Don’t Be Silent About Your Blood Pressure Health

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There is a reason that hypertension is called the silent killer. There may be no symptoms or the symptoms are easy to ignore and misunderstand. As many 30% of Americans have it and at least 60,000 die from it each year, according to the American Heart Association. Then there is the fact that the range for healthy versus unhealthy blood pressure has changed in recent years. Could you be the one-in-three people with hypertension? Don’t know? It might be a good time to visit a naturopathic physician to find out. 

Why are healthy blood pressure levels important? 

Because hypertension often has few symptoms, it is important to be checked regularly to assess your blood pressure levels. Having high blood pressure increases your risk for stroke and heart disease

Blood pressure is measured in two numbers, for instance, 120/80mm Hg. 

  • Systolic blood pressure (the first number) – is a measure of how much pressure your blood is exerting against your artery walls when the heart beats.
  • Diastolic blood pressure (the second number) – is a measure of how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Physicians pay close attention to the first number (systolic) because when it is too high, there may be a greater risk of cardiovascular disease. This is particularly true as one ages and the blood vessels become stiff and are more prone to collecting damaging plaque. This however does not mean that the second number (diastolic) should be ignored. Studies show that death from coronary heart disease (narrowing of the blood vessels) and stroke (blockage of arteries to the brain) doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase from age 40 and upward.

When Should you See a Health Professional? 

  1. Healthy: Systolic is less than 120 and diastolic is less than 80
  2. Elevated/See a Doctor about Lifestyle Changes: Systolic is 120 – 129 and diastolic is less than 80
  3. First Stage/See a Doctor as Soon as Possible: Systolic is 130 – 139 or diastolic is 80 – 89
  4. Stage 2 Hypertension/See a Doctor as Soon as Possible Systolic is 140 or higher or diastolic is 90 or higher
  5. Crisis Hypertension/See a Doctor Right Away: Systolic is higher than 180 and/or my diastolic is higher than 120

How do naturopathic doctors treat hypertension? 

Naturopathic doctors help patients modify risk factors and identify healthy lifestyle approaches known to decrease blood pressure. Licensed naturopathic doctors also prescribe an individualized natural medicine plan, which may include a change in diet, exercise, weight management and prescribed dietary supplements. 

First visit appointments with most naturopathic doctors are 1-2 hours. After gathering detailed information and understanding of your health history, lifestyle habits and current medications, you and your naturopathic doctor will create a plan to get you started in lowering your blood pressure. Reducing or discontinuing your medication would only be done in conjunction with the prescribing provider and with appropriate medical guidance and support.

The main modifiable risk factors for developing hypertension include: being overweight, having a sedentary lifestyle, smoking, a diet high in sodium, alcohol overuse, excessive stress, sleep apnea, and diabetes. A naturopathic doctor works to prioritize eating a healthier diet, exercising regularly and underlying emotional causes of eating and ensuring proper thyroid function. 

Less modifiable risk factors are one’s genes, aging, being male and being African American. Certain illnesses, such as autoimmune disease can put a patient at risk for hypertension. Some essential medications, such as those used in the treatment of cancer, may also cause hypertension, for which natural medicine approaches may not be as effective.

Naturopathic doctors work to identify underlying cause(s) of hypertension and to create a unique, whole-person plan for you. A naturopathic doctor’s recommendations will fall into a number of categories and aim to:

  • Address nutritional deficiencies
  • Examine and adjust your diet
  • Insure optimal weight
  • Decrease overall inflammation
  • Prioritize exercise
  • Encourage the adoption of body-mind medicine techniques
  • Educate and inform about natural medicine products like nutritional supplements and botanical medicine 
  • Adjust medications as appropriate. 

Dietary changes that lower hypertension risk 

What you put in your body can make a difference in your blood pressure numbers. For instance, nutritional deficiencies related to magnesium, potassium, calcium, protein, and fiber have been shown to contribute to hypertension. Ensuring adequate intake of these nutrients through diet and or prescribed supplements can help support healthy blood pressure levels.  

Increasingly, research underscores the role that inflammation plays in the development and maintaining of hypertension. Eating an anti-inflammatory diet and reducing refined sugar and alcohol can help in this regard.

All NDs have advanced training in therapeutic nutrition, so you will have a nutritional plan tailored to your specific needs.

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is a proven approach to help reduce hypertension. The DASH diet is important because it emphasizes fruits and vegetables (4-5 servings/day) and low-fat dairy products (2-3 servings/day), as well as high-fiber whole grains, poultry, fish, nuts and seeds. The DASH diet provides specific nutrients the body needs to regulate health blood pressure levels, such as potassium, magnesium, calcium, dietary fiber, and protein. Specific foods to consider include, garlic, olive oil, beetroot juice, pomegranate juice, green tea and cocoa, which is clinically proven to support healthy blood pressure levels. 

Lowering salt intake is another benefit to following a DASH diet. The typical American adult consumes more than 4 teaspoon of salt per day, mostly from processed foods and eating out. It is important to shop for low-sodium foods and work toward lowering salt intake to 1.5 teaspoons per day or no more than 2300mg per day. 

Other dietary considerations include reducing consumption of refined carbohydrates, red meat and sugary treats are excluded from this eating strategy. These recommendations have other beneficial side effects that help prevent osteoporosis, cancer, heart disease and diabetes. Being overweight is a stand-alone risk factor for hypertension. 

For more on how to use nutrition to maintain healthy blood pressure, see Clinical nutrition can play a big role in managing high blood pressure. 

Get moving and get mindful 

Studies on the role of exercise in reducing blood pressure are convincing. A combination of aerobic exercise with dynamic resistance training is found to offer the most help. Working to prioritize daily exercise and make it part of your routine is an essential component to the treatment of hypertension. Of course, like many good habits,  it has widespread benefits including stress reduction, improved cognition, better insulin sensitivity and enhanced sleep.

Body-mind medicine, including mindfulness meditation, and yoga, has been shown to lower blood pressure. By adopting an approach that incorporates deep breathing and attention to the moment, body-mind medicine approaches comprise a low cost, no side-effect approach to add to a treatment plan. Stress reduction is an important component to the treatment of hypertension, so working with your naturopathic doctor and having an honest assessment of the stressors in your life as well as learning and practicing stress reduction techniques can be helpful in the treatment of hypertension.

What about dietary supplements and medication? 

There are numerous nutritional supplements that show positive impact on lowering blood pressure. The list is long: Coenzyme Q10, fish oil, garlic and vitamin C have all been studied for their positive impact on hypertension. In that group we can also find Omega‐3 polyunsaturated fatty acids, Pycnogenol, Reservatol, probiotics, lycopene, Vitamin E, Vitamin C, magnesium, alpha lipoic acid, carnitine, potassium and melatonin among others. It is important to understand that dietary supplements should be taken under the guidance of a naturopathic doctor. 

Naturopathic doctors are uniquely educated and trained to help you both address your risk factors for hypertension and to help you bring your blood pressure to healthier levels. “Doctor as Teacher,” is a foundational tenet of naturopathic medicine and is especially true when patients present with hypertension. Modifiable lifestyle factors make all the difference when treating  hypertension but you need to know which ones to modify! All NDs have advanced training in therapeutic nutrition, so you will have a nutritional plan tailored to your specific needs. Naturopathic doctor  training and experience in botanical medicine will also be put to use, as many herbs show evidence of bringing blood pressures into the more normal range. Research  includes study of many of the culinary herbs like Allium sativum (garlic) and Zingiber officinale (ginger) as well as Crataegus pinnatifida (hawthorn) and Lavandula stoechas (lavender), all of which can have a positive impact on blood pressure.

Some patients will need to remain on pharmaceutical medication. As state law allows, a naturopathic doctor can offer informed guidance. Medications for hypertension are common and often effective. The main types of drugs for hypertension include:

  • Diuretics assist your kidneys in removing sodium so your blood vessels can hold less fluid which causes your blood pressure goes down.
  • Beta-blockers cause a slowing of the heart rate, so your heart pumps blood with less force.
  • Angiotensin-converting enzyme inhibitors (ACE inhibitors) work to relax your blood vessels and which helps reduce your blood pressure.
  • Angiotensin II receptor blockers (also called ARBs) work similarly to ACE inhibitors.
  • Calcium channel blockers also work to relax your blood vessels by reducing the amount of calcium entering your cells.

When you work with a licensed naturopathic doctor to treat hypertension, he or she will discuss the medications you take and if you experience any side effects. The most common side effects from anti-hypertension medications include: cough, loose stool or constipation,  dizziness or lightheadedness, erectile dysfunction, anxiety, fatigue, headache, nausea or vomiting, rashes, and changes in weight.

In summary, hypertension can be treated well under a physician’s supervision. It should not be ignored as high blood pressure significantly raises the risk for coronary artery disease. The steps a naturopathic doctor will advise include lifestyle modifications, including diet, exercise, stress management, dietary and herbal supplements and if, necessary, guidance on pharmaceutical medications. Working to lower your blood pressure through lifestyle and natural medicine makes good sense. Get your numbers checked and let your naturopathic doctor be your guide to establishing healthy blood pressure numbers. Your heart will thank you for it. 

A service for the public from the American Association of Naturopathic Physicians (AANP) and the Institute for Natural Medicine (INM). The AANP and the INM would like to acknowledge Amy Rothenberg, ND, for her contributions to the content of this FAQ.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.