By Dr. Nicole Sundene
Naturopathic Cardiology and Hormones
QUESTION: "My blood pressure is 135/85. My Cardiologist just says to watch it for now. What else can I do to reduce it naturally without medications?" Linda S. Scottsdale, AZ
High blood pressure or “hypertension” in a mild to moderate range responds beautifully to Naturopathic Medicine in my twenty five years of experience in chronic disease and Women's Health! Women with blood pressure ranging from 130/85- 159/95 can expect to have their blood pressure lowered effectively with natural medicine. As a Naturopathic Doctor, I have helped hundreds of patients avoid the use of high blood pressure medications.
Although this should be done gradually and with someone experienced at doing so (such as myself) that I explain further in my "Hibiscus High Blood Pressure Tea" blog.
Patients with suspected high blood pressure should check their numbers twice daily preferably at 6 am and 6 pm for at least one month and contact their doctor if they have two readings above 140/90 on either number. As we must have at least two abnormal readings to diagnose high blood pressure.
Usually, medication is required in addition to natural herbs, vitamins, supplements, and diet when it is a more severe range ie: >160/90 - 180/100
Patients with a blood pressure above 180/100 on either number have "Malignant Hypertension" and should be at the hospital. IV blood pressure medications are needed in this emergency to get the numbers down and prevent stroke.
High Blood Pressure is the "Silent Killer" of women. Women will not have any symptoms related to high blood pressure and are at risk for stroke, heart attack, kidney damage, eye damage, blood clots, and premature aging.
My #1 biggest pet peeve as a Naturopathic Doctor is finding women have high blood pressure and/or borderline "grey zone" blood pressure that they are not going to do anything about. Too many times I have heard, "the cuff is squeezing my arm too tight," or "It gives me too much anxiety to check it." Yes, the anxiety of suddenly becoming blind or having kidney failure could also be very high, and sadly most women with high blood pressure that have not properly cared for their BP have just suddenly dropped dead of ruptured aneurysms, strokes, or heart attacks.
So please do not ignore your blood pressure just because you have "medical anxiety" or "White coat hypertension." The studies show that you also have high blood pressure in other stressful situations and ignoring it will have zero symptoms until it is too late. Once that happens my patient is either dead, eating an awful kidney disease diet/getting kidney dialysis, getting eye surgery after eye surgery.... or recovering from a stroke.
So for my patients that tell me they are too busy to check their blood pressure my Scandinavian doctor response is, "Are you too busy to learn to walk again? Because that can take around six months."
I may blog very bluntly, but I also know that people search for protocols and information such as mine to avoid going to the doctor and avoid using prescription medications, which is not at all what I want.
I always want the best for people. #1 Always do what your Cardiologist says unless I say otherwise. My method of dealing with female Cardiology issues is to fine tune and test for hormone imbalance, nutrient deficiencies, test and remove trigger foods individual to the patient, and improve overall nutrition prior to even entertaining the thought of tapering medications.
By working with your Naturopathic Doctor and slowly adding natural treatments in which we will discuss today, I generally see my patients require LESS medication and thus we taper the dose of their medications down as they improve.
The most dangerous thing high blood pressure patients can do with herbal medicine and Naturopathy is to not be monitoring their numbers daily. Generally, after 2-3 months my patients improve and need less medication when we implement natural medicine. Therefore, it is dangerous to not be monitoring the numbers when using herbal medicines to lower BP.
Of course, there are many etiologies to this common disease; however, most cases are because we have gotten fat, old, and out of shape.
Yes I said it outloud, but it is true and my blood pressure patients are almost always inactive which is why I see so many women that are thin with high blood pressure... because they don't have to exercise to maintain their weight. Exercise is needed to maintain the body as a machine. Ignoring exercise with blood pressure is the equivalent of never putting air in your tires, putting too much air in your tires... never checking the air level in your tires and then wondering why the "tire pops" in the form of a heart attack or stroke. Sometimes we care for our cars better than our bodies.
Yes, there are exceptions to the rule, such as insulin resistance, thyroid disorders and hormone imbalance causing high blood pressure in Women's Health. Otherwise the #1 reason I see why my patient has high blood pressure is lack of physical fitness. Exercise is needed to tonify the cardiovascular system and maintain the elasticity of the arteries. Without exercise, the arteries harden and become more narrow. So you must exercise for your arteries and it must be at a level that makes you slightly out of breath and makes you sweat or it generally does not work.
Regardless, I just announced the pink elephant in the room and everyone is mad at me for calling them fat and old...but I promise to help fix this in exchange of stating the facts.
In order to do that with Naturopathic Medicine we must understand elasticity. We want an “elastic” cardiovascular system and not a hard or "non-compliant" one as we say in medical terminology. And when I say non-compliant, I am not talking about a badly behaving cardiovascular system. I am talking about the elasticity of your arteries.
Non-Compliant Arteries=Hard Arteries = Old Garden Hose
Alternative treatments are not as efficacious as they could be when it comes to hypertension, and diet and exercise are the keys to keeping blood pressure low. The fact that you are no longer young and fit is the real problem, and we all inevitably develop hardening of the arteries known as “atherosclerosis”, which is the leading cause of high blood pressure. The arteries harden like an old garden hose that is then at risk for cracking in the form of an aneurysm.
While you are working to adopt a healthier lifestyle, I typically prescribe a basic Naturopathic regime of a Whole Foods Diet, magnesium, coQ10, vit C, Potassium, and fish oil as my first step.
Please note: Do NOT take fish oil if you are on anti-coagulants. Otherwise most of these nutrients combine well with most medications but your Naturopathic Doctor should supervise you.
*Always remember to check with your naturopathic doctor or MD before implementing ANYTHING new as even vitamins can be dangerous.
Monitor your blood pressure three times a day while making new changes to ensure you are not over-medicating with natural remedies. Signs of low blood pressure will look like fatigue, dizziness, seeing floaters, feeling cold, and feeling light headed when you get dehydrated or change positions.
The best natural medicines for high blood pressure:
1. Magnesium: 300-500mg daily of magnesium glycinate (may need to divide doses to avoid diarrhea) Magnesium is a muscle relaxant and the arteries are all surrounded with smooth muscle. Magnesium oxide at high doses will cause diarrhea. Magnesium glycinate is better for cardiac patients.
When the smooth muscle surrounding your arteries relaxes, it causes your arteries to dilate which results in a drop of blood pressure. Most people are deficient in magnesium anyway, as the richest sources are found in green veggies. I would guess about 90% of American’s are magnesium deficient.
2. CoQ10: 100-200 mg daily. You should be on this anyway if you have high cholesterol as statins deplete this nutrient, and the common sign is muscle weakness or pain, or in the severe form rhabdomyolyosis.
CoQ10 is depleted by statins (lipitor, lovastatin, etc) inhibition of HMGCoA reductase in the cholesterol pathway, so it is best to replete this potent antioxidant, and you may feel more energetic on your lipitor. I am just waiting for a pharmaceutical company to smartly come out with a statin that includes CoQ10. This nutrient is expensive, but it is worth the bang for the buck if you can afford it.
If you can’t afford it, remember that exercise is free and it is one of the better treatments anyway. If you have high BP check with your doc before starting a new exercise program as they may want to do an EKG or exercise stress test. Otherwise, be sure to purchase a high quality brand of CoQ10 in an emulsion (liquid capsule not tablet) form as this nutrient is fat soluble.
3. Garlic: Liberally in the diet (cooking does reduce the allicin content, so raw is best but I understand if you still need to keep a few friends around…it just means you have to eat more cooked or roasted garlic to attain the same therapeutic effect.)
Or just take garlic as directed if you are going with a supplement form. (Kyolic brand has been widely studied and shown to be efficacious according to the studies.)
Because various studies have shown garlic to be effective as an anti-hypertensive agent, I would start low and monitor blood pressure. Garlic also lowers blood sugar, so if you are diabetic you should check your blood sugar numbers more often while implementing this natural therapeutic for hypertension.
4. Potassium: at 24 mmol (ask your doc for a prescription, but chances are you are already on this as most anti-hypertensives are potassium depleting) If you want to get this from dietary sources, then just eat avocadoes, green leafies and fruits like bananas. Check with your doctor before using this as a therapeutic agent if you have kidney disease or if you are already on a potassium sparing diuretic medication (used for high BP.)
5. Vitamin C: 1000 mg twice daily. Emergen-C packets are the simplest way to achieve this along with vitamin C rich foods.
One of the cheapest and most well studied anti-oxidants by Linus Pauling: the theory with vitamin C and blood pressure is that high blood pressure typically results from a few causes.
Hyptertension is caused either by problems in the kidneys, or “atherosclerosis” or hardening of the arteries. We want arteries to be elastic and stretchy.
Vitamin C is a very cheap antioxidant that helps prevent the LDL from “oxidizing” and forming the hardened plaques in our arteries that cause them to lose their elasticity. Think of vitamin C as the nutrient that keeps your pipes from rusting. Just about everyone should be on vitamin C anyways.
6. Calcium: 800 mg daily. Most Americans do not achieve this in the diet. Research has shown that calcium will slightly help to lower blood pressure…and we’ll take every little bit we can. Natural medicines work well in incremental steps and synergistically.
The goal with most of these supplements is to create an additive effect. Most people are deficient in this essential nutrient anyway, as 800mg is required for the average adult. Take your calcium and magnesium 1-2 hours before bed to ensure a good night’s sleep as they are also great muscle and nervous system relaxants.
7. Fish Oil: 1 tablespoon of fish oil daily. Taking a liquid is more powerful and less expensive than capsules. Omega 3 fatty acids, as noted in my article “Fish vs Flax” if you have hypertension, I frankly wouldn’t waste my time with flax oil unless you are Vegan as it is not the active Omega-3 your cardiovascular system needs in high blood pressure. Not trying to upset my Vegan patients, but I always try to offer realistic expectations.
Trust me, I love flaxseeds, and I put every menopause patient on them, but if you are really trying to get a therapeutic effect you need something that is ACTIVE aka further along the anti-inflammatory pathway.
Many nutrient cofactors and coenzymes that most Americans are also deficient in are needed to convert flax to what fish oil is. Also those of Northern European descent such as Scandinavians likely are deficient in the enzyme needed to convert flax seeds, as their traditional diet is based on cold water fish rich in Omega 3′s.
8. Rauwulfia: Don’t use this herbal medication without consulting your naturopathic doctor. This is “big medicine” in my opinion, and should not be used without being adequately monitored. However, a randomized study showed less depression when compared to reserpine. Ask your naturopathic doctor about this medicine. I am happy to prescribe this herb as alternative to blood pressure medicine but it must be taken daily like a drug or it will not be effective.
9. Stevia: The herb known for its sweetness has also been shown to reduce blood pressure at 500 mg three times daily! If you have high blood pressure, you have my permission to try out some of the new stevia containing foods and beverages such as Zevia soda. I prefer the “Wisdom of the Ancients” in the green packets as my fav Stevia. Keep some packets on you and try it in your coffee or tea instead of your typical sweetener. Just don’t use too much as it is REALLY sweet! I have messed up many of my meals by adding too much which is why I always buy it in packets. Make sure your stevia is pure and not combined with erythritol or other artificial sweeteners that cause diarrhea.
10. L-Arginine: 2 grams three times daily. The amino acid that is famous in those late night infomercials for “Extenze” L-arginine works to enhance blood flow by being the precursor to nitric oxide production. Nitric oxide dilates our blood vessels and when we go back to the garden hose analogy we decrease the flow when we take our thumb off the hose. That is what L-arginine and similar nutrients for vasodilation do for hyptertension.
11. The Dash Diet: Involves extreme sodium reduction to <2000mg daily. But most people should be reducing sodium in the diet anyways. The best way to do this is to avoid packaged food and cured meat. Salt your food with organic sea salt when it is finished cooking….not during. Salt just makes us look unnecessarily fat and bloated anyways. Eat fruits and veggies, lean proteins, and learn to cook with herbs and citrus foods to enhance the flavor of your foods. Salt and pepper as the final garnish.
12. Tai Chi: This gentle exercise is perfect for everyone trying to lose weight or reduce arthritis, stress, or just increase agility, balance and peace of mind. Tai Chi is a powerful tool to calm yourself, stretch and tone muscles. Find a few favorite Tai Chi moves from classes at your gym or favorite video and try to incorporate at least five to twenty minutes of these gentle stretches in to your day. Do you know when I do them? When someone says “Can you hold please?” I then put them on speaker phone and say “sure no prob.” Sometimes I can get a whole fifteen minutes in. First thing in the AM and before bed every night I want my blood pressure patients starting their day with something calming that is heart health such as Ta Chi, Meditation and Yoga.
13. Weight Loss: Nag, nag, nag…lose weight. Yah, yah, yah….You’ve heard it. If you are struggling to lose weight you need an appointment with me.
If you are over-weight you most likely already know it so I would recommend following my simple weight loss plan at www.PGE-2.com and if you can’t do that then please consider investing in some long term help such counseling. If you can't afford counseling I suggest the bookk “The Gift of Our Compulsions” by Mary O'Malley to begin to address the route underlying cause of over-eating issues.
Of course our metabolism gloriously slows down about 1% each year, which accounts for the 10 pound weight gain each decade.
It may be just a discipline thing. Each year we have to learn to eat 1% less, otherwise each decade we will gain at least ten pounds. How is that for a birthday present?
14. Decrease/Eliminate Caffeine: Caffeine is just like throwing gasoline on the hypertensive fire.
Now the reason why people get those “caffeine headaches” is because they are used to caffeine restricting all their blood vessels…but once the body metabolizes all the caffeine we get the painful rebound headache effect called “vasodilation” which means that our arteries dilate and cause a throbbing headache.
So why do we care about caffeine headaches? Because when we constrict blood vessels we increase blood pressure.
Remember again sticking your finger over the hose when you were a child and making the water shoot further? Well that is not necessarily a good thing in the body. A cup or two of coffee a day typically isn’t the problem, it is caffeine in excess.
If you have severe hypertension you may want to consider switching to decaf green tea, or herbal tea. Otherwise, you can likely enjoy certain caffeinated beverages socially, or moderately as long as your hypertension is within optimal range through the use of other natural modalities or prescription medicines. Generally, 1-2 cups of coffee or tea is not the problem but a pot of coffee every day is a massive problem for hypertension. I have many patients with high blood pressure still enjoying their caffeinated beverages and not giving them completely up.
15. Quit sugar. Sugar is the culprit for many diseases, and although not typically associated with hypertension may be the root cause. Try eliminating sugar or cutting back for a few weeks and track your daily BP numbers.
I have seen hundreds of my Naturopathic patients reduce their salt and not see any results. Because salt has wrongfully been made the only villain in hypertension and it is not always the bad guy.
When I tell these patients not improving to instead reduce sugar... SHAZAM…the blood pressure goes down! This is because Insulin Resistance is a leading cause of high blood pressure. Blood pressure can be affected by basic osmosis meaning the dilution or concentration of their blood with salt, electrolytes, and sugar. Too much sugar or salt can increase blood pressure.
Refined sugar throws the body out of balance because it simply is just not natural. Everyone ishould read my Naturopathic friend Dr. Scott Olson’s brilliant book “Sugarettes,” to fully understand how refined sugar is destroying your body from the inside out.
16. Consider food intolerances and allergies. A recent study has linked food allergies to hypertension. Food allergies can cause a myriad of problems and a food allergy elimination diet is a great thing for everyone to try at some point. A Food Sensitivity Test can help uncover problem foods.
Many patients struggle to complete a 3 Week Elimination Diet, as it entails you have to eat completely differently for about a month and then you test the foods you most commonly eat to determine if they are causing a symptom within a three day window.
What is the first thing your doctor does if they think you are having an allergic reaction? They check your pulse and BP! Low grade allergies may go unnoticed, and high blood pressure or a rapid pulse may be the only clue. If you have high blood pressure check your pulse before and after your meals. If it is high then you need to call me to schedule a Food Sensitivity Test.
17. Not enough good oil, too much bad oil. We want to increase our good fats such as olive, fish, and flax, and decrease fried and fatty foods.
Think of saturated fat as little cement bricks building up in your arteries and making them hard and narrow. The good fats as recommended in “The Mediterranean Diet” are what will keep your cardiovascular system running like a race car. Most men worry about changing the oil in their cars more than they do than changing the oils in their body. But, just remember impotence is better prevented.
18. Coleus forskhohlii: Ask your naturopath about this herb. I don’t recommend self-treatment with herbs for high blood pressure. But the studies show it to be efficacious, and it is certainly worth trying.
19. Manage Stress. Blah blah blah stress. I can see you all rolling your eyes as you read this, but really stress is often the root cause of hypertension. Having worked 22+ years checking blood pressure, I have seen enough cases of “White Coat Hypertension” to know that stress causes high blood pressure.
The doctor’s office may not be that thing that gets your blood pressure raging, but if you have high blood pressure you likely need to cut back on activities, work, and practice some breathing exercises shown to reduce BP such as “Square Breathing” where you breathe in to the count of five, hold for five, breathe out for five, and hold for five. Consider taking up a relaxing hobby, musical instrument, or new craft.
20. Eat celery and parsley. Who knew that garnish on your plate is an actual diuretic? Celery has been used anecdotally with many patients. If you are trying to lose weight, increase fiber, or just be healthy….celery should be a daily snack anyway. Parsley is a diuretic that lowers blood pressure similar to dandelion.
21. Exercise *shudder* I know. I know. But in my expert medical opinion, you HAVE high blood pressure because you don’t exercise. I put this last because it is the most important and I would like to go off on a little bit of a rampage on why none of the aforementioned natural substances or pharmaceutical medications will work in the way that diet and exercise will.
Why is that? Well, hypertension is a sign that you are in poor physical condition, that is if you have the typical form of high blood pressure caused by being overweight and over the whole exercise thing. There are other forms, but the average American has high blood pressure because they are out of shape.
It is time to start eating better, exercising daily, as well as add in a few supplements to help maintain a healthy “flexible” cardiovascular system. Your cardiovascular system cannot be “conditioned” without a minimum exercise of twenty minutes daily in the cardio zone which is 70-80% of your max heart rate (220- (your age) x .7= Target cardio zone. Shoot for daily and then if you hit five days a week or even three days a week it will make your Naturopathic Doctor very happy!
So in order for me to make any progress with preventing cardiovascular disease I need my patients exercising. If you are not out of breath you are not exercising hard enough. If you are working out too hard you may be causing damage. High Blood Pressure patients should always exercise with a heart monitor. So if you are reading this the good news is you get to go shopping for a Fitbit and an Omrom blood pressure cuff.
Keep in mind that herbs such as dandelion that have been shown to be efficacious against anti-hypertensive medications such as furosmeide require HIGH doses in order to be effective. In order to lower pressure using dandelion, you have to literally take tablespoons of the tincture daily…and that is LEAF not root. The root serves to detox the liver and the leaf is used for blood pressure. You must work with a Naturopathic Doctor that knows how to safely combine cardiac medications and herbs such as myself!
Be sure you are always using the correct form of the plant. Many research studies done to show herbal medicines as ineffective have been done on the wrong form of the plant, whether intentional or not. Always read the label and make sure you are purchasing the correct form of the herb you are using.
Exercise, Whole Foods Diet, fish oil, vitamin C, CoQ 10, magnesium, and potassium are the most benign substances on this list if you are concerned about combining them with anti-hypertensive drugs. That combined with diet and exercise should help you gain better control of your numbers.
You may at some point want to discuss lowering your blood pressure medicine if not phasing off it, as the goal is to be on as few meds as possible, and many patients do not like the typical side effects of high blood pressure medicine such as fatigue, dizziness, and so forth.
Once stable on natural meds, your blood pressure should still be monitored daily to ensure there is not an additive effect and you end up with too low blood pressure aka “hypotension." BP below 90/50 is not good and indicates too low of sodium or adrenal issues. Perfect BP is between 120/80- 110/60. It is important for anti-aging reasons that your BP is optimally under 120/80 if not 120/70.
If you tend towards hypertension remember that anytime you are not feeling well the first thing you should grab is your home blood pressure cuff (the best brand is Omron according to my experience.)
High blood pressure with any of the following symptoms requires the patient to go to the ER or call 911 because you are having chest pain or any other potential cardiac symptoms such as pain in the neck, arms, flu-like symptoms, sweating, and so forth. As my very wise cardiology teacher, Dr. Pournadeli states, “anytime there is pain above the belly button assume MI (Myocardial Infarction=Heart Attack) until ruled out.” Blood pressure >180/110 requires hospitalization.
Stroke, heart attack, impotence, kidney failure, and eye disease are all part of the ugly sequalae to uncontrolled high blood pressure. Prevention of chronic disease and aging is key with hypertension. Try one new thing at a time and give it a few days to make sure it is not causing adverse side effects.
Thank you for sending me your Naturopathic questions to blog about. You can drop me a postcard with your question. If your question can't fit on a postcard then you need an appointment with me!
Dr. Nicole Sundene
Naturopathic Doctor
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
