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Medicial Mistakes?
How many people each year suffer some type of preventable harm that contributes to their death after a hospital visit?
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| | Naturopathic Medicine: Hypertension | |
Hypertension
Hypertension is defined as a repeated blood pressure (BP) reading of greater
than 150/90 mm Hg (mercury). There are two types of hypertension: primary
(aka essential or idiopathic, which means no particular cause can be identified)
and secondary, which means due to some definable cause such as kidney failure
or atherosclerosis.
About 89% of cases are considered to be primary hypertension, and while
no specific cause can be singled out as the culprit, many factors are implicated
in the development of primary, or essential hypertension. Some of the recognized
risk factors include family history, environment (family size, crowding,
eating patterns, occupation, obesity), salt ingestion and sensitivity (there
is controversy over whether the sodium or chloride part of the salt molecule
is the principal factor), race (blacks have more primary hypertension and
more morbidity and mortality than whites), hyperlipidemia, smoking, and
diet.
Secondary hypertension accounts for only a small minority of patients with
hypertension, but must be ruled out in all cases, as discovery and treatment
of the cause will cure the hypertension. Causes of secondary hypertension
include:
- sympathetic nervous system compensation in response to pancreatic
hypoglycemia which usually will fluctuate; in the morning it will be better
and in the afternoon it will be worse.
- epinephrine compensation in response to severe pancreatic hypoglycemia:
the patient will seem like they are calm outside but really tense inside.
They will tend to have increasing hypertension as the day goes on.
- obese hypertension: may be hormonal, hormonal with adrenal compensation,
or hormonal with liver compensation.
- renal hypertension: divided into renovascular hypertension (pre-eclampsia
and eclampsia, usually seen in pregnancy), and renal parenchymal hypertension
(stenosis of a renal artery causing decreased renal perfusion which results
in the kidneys activating the renin-angiotensin pathway)
- endocrine hypertension: this includes adrenal hypertension (primary
aldosteronism, Cushing's syndrome, and pheochromocytoma), acromegaly, hypercalcemia,
and oral contraceptives (probably the most common cause of secondary hypertension).
- coarctation of the aorta
Signs and symptoms of hypertension are as follows:
In primary hypertension patients are often asymptomatic until late in the
disease, and frequently hypertension is discovered during routine physical
examination.
- occipital headache: seen only with severe, advanced disease; worse
in the morning on rising, and better as the day goes on
- dizziness
- palpitations
- blurred vision
- epistaxis (nosebleeds)
- hematuria (blood in the urine)
- abnormal sounds over the renal arteries, possibly due to abdominal
aorta aneurysm
- no fall in BP from supine to standing. Blood pressure should normally
drop slightly with position changes just momentarily, then calibrate.
In secondary hypertension the same symptoms as primary hypertension are
seen, plus symptoms or history related to whatever is the inciting cause.
In addition:
- blood pressure falls during orthostatic measurement (sitting to standing)
- sympathetic nervous system compensation may cause BP fluctuations
with a better BP reading in the morning and worse in the evening. The individual
will appear calm but experiences internal tension.
To treat hypertension from a physical medicine standpoint, the first order
of business is to assess cardiovascular fitness with a submaximal stress
test. This is something typically done in a hospital or sports medicine
setting, by a qualified exercise physiologist. Your aerobic condition is
calculated, compared to normal for your age and other factors, and then an
aerobic exercise program tailored to your needs can be designed. Typically
heart patients need to work out in the range of around 40% of their maximum
target heart rate, sometimes for only 10 minutes a day at first. Don't
overdue. Consistency, and slowly building up as your condition improves
is the key. Severe hypertension patients may be advised to do NO aerobic
exercise at first. Isometrics are strongly contraindicated because they
can unduly stress the venous system. A system of slow, standing Chinese
exercise movements called Qi Gong have helped many people and are widely
practiced in China not only as therapy but treatment of many diseases, including
cardiovascular problems.
Physical medicine therapies using water may also provide great benefit.
Some of these include:
- hot baths: to promote sweating
- peroxide baths: to greatly stimulate skin circulation
- constitutional hydrotherapy
- for acute hypertension : enema, then full body hot bath with cold
compress to head and neck
- foot baths: alternating between tubs of hot and cold water.
Stress is an important complicating factor in hypertension, so you may
benefit from stress reduction techniques. One of the oldest and best beloved
stress management technique is treating yourself periodically, as your budget
allows, to a gentle, full body massage.
The importance of nutrition and diet cannot be overemphasized in disease
control, and hypertension is no exception. In general, attempt to adhere
to the following eating principles:
- low sugar, especially refined, white sugar and products which contain
it.
- low fat diet of unsaturated fats -- no more than 15% is optimal,
and try to avoid saturated fats (meat fat) altogether.
- your daily food intake should provide calories in the following percentages:
70% complex carbohydrates, 12-15% protein and 10-15% fat .
- high fiber, such as the good old apple a day, and whole grains
- low cholesterol (avoid animal fat).
- low Sodium/Sodium-restricted diet . Take the salt shaker off the
table.
- 1-2 week fast on alkaline juices or watermelon fast, followed by
a vegetarian diet .
- if overweight, reduce weight to normal range.
Foods that can provide specific therapeutic benefit in hypertension include:
- high Potassium foods such as millet, buckwheat, oats, rice, raw goat's
milk, raw leafy vegetables, watermelon, garlic, onions, rutin-rich foods,
cornsilk tea, garlic, broccoli, celery, cherries, nectarines, pineapple,
kumquats, watermelons, squash, pomegranate, guava, parsley, cucumber, dandelion
greens, cornsilk and white mushroom soup. If you are taking diuretics as
part of your plan to control or reduce your hypertension, replacing Potassium
is especially important.
- increase omega-3 and omega-6 fatty acids. These high quality oils
are found in vegetable, nut, and seed oils (particularly good is flaxseed
oil), salmon, herring, mackerel, sardines, walnuts, evening primrose oil,
and black currant oil.
Therapeutic foods used in Oriental cultures for hypertension include:
- mung bean soup
- chrysanthemum and spinach tea
- persimmon
- radish
- cucumber vine tea
Other specific food-based remedies include:
- take 60 g of banana skins or stems, steam in water and eat three
times daily
- one cup of grape juice and celery juice each, taken with warm water
three times daily for 20 days. After one 20-day course of treatment, a
5-7 day rest, then resume another course.
- drink the decoction of 10 water chestnuts and 25 g each of kelp and
corn silk. This means bring 1 quart of water to a boil, add the ingredients
and simmer for about 20 minutes on a low heat.
- soak peanuts in vinegar for 5 days, then eat 10 peanuts every morning.
- take a handful of sunflower seeds every morning and evening with
1/2 cup of celery juice (an effective, potassium-sparing diuretic) for one
month.
- drink one small "wine glass" of freshly pressed turnip
juice morning and evening for 10 days
- soak 6 g black fungus in water overnight; steam for one hour; sweeten
with sugar to taste. Take one time per day in evening before bed until
the symptoms and blood pressure have improved.
- for constipation caused by hypertension take 500 g of peeled banana
and mash together with 15 g black sesame seed. Eat daily.
- take 60 g of water chestnuts and 30 g of fresh orange peel. Add
water, steam until cooked and eat this dish 2 or 3 times daily.
- take 30 g dried green peach (pitted young green fruit left to dry
in the sun) cover with water and simmer until cooked and drink in place
of tea.
avoid:
- allergenic foods
- salt, salty foods: pickles, olives, chips, packaged snacks, meat,
(especially ham, frankfurters, bacon, bologna, corned beef, lunch meats,
frozen fish fillets, sardines, herring, caviar, anchovies, shellfish),
dairy products, spicy foods: salsa, white and black pepper, mustard, ginger,
hot foods, canned tomato juice, V-8 juice, processed cheese, canned, dried
or instant soups, frozen peas and beans, most processed and refined foods,
MSG, mayonnaise, salad dressings, gravies, ketchup, food with Sodium benzoate
as a preservative, Sodium proprionate in cheese and bread, baking powder,
baking soda, ice cream, milkshakes, soft drinks, smoked meats and fish,
Jello, pretzels, potato chips, salted nuts, candy, rennet tablets, pudding
mixes, beverage mixes, spicy foods, alcohol, fried foods, fatty foods, pork,
overeating, low levels of Calcium
- alcohol, sucrose, caffeine
- trans-fatty acids, hydrogenated oils (margarine, vegetable shortenings,
imitation butter spreads, most commercial peanut butters) oxidized fats
(deep fried foods, fast food, ghee, barbecued meats)
Supplements that may be additionally helpful, because it is sometimes impossible
to get therapeutic levels of certain nutrients through diet alone. Please
contact a qualified health care provider for specific dosages.
- Vitamin A
- Vitamin B-complex
- Vitamin B3
- Vitamin C
- Vitamin D
- Calcium 1-2 grams
- Magnesium 500 mg daily
- Potassium 100 mg daily
- Coenzyme Q10 60 mg daily
- omega-3 fatty acids 10-15 g daily
- omega-6 fatty acids, especially evening primrose oil (EPO)
The world of plant medicine has much to offer for controlling or even reducing
chronic high blood pressure. Please consult with a qualified herbalist
or naturopathic doctor to find out about specific dosages, or the form
in which to take the herbs. The following list will provide a guideline.
- Achillea millefolium (Yarrow) for essential hypertension
- Allium sativum (garlic)
- Apium graveolens: juice and seeds
- Arctium lappa (Burdock)
- Arnica spp. (toxic)
- Berberis vulgaris (root bark of Oregon Grape Root)
- Cimicifuga spp. (Blue cohosh)
- Crataegus oxyacantha: cardiotonic, stabilizes heart (Hawthorne berries)
- Fagopyrum esculentum (buckwheat) with vitamin C for raised arterial
tension with capillary bleeding
- Ginkgo biloba (standardized extract)
- Hamamelis virginiana (Witch Hazel)
- Olea europaea (olive oil)
- Rauwolfia serpentina (toxic):primary hypertension
- Scutellaria lateriflora (Skullcap) to soothe the nervous system
- Taraxacum officinale (Dandelion), useful as a diuretic and to tone
the vasculature
- Tilia platyphyllos for hypertension associated with atherosclerosis
- Valeriana spp. (Valerian root)
- Viscum album (Mistletoe). Beware! this plant is toxic in relatively
low doses but useful for high blood pressure which presents with headache,
dizziness, loss of energy, and irritability
Chinese herbs:
- Coptis and Scute (Huang Lian Jie Du Tang) (or if constipation, Coptis
and Rhubarb C. (Xie Xing Tang)); Jiang Ya Wan (patent); Uncaria 6 (patent):
Liver Fire Blazing Upward: irritability, dry mouth, insomnia, dark urine,
red tongue with yellow coat, forceful pulse
- Bupleurum and Dragon Bone (Chai Hu Jia Long Gu Mu Li Tang): Gall
Bladder Phlegm: irritability with occasional attacks of palpitations, constipation,
heavy sensation in the body, wiry rapid pulse , greasy tongue coat
 | A graduate of Bastyr University in Seattle, she completed both the Naturopathic and Acupuncture/Oriental Medicine programs. Her preceptor work (similar to residencies) took place in Seattle, West Virginia and China,......more |
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