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.