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Ask the Doctor
About High Blood Pressure
By Tom Cowan, MD
Question: I am a 45-year-old man in relatively good
health, maybe 20 pounds overweight, a little stiff, a little tired.
I have recently been diagnosed with hypertension (high blood pressure).
My doctor found that my blood pressure is in the 150-160/95-100 range
over a number of visits. He has suggested that I go on blood pressure
medicine, which he indicated may be for the rest of my life. Is there
any way to threat this condition without using drugs?
Answer: This question comes up often in my practice.
The long answer could fill a medical textbook. The short answer begins
with a definition of hypertension-which has changed a number of times
during my 20-year career in medicine. In medical school we learned that
the top or systolic number was normal if it was less than 100 plus the
age of the patient. Thus 170 would be normal for a 70-year-old man.
The bottom or diastolic number was considered normal if it was under
90. About ten years ago, a number of studies seemed to show that the
bottom number was more important than the top number in predicting adverse
outcomes such as stroke and kidney disease. For years physicians mostly
ignored the systolic pressure and focused on normalizing the diastolic
pressure but lately a few studies have shown that both numbers are important
for predicting outcomes. Also, we no longer say that 100 plus the patient's
age is normal; rather, 140 is said to be the safe limit, regardless
of the age of the patient.
The issue of whether hypertension needs to be treated has also vexed
researchers for many years. If the pressure of the blood inside the
arteries is too high, leading to kidney damage and stroke, it would
seem that we should try to lower blood pressure. But the studies show
that while it is clear that having normal blood pressure is better for
your long-term health than elevated blood pressure, lowering pressure
with medicines does not demonstrably improve the outcome. Furthermore,
many of the drugs in use to treat hypertension have unfortunate side
effects. Diuretics cause the loss of valuable electrolytes (minerals),
thereby predisposing the patient to cardiac arrhythmia. Beta-blockers
alter lipid levels and can worsen the tendency to type-II diabetes,
which can lead to the same adverse outcome as elevated blood pressure.
Similar problems have been found with calcium channel blockers and even
with the new ACE inhibitors.
High blood pressure is, therefore, best treated without drugs. If we
consider the fact that in this condition, the circulation is working
too hard to nourish the cells, then it seems reasonable that some of
the causes include excess weight, electrolyte imbalances, lack of exercise,
fluid overload (due to poor kidney function), stress and fatty-acid
imbalances. The last cause usually involves deficiency of omega-3 fatty
acids and too much trans fat in the diet. These trans
fats replace saturated fats in the cell walls with the result that they
become too stiff.
These imbalances must be corrected and maintained for the life of the
patient. In practical terms, this means following the diet recommended
in Nourishing Traditions with its emphasis on traditionally prepared
whole foods; the use of mineral-rich Celtic sea salt; and a supplement
of omega-3 fatty acids, usually in the form of a small amount of flax
oil. Restriction of carbohydrates, as outlined in The Schwarzbein
Principle, will help with weight loss and will also lower insulin
levels, thereby helping your body eliminate excess fluid and burn excess
fat. A regular exercise program is important. Finally, studies have
repeatedly shown that the regular practice of some sort of meditation
or relaxation response can be very successful in treating hypertension.
The classic work in this field is still The Relaxation Response.
Following these guidelines at least 90 percent of my patients have successfully
lowered their blood pressure without resort to drugs.
About the Author
 Thomas
Cowan, MD, is a physician in private practice in San Francisco, California,
a board member of the Weston A. Price Foundation, and a regular contributor
to our "Ask the Doctor" column. His book The Fourfold Path to
Healing is now available from NewTrends Publishing, http://www.newtrendspublishing.com/.
Visit Dr. Cowan's website at http://www.fourfoldhealing.com.
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