Hypertension, also known as high blood pressure, is a medical condition in which the blood pressure in the arteries is persistently elevated, specifically with a sustained blood pressure reading of over 140/80 mmHg or higher. The first number (systolic) represents the pressure when the heart contracts, and the second number (diastolic) represents the pressure when the heart relaxes between beats. It is frequently referred to as “the silent killer”, as many people with hypertension are asymptomatic, i.e., they do not experience any obvious symptoms, especially in the early stages of the condition. However, there are many indicators that can assist with prevention and earlier detection, so it’s important to understand the full scope of the disease.
To start, there are four main types of hypertension:
- Primary (Essential) Hypertension — the most common type, accounting for about 90-95% of cases; the exact cause is unknown, but it is likely due to a combination of genetic and lifestyle factors.
- Secondary Hypertension — caused by any of various underlying medical conditions, the most common of which include kidney disease, thyroid disorders, sleep apnea, and or certain medication, e.g., corticosteroids, birth control pills.
- Resistant Hypertension — when blood pressure remains high despite the use of three or more blood pressure medications; often due to lifestyle factors, underlying medical conditions, or medication non-adherence.
- Malignant Hypertension — a severe and life-threatening form, characterized by extremely high blood pressure (often over 180/120 mmHg) and can lead to organ damage if left untreated.
Just as there is a range of disease types, the clinical manifestations of hypertension can vary depending on the severity and duration of the condition once beyond the asymptomatic phase. Some of the common symptoms of hypertension follow:
- Headache – Persistent or recurrent headaches, particularly in the back of the head or at the temples.
- Dizziness or Lightheadedness – Especially when standing up quickly.
- Chest Pain or Discomfort – Uncontrolled hypertension can lead to chest pain or a feeling of tightness or pressure in the chest, which may indicate underlying heart disease.
- Shortness of Breath – High blood pressure can put strain on the heart and lungs, leading to difficulty breathing or shortness of breath, especially with physical activity.
- Nosebleeds – Caused when small blood vessels in the nose burst, leading to nosebleeds.
- Fatigue and Weakness – From persistent high blood pressure.
- Vision Changes – Uncontrolled hypertension can damage the small blood vessels in the eyes, leading to vision changes or even vision loss.
- Swelling (Edema) – Fluid buildup and swelling, particularly in the legs, ankles and feet.
Hypertension Through A Functional Medicine Lens: Symptoms and Treatment
When considering the causative factors of essential (primary) hypertension, using a functional medicine perspective offers a more comprehensive, holistic view. From lifestyle habits to hormone and gut imbalances to toxins, here are some of the key factors that may contribute to the development of essential hypertension.
Lifestyle Factors
A poor diet and lack of exercise are two of the biggest reasons contributing to high blood pressure. This can include an excessive intake of sodium, saturated fats, processed foods and alcohol, as well as a lack of fruits, vegetables, and whole grains. The lack of regular physical activity, or having a sedentary lifestyle, compounds the problem, as does chronic or poorly managed stress. Tobacco use and exposure to secondhand smoke also negatively impact blood pressure.
Hormonal Imbalances
It’s no surprise that imbalances within the complexity of our hormonal system impact blood pressure. Insulin resistance, or impaired insulin sensitivity, and obesity can lead to hypertension. Chronic stress and elevated cortisol levels are potential contributing factors. And both hypothyroidism and hyperthyroidism can affect blood pressure regulation.
Nutritional Deficiencies
Insufficient or unbalanced amounts of key vitamins and minerals can contribute to hypertension. Among these include magnesium, Vitamin D, and anti-inflammatory omega-3 fatty acids.
Gut Health Imbalances
Imbalances in the gut microbiome, known clinically as dysbiosis, can lead to inflammation and metabolic disturbances. Leaky gut, or intestinal permeability, can also contribute to systemic inflammation and hypertension.
Nature and Nurture – Genetic and Environmental Causes
There is a genetic predisposition to hypertension; certain genetic variants and family history can increase the risk of developing essential hypertension. Although genetics are not in your control, your environment is. Be mindful that exposure to heavy metals, air pollution, and other environmental toxins can disrupt the body’s regulatory mechanisms and lead to hypertension.
Inflammation
Inflammation, from various sources, is a key mechanism that can contribute to the development and progression of hypertension. The relationship between the two is multifaceted. Chronic inflammation leads to the release of various inflammatory mediators, such as cytokines and chemokines. These inflammatory molecules can directly impact the function of the cardiovascular system, including the blood vessels and the heart.
Chronic inflammation is associated with increased production of reactive oxygen species (ROS) and oxidative stress. Oxidative stress can damage the endothelium, which is the thin lining of the blood vessels, thereby promoting vascular inflammation and impairing the body’s ability to regulate blood pressure.
Furthermore, inflammation can increase the activity of the sympathetic nervous system, which is responsible for the “fight-or-flight” response. Heightened sympathetic activity can lead to increased heart rate, vascular resistance, and blood pressure.
Treatment Options
From a functional medicine perspective, the treatment of hypertension often involves a holistic approach that includes dietary modifications, lifestyle intervention, and targeted supplementation. Here is an overview of some essential elements necessary for managing hypertension.
Dietary Recommendations
A healthy diet and weight are the first line of defense, especially when supported by emphasizing a plant-based, whole foods diet rich in fruits, vegetables, whole grains, and healthy fats; or a Mediterranean style diet of fish, lean meat, eggs, vegetables, fruits, and some nuts, but with no seed oils or refined sugar intake. Increase consumption of potassium-rich foods, such as leafy greens, bananas, and avocados; and incorporate anti-inflammatory foods like fatty fish, berries, and turmeric. Reduce intake of processed foods, refined carbohydrates, and sodium; and reduce or eliminate alcohol. And for all meals, portion control is key.
Lifestyle Modifications
Habits encouraging health and wellness are critical for preventing and/or managing hypertension. Engage in regular physical activity, such as brisk walking, swimming, or cycling, to improve cardiovascular function and reduce blood pressure. Incorporate stress-reducing techniques, such as meditation, deep breathing exercises, and Yoga. In addition, don’t underestimate the importance of adequate sleep; aim for 7-9 hours of quality sleep per night, as sleep deprivation can contribute to hypertension. Lastly, quit smoking, as this habit can have a detrimental impact on blood pressure, and overall health in general.
Targeted Supplementation
Supplements are an important part of the functional medicine approach to hypertension management. They can address specific nutritional or metabolic deficiencies or imbalances, as well as inflammation. In addition, they bolster endothelial and cardiovascular function, provide antioxidants, and improve insulin sensitivity and blood pressure regulation. Of the many supplements available as part of treatment, magnesium, omega-3 fatty acids, Vitamin D, and potassium are among the most popular.
Additional supplements particularly for reducing inflammation include: curcumin (compound in turmeric), Resveratrol, Boswellia Serrata (herbal extract), and Quercetin. The following supplements are specifically for metabolic support: magnesium glycinate or magnesium citrate, chromium, Alpha-Lipoic Acid (ALA), Berberine, and cinnamon. As with all treatment plans, it will be important to work with a qualified health care professional to ensure you are taking the right supplements targeted for your individual needs.
Acupuncture and TCM for Hypertension
For individuals looking for natural alternatives to treat hypertension, both acupuncture and herbal remedies from Traditional Chinese Medicine (TCM) are good options.
There are specific acupuncture points and meridian patterns commonly associated with the treatment of hypertension. The specific acupuncture pattern and points used will depend on the individual patient’s presentation and underlying imbalances. Acupuncturists may also use additional points based on the patient’s symptoms and the practitioner’s clinical experience. Some of the key acupuncture patterns and points used include: Liver-Kidney Disharmony Pattern; Qi and Blood Stagnation Pattern; Yang Hyperactivity Pattern; Yin Deficiency Pattern; and the Qi and Blood Deficiency Pattern.
With respect to TCM, there are some commonly used Chinese herbs for hypertension. These herbs are often combined in formulas based on the individual’s specific pattern of imbalance and symptoms. Like supplements, they work to improve circulation, reduce fluid retention and oxidative stress, boost cardiovascular health, and assist with regulating blood pressure. Some of the most commonly administered herbs include: Salvia (Danshen); Uncaria (Gou Teng); Gastrodia (Tianma); Hawthorn (Shanzha); Chrysanthemum (Juhua); and Eucommia (Du Zhong). It’s important to consult with a qualified Traditional Chinese Medicine practitioner who can provide a personalized herbal prescription.
The World Health Organization considers hypertension a major cause of premature death worldwide as of their 2023 reporting; and as of the Centers for Disease Control’s 2020 reporting, as much as 48% of adults in the U.S. have hypertension. Considering this statistic doesn’t take the pandemic years into account, that figure is likely higher. Therefore, it’s imperative we increase our understanding of the condition, especially how to recognize and treat it.
The functional medicine approach emphasizes the individual’s unique needs, genetics, and underlying imbalances to develop tailored treatment plans. And with the possible support of alternative methods such as acupuncture and TCM, sufferers of hypertension have many ways to turn for help with getting high blood pressure under control and/or eliminated.
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If you suspect you are suffering from hypertension, or want assistance managing your condition with acupuncture, TCM & FM approaches, schedule a FREE consultation, or book an appointment with us. Contact our office: 301-881-2898, or email [email protected].