thyroid disorders. It is recommended that your doctor check you for any of these underlying conditions if you have high blood pressure and you’re under 30 years old, if your blood pressure rises suddenly, or if you need more than 3 medications to manage your blood pressure. If your doctor decides you have secondary hypertension, they will work to identify the cause and recommend medication to manage that condition.
3. There is a third type of hypertension called “White Coat Hypertension”, and this is where people’s blood pressure goes higher in the doctor’s office because they’re nervous. Your doctor may want you to check your readings at home to confirm if this is the case.

Why is it important to treat high blood pressure? 

It is very important to treat and monitor high blood pressure. If your blood pressure stays high, it forces the heart to pump harder over time. This additional strain on your heart can lead to serious health problems like a heart attack, stroke, heart failure, and kidney failure. 
However, high blood pressure is a modifiable risk factor for cardiovascular disease, which means that there are things you can do to modify your risk of getting these complications. By keeping your blood pressure in an ideal range, you can prevent these complications. Your doctor may even prescribe you a blood pressure cuff to use at home to monitor your blood pressure. You should see your doctor regularly if you believe your high blood pressure is not well controlled on your current treatment plan.

My doctor diagnosed me with hypertension and prescribed me a pill. Do I have to take it? 
It is best to follow your doctor’s advice to decrease your risk of health problems associated with high blood pressure. Your doctor should thoroughly review this medication with you and discuss the pros and cons of you taking it. Some medications for the high blood pressure may have some minor side effects, but there are ways to manage these if they become bothersome. Your doctor may choose to switch you to a different medication. 

Do I have any other options?
There are many lifestyles and dietary choices that can contribute to high blood pressure. This includes smoking, drinking alcohol, physical inactivity, high-salt diets, and a higher body mass index (BMI). However, there are some things you can’t change. These include your genetics, age, and previous diagnoses. Medications may be the best option for you, but there are also many other ways you can reduce your blood pressure naturally. Additional lifestyle recommendations include a heart-healthy diet like the DASH (Dietary Approaches to Stop Hypertension) diet, increased physical activity, decreasing alcohol consumption, and weight loss in some individuals. Making an appointment with a licensed Naturopathic Doctor (ND) is a great way to learn about which of these options is best for you. 

What makes the Naturopathic Doctor (ND) different? Why should I see one?

Naturopathic doctors address the root cause of disease by addressing the foundations of health. Naturopathic doctors follow the Therapeutic Order, which is a tiered system that guides treatment. One of the first steps is establishing the foundations of health. This can include dietary changes, exercise, sleep, and managing mental and emotional health. The next step is stimulating the healing power of nature to support your body’s natural processes. This can include treatments like acupuncture or hydrotherapy. If your condition is more serious, NDs can also utilize treatments like supplements, herbal medicine, IV therapy, and even pharmaceutical medicine when needed. NDs have a large toolbox of treatment modalities and they understand how to safely prescribe treatments that are individualized to your specific health needs. 
Many conventional doctors may also recommend some of these therapies in your treatment plan. They may recommend the DASH diet to help lower your sodium intake and blood pressure and may tell you to exercise more. The main difference is that when you see an ND, you will have a longer appointment time. Most visits are 60 minutes long, which allows time for the doctor to get to know you and your health goals. During these longer appointments, you can work together to come up with a specific treatment plan that works for you, including recipes, a weekly exercise plan, a personalized herbal formula, and more. Dietary and lifestyle changes are hard, but if you’re willing to begin implementing some healthy changes in your life, working with an ND is a great place to start. 

Are there herbs or supplements that can lower my blood pressure naturally? 
Most herbs and supplements have not been studied as extensively as medications. That being said, there are some treatments that have been researched for hypertension, and an ND may consider prescribing some of these to help lower your blood pressure. 
For supplements, an ND may prescribe fish oil for heart-healthy omega-3 fatty acids, a fiber supplement, Magnesium, CoQ10, acupuncture, and/or mind-body exercises for stress reduction.
If you’re interested in herbal supplements, consider asking your ND about the following herbs:

1. Hibiscus sabdariffa may reduce blood pressure and cholesterol. It is typically prepared as a tea and has a sour taste.
2. Crataegus (Hawthorn) may help to reduce high blood pressure and has numerous positive effects on the cardiovascular system. It is typically prepared as a tea or tincture and may be combined with other herbs such as Tilia (Linden), and Melissa officinalis (Lemon Balm).
3. Taraxacum officinale (Dandelion) leaf is a natural diuretic, which helps the body get rid of excess fluid, and can lead to a decrease in blood pressure. This is commonly prepared as a tea.
4. And many more! 

It’s very important to know that even though supplements and herbs are sold over the counter, this does not mean they are safe, and they may not be the right fit for you. Some herbs and supplements can interfere with your medications, may have adverse side effects, and are not recommended in pregnancy. You should talk with an ND before starting any herbal or nutritional supplement.

Can I still take my medications and see an ND? 
A common misconception is that you cannot keep taking your medications and see an ND. This isn’t true! Naturopathic Doctors understand that prescription medications can be lifesaving. NDs are trained in prescribing and managing medications and utilize them when necessary. In some cases, they may request that these medications be managed by your current doctor, but they will not judge you or force you to stop taking your medications. It may or may not be safe to decrease your dose of a medication, and you can work with an ND to decide what is a safe option for you. No matter what you choose, an ND can work with you to make positive lifestyle changes that can help you to feel better and become healthier. 

Can I keep seeing my Primary Care Physician (PCP) and Cardiologist if I start seeing and ND? 
NDs believe in integrative and collaborative care. If you have a good relationship with your other doctors, NDs will encourage you to keep seeing them too. It is important, to be honest with your other doctors about any new supplements or treatments that you start with an ND. 

Summary
High blood pressure is a very common but treatable condition. Working with a licensed naturopathic doctor can provide additional treatment options that are safely tailored specifically for you. Naturopathic Doctors offer a comprehensive and holistic approach to hypertension that can help you lower your blood pressure and can be a great asset to your integrative care team.