Hypertension, also known as high blood pressure, affects 1 in 2 adults in the United States, according to the CDC (1). Given that uncontrolled hypertension can lead to heart disease and stroke (the leading causes of death in the US), and that only 1 in 4 adults have their high blood pressure under control, hypertension is a serious issue (1).
While there are many medications to help control high blood pressure that can be life-saving, they may also have side effects (2). And while any medication can be helpful for a time, the goal should always be to address the root causes and work to heal those health issues, instead of taking medication to manage an issue for the rest of your life. This is where functional medicine comes into play. Through taking stock of all current and past health events, medications, lifestyle choices, and genetics, we can work together to not only manage hypertension but truly get it under control - sometimes solely through natural means!
What is hypertension? How does it develop?
We all have necessary pressure in our blood vessels that helps to circulate blood throughout our bodies, giving all of our cells life-giving nutrients and oxygen. However, this pressure can build and exceed healthy levels. When this pressure is too high for too long, hypertension develops. Long-term excessive force from the blood against artery walls can cause a number of health problems, including coronary artery disease leading to heart attacks, congestive heart failure, stroke, kidney failure, and even blindness (2, 3).
The cause of hypertension depends on the type. Primary hypertension is the most common and does not have any one identified cause. Blood pressure rises gradually over the course of years until it is at unhealthy levels (3). While the exact mechanism underlying primary hypertension is not agreed upon, there are a number of risk factors mentioned below that are thought to contribute to its development.
Secondary hypertension is high blood pressure that is a side effect of another underlying condition (3). It usually develops quickly, and causes higher overall blood pressure than primary hypertension. Conditions that commonly put people at risk of secondary hypertension include obstructive sleep apnea, kidney disease, adrenal gland tumors, congenital blood vessel defects, as well as side effects from many different drugs (birth control, pain relievers, NSAIDs, antidepressants, and illegal drugs like cocaine and amphetamines) (3, 4, 5, 6, 7).
What are the symptoms and risk factors for hypertension? And what can happen if high blood pressure is not controlled?
Surprisingly, most people who experience hypertension do not have any symptoms. Those who do may experience headaches, shortness of breath, chest pains, or even nosebleeds, though these are almost exclusively experienced by those with very severe hypertension (3). This is why it is important to have regular physicals to measure your blood pressure, pulse, and other baseline factors that can alert you to hidden problems.
There are a number of risk factors for hypertension, including (3):
Race (African heritage is associated with earlier hypertension development and more serious complications)
Being overweight or obese
Lack of physical activity
Too much sodium in your diet and/or
Too little potassium in your diet
Excessive alcohol use (more than 1 (women) or 2 (men) drinks per day)
High levels of stress, including stress-related habits like overeating or drinking
Chronic conditions like diabetes, kidney disease, or sleep apnea
Certain medications (listed above)
If hypertension is not controlled, it can lead to a number of organ and system failures. Unchecked high blood pressure can result in heart attack, heart failure, stroke, and even atherosclerosis (hardening of arteries) and aneurysms (weak or bulging blood vessels that may rupture) (3). It can also be associated with metabolic syndrome, which is a group of metabolism-related disorders such as higher cholesterol, insulin resistance, and risk of diabetes, and increased waist size (3). Lastly, uncontrolled hypertension can affect your brain. Hypertension can limit blood flow to the brain (due to atherosclerosis), leading to cognitive problems with learning, understanding, and memory, including an increased risk of developing dementia years later (3, 8).
This is why finding means to lower blood pressure and reduce spikes is so important. Hypertension not only increases present health risks but also creates risks for you years down the road.
What are the best methods for reducing blood pressure levels?
At Temecula Center for Integrative Medicine, our primary goal is discovering the root issues that are causing any discomfort or keeping your body from working at its highest capacity. So, the first step in treating high blood pressure is to determine what is causing it. If you have known conditions that are causing secondary hypertension, then we will focus on treating those alongside your hypertension. If not, we will take note of all other complaints or discomfort, ruling out all other possibilities before determining that it is primary hypertension.
Regardless of the type of hypertension, these same lifestyle changes can make a huge difference in blood pressure levels and lead to not only better blood pressure readings and overall health, but also feeling a lot better. The good news is that these same measures are preventative, too! If you employ the lifestyle habits listed below, your risk of hypertension is drastically decreased.
Diet is the first aspect to focus on when reducing blood pressure, including (9, 10):
Cutting down on unhealthy fats, sugar, and refined/processed foods (even drinking one less sugary drink per day can reduce blood pressure levels! (11))
Replacing those foods with vegetables, fruits, dairy, wild-caught and organic healthy fish, beans, and other foods high in vitamins, calcium, and healthy fats
Reducing sodium in your diet to healthy levels, and increasing potassium intake. Focusing on eating leafy greens, dairy, bananas, melons, and nuts can help with this!
Adding more foods (like berries) containing polyphenols to your daily diet, since these are good for your heart, and can improve blood pressure, inflammation, and insulin resistance
Working with your functional medicine doctor to add in supplements such as multivitamins, aged garlic extract, fish oil, etc. (12, 13)
Discuss a low-carb and/or ketogenic diet with your doctor to see if it could be right for you to lower blood pressure (14)
Diet is highly personal and can take some time to change, and we know this can be a difficult thing to do! Our Functional Nutrition Lifestyle Practitioner would love to work with you to make some small changes over time to create a big difference.
Exercise is another key part of controlling and reducing high blood pressure. Getting regular exercise for about 30 minutes most days of the week (150 minutes a week) will make a significant change to your overall health and blood pressure levels (9, 10, 15)! Walking, jogging, cycling, swimming, dancing, yoga, pilates, or even strength or HIIT training are all excellent options to pursue depending on your current activity level. Exercise can also help reduce stress levels, another key aspect in managing hypertension.
Reducing stress is very important in keeping consistent, healthy blood pressure levels (3, 9, 10). Stress is one of the factors that can immediately spike blood pressure by speeding up your heart rate and constricting blood pressure (10). If you can’t reduce or eliminate stressful situations, learning to cope with daily stress in a healthier way can make a big difference. Exercise, rest, meditation and prayer, deep breathing, grounding techniques, and making time to do things that you enjoy are all important to maintaining healthy stress levels (9, 10).
Air quality and smoking are other factors that can contribute to hypertension. Increased or long-term exposure to pollution from cars, smoking, and other particulate matter can all raise blood pressure levels, even in young, healthy adults (9, 10, 16). The good news, however, is that using a HEPA-grade air purifier in your home for just three days can reduce blood pressure, and this effect is even greater for those who are obese. Pairing an air purifier with an effort to reduce exposure to other toxic substances (such as cigarettes) can make a big difference.
Changing medication may be another potential option for treating hypertension. While this should only be discussed and executed in partnership with your physician, there are a number of medications that are known to increase blood pressure levels, and it is worth talking with your doctor to see if changing medications could help your hypertension. Commonly known hypertension-inducing medications include oral contraceptives, NSAIDs, corticosteroids, and antidepressants (17, 18, 19, 20).
It is important to note that people with severely high blood pressure, or those who have secondary hypertension and have not fully treated their causal underlying condition, may not be able to fully control their high blood pressure through natural means. For these patients, some medication may still be needed. However, when employing the lifestyle changes listed above, the amount of medication that is needed is often drastically reduced, and overall, far greater total health is achieved.
If you or someone in your family has hypertension, are concerned about your heart health, or has a secondary condition that puts you at risk for hypertension, please don’t hesitate to contact us. It is our joy and privilege to partner with our patients and help them achieve greater health, and we would love to partner with you too!
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
1. Centers for Disease Control and Prevention. (2021, July 19). Facts about hypertension. Centers for Disease Control and Prevention. Retrieved September 23, 2021, from https://www.cdc.gov/bloodpressure/facts.htm.
2. Commissioner, O. of the. (n.d.). High blood pressure. U.S. Food and Drug Administration. Retrieved September 23, 2021, from https://www.fda.gov/consumers/free-publications-women/high-blood-pressure.
3. Mayo Foundation for Medical Education and Research. (2021, July 1). High blood pressure (hypertension). Mayo Clinic. Retrieved September 23, 2021, from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410#:~:text=High%20blood%20pressure%20(hypertension)%20is,problems%2C%20such%20as%20heart%20disease.
4. AG;, J. (n.d.). Nsaids and increased blood pressure. what is the clinical significance? Drug safety. Retrieved September 23, 2021, from https://pubmed.ncbi.nlm.nih.gov/9391772/.
5. S;, O. (n.d.). Hypertension and oral contraceptives. The Journal of cardiovascular medicine. Retrieved September 23, 2021, from https://pubmed.ncbi.nlm.nih.gov/12263383/.
6. ScienceDaily. (2011, May 27). Chronic estrogen exposure linked to high blood pressure. ScienceDaily. Retrieved September 23, 2021, from https://www.sciencedaily.com/releases/2011/05/110526114533.htm.
7. Crookes, D. M., Demmer, R. T., Keyes, K. M., Koenen, K. C., & Suglia, S. F. (2018, July). Depressive symptoms, antidepressant use, and hypertension in young adulthood. Epidemiology (Cambridge, Mass.). Retrieved September 23, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980764/.
8. Sierra C. (2020). Hypertension and the Risk of Dementia. Frontiers in cardiovascular medicine, 7, 5. https://doi.org/10.3389/fcvm.2020.00005.
9. Mayo Foundation for Medical Education and Research. (2021, February 24). 10 drug-free ways to control high blood pressure. Mayo Clinic. Retrieved September 27, 2021, from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974.
10. MediLexicon International. (n.d.). 15 natural ways to lower your blood pressure. Medical News Today. Retrieved September 27, 2021, from https://www.medicalnewstoday.com/articles/318716.
11. Chen, L., Caballero, B., Mitchell, D. C., Loria, C., Lin, P.-H., Champagne, C. M., Elmer, P. J., Ard, J. D., Batch, B. C., Anderson, C. A. M., & Appel, L. J. (2010, June 8). Reducing consumption of sugar-sweetened beverages is associated with reduced blood Pressure: A prospective study among United States adults. Circulation. Retrieved September 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892032/.
12. Ried, K., Travica, N., & Sali, A. (2016). The effect of aged garlic extract on blood pressure and other cardiovascular risk factors in uncontrolled hypertensives: the AGE at Heart trial. Integrated blood pressure control, 9, 9–21. https://doi.org/10.2147/IBPC.S93335
13. Morris, M. C., Sacks, F., & Rosner, B. (1993). Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation, 88(2), 523–533. https://doi.org/10.1161/01.cir.88.2.523
14. Kosinski, C., & Jornayvaz, F. R. (2017). Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients, 9(5), 517. https://doi.org/10.3390/nu9050517
15. Tsukiyama, Y., Ito, T., Nagaoka, K., Eguchi, E., & Ogino, K. (2017). Effects of exercise training on nitric oxide, blood pressure and antioxidant enzymes. Journal of clinical biochemistry and nutrition, 60(3), 180–186. https://doi.org/10.3164/jcbn.16-108
16. December 2018 Hot Topic: Air pollution and hypertension. The Institute for Functional Medicine. (2019, February 15). Retrieved September 27, 2021, from https://www.ifm.org/news-insights/cardio-air-pollution-hypertension/.
17. Oparil S. (1981). Hypertension and oral contraceptives. The Journal of cardiovascular medicine, 6(4), 381–387. https://pubmed.ncbi.nlm.nih.gov/12263383/.
18. Johnson A. G. (1997). NSAIDs and increased blood pressure. What is the clinical significance?. Drug safety, 17(5), 277–289. https://doi.org/10.2165/00002018-199717050-00001
19. Goodwin, J. E., & Geller, D. S. (2012). Glucocorticoid-induced hypertension. Pediatric nephrology (Berlin, Germany), 27(7), 1059–1066. https://doi.org/10.1007/s00467-011-1928-4
20. Crookes, D. M., Demmer, R. T., Keyes, K. M., Koenen, K. C., & Suglia, S. F. (2018). Depressive Symptoms, Antidepressant Use, and Hypertension in Young Adulthood. Epidemiology (Cambridge, Mass.), 29(4), 547–555. https://doi.org/10.1097/EDE.0000000000000840