Karen came to see me because her doctor said her blood pressure was too high and gave her the diagnosis of pre-hypertension. “I hope the white coat doesn’t increase your blood pressure too much, especially when you think about the acupuncture needles,” I joked. Fortunately, Karen had a sense of humor.
“I never could have imagined my doctor would tell me I have high blood pressure,” Karen said. “I thought only men had trouble with that. And what’s ‘pre-hypertension’ about? He wanted to start me on medication.”
New guidelines have lowered the bar for defining hypertension, and experts have added a new category, pre-hypertension, defined as follows:
• Normal blood pressure:
less than 120/80 mm Hg
120 to 139/80 to 89
• Stage 1 hypertension:
140 to 159/90 to 99
• Stage 2 hypertension: 160/100
Believe it or not, I told Karen, about 24 percent of men and 23 percent of women in the United States have hypertension (about one-fourth of all adults).
Saying that people with mildly elevated blood pressure have pre-hypertension is controversial. Some researchers and doctors believe the diagnosis will unnecessarily worry people who aren’t in any real trouble. Others say we need to alert people when their blood pressure starts trending upward and control it with medication. Hypertension can be a major risk factor for strokes, heart attacks and kidney disease.
Decrease Your Risk
As Karen and I talked, I noted a few risk factors she had that, if addressed, could help reduce her blood pressure and eliminate the need for prescription drugs. These included alcohol consumption and the 15 to 20 pounds of extra weight she carried. She told me her father had hypertension and that he had died of a stroke a few years before. “I guess I got the gene,” she said.
However, I told her that two new studies analyzed data from two huge trials, one of which followed more than 400,000 people for up to 30 years. The lead author said the studies “blow away the myth of bad genes” as a major factor in heart disease.
Because Karen’s doctor wanted her blood pressure down to about 120/80, we both wanted to see what herbs, diet and a few changes in health habits could do. Karen had read about the side effects of commonly prescribed drugs like diuretics and beta-blockers — frequent urination, fatigue and low sex drive — and she was enthusiastic to try a natural program first.
We discussed her weight, and Karen told me it had slowly come on over the last few years, right after menopause. Slimming down can provide amazing benefits for hypertension. An analysis of 25 controlled human studies by an international group of researchers showed that losing 10 pounds could result in a 4.5 mm Hg reduction in systolic pressure and 3.5 mm Hg in diastolic pressure. These results mean a pre-hypertension level of 120/80 could be reduced to a healthy level of about 116/77 by losing just 10 pounds. Larger blood pressure reductions were seen in study participants who lost more than 10 pounds.
Since salt intake is another major risk factor, we discussed ways she could reduce her intake, especially by not adding salt to meals at home and by substituting a moderate amount of sea vegetable flakes. Sea vegetables contain all the important mineral salts, not just sodium chloride, a mineral that is increasingly linked to hypertension.
Stress is an additional risk factor. Karen had a stressful job, so I strongly encouraged her to take a yoga class two to three times weekly. I’ve had a number of patients report that regular yoga dramatically increased energy levels and reduced feelings of anxiety and stress.
Make Positive Changes
When I examined Karen’s tongue and felt her pulse, I found that her tongue was covered with a slightly yellow coating, except for the sides, which were redder than normal. This is a clear sign of liver stress in Traditional Chinese Medicine (TCM). In TCM, an overactive liver can be a major cause of hypertension, often accompanied by feelings of frustration, irritability and anger.
I didn’t want to overload Karen with too many treatments and changes to her usual routine, as I’ve found this to be discouraging to many patients. A simple approach is best, adding only a few new things, then checking for results after about six weeks. With hypertension, it’s fairly easy to see changes along the way. All it takes is a high-quality blood pressure-measuring device, available from any drugstore.
Karen agreed to keep a daily chart of her blood pressure and to make a few healthy additions to her daily routine. She also agreed to take two herbal supplements designed to relax her liver and symptomatically reduce blood pressure.
The healthy habits she said she’d try to practice included brisk walking for at least 20 minutes daily and eating more vegetables and fruits and fewer refined carbohydrates. She also agreed to cut her alcohol consumption in half (she had about two drinks several times weekly).
Helpful Herbal Formulas
It’s always best to work with an experienced herbalist as part of a team with your doctor when dealing with high blood pressure.
The first herbal formula I recommended was designed to relax and regulate her liver and included the following herbs, which are widely available in capsules, tablets or, for the more adventurous, in bulk to make into a tea (these herbs have a bitter taste).
• Artichoke leaf (Cynara scolymus): moves bile and reduces cholesterol.
• Dandelion root and leaf (Taraxacum officinale): a mild diuretic and bile-moving herb.
• Burdock root (Arctium lappa): regulates the liver.
• Yellow dock (Rumex crispus): regulates the liver and bowels and helps reduce internal heat.
I recommended a separate formula to gently reduce blood pressure. These herbs are best taken in tincture form. The individual tinctures can be purchased and blended together, using equal parts of all the herbs except mistletoe (use half the quantity of this herb).
I’ve seen a 10 to 15 percent reduction in blood pressure after six to eight weeks in some patients when they take 2 to 3 droppersful, twice daily, of a formula similar to this one.
• Mistletoe herb (Viscum album). Do not use the berries, which are toxic.
• Shepherd’s purse (Capsella bursa-pastoris)
• Hawthorn flowers and leaves (Crataegus spp.)
• Motherwort (Leonurus cardiaca)
Karen wasn’t perfect in following the program, but she was faithful about taking the herbs. After six weeks, her blood pressure came down about 5 mm Hg, and this gain seemed to persist. After a few months, she brought her blood pressure down to normal, and that was accompanied by an eight-pound weight loss, which was not too difficult for her to achieve.
Neither Karen nor I knew which of the changes had really worked for her. I have faith in the herbs, especially herbs that address a clearly identified constitutional pattern, like liver excess. And I’ve seen good results with the mistletoe-shepherd’s purse combination, which often is prescribed in Germany for mild hypertension. Still, I had the feeling that the total program was really the key to success, and recent science, as well as common sense, backs this up.
Christopher Hobbs’s case studies are gleaned from his 30 years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the correspondence course Foundations of Herbalism; www.foundationsofherbalism.com.
“Case Studies” is not intended to replace the advice of your health- care provider.