Elevated blood pressure, or hypertension, is defined as elevated systolic pressure above 120 mm Hg, elevated diastolic pressure over 80 mm Hg, or both. Elevation of both systolic and diastolic blood pressure increases the risk for heart disease. Unfortunately, a simple blood pressure taken at the doctor’s office can be misleading. For example:

  1. Some patients experience elevated blood pressure when they get checked in the doctor’s office but not at home, a condition known as “white coat hypertension”.
  2. Others have normal blood pressure in the doctor’s office but elevated at home when checked with a 24 hours blood pressure monitor; this is known as “masked hypertension”.
  3. Normally, our blood pressure should be lower at night (dips); those whose blood pressure does not dip at night are at higher risk of heart disease and/or stroke; those which excessive dipping are also at increased risk as well as those whose blood pressure rises (reverse dipping).
  4. Morning surges of blood pressure increase risk of heart disease and/or stroke.
  5. Extreme fluctuations in blood pressure over the 24 hour period increase the risk of heart disease and/or stroke.
  6. Elevated blood pressure in response to exercise indicates extremely poor cardiovascular conditioning.
  7. Hypertension induced by stress, medication, diet, or supplements.

In our office we do not rely on a single blood pressure reading, but we routinely perform the 24 hour ambulatory blood pressure monitoring (ABPM) for our patients. This is a very simple procedure: a blood pressure cuff is attached to your arm and, through a wire is connected to a small monitor which is hooked to a belt. This will not prevent you from any of your daily activities other than taking a shower or swimming; you will sleep with the ABPM attached to your arm. After 24 hours, you return the ABPM to our office and measurements are downloaded into a computer. A detailed report is created and discussed with you afterwards. ABPM is now the “gold standard” test, providing much more information than the standard blood pressure performed in the doctor’s office.

What causes hypertension?

The last 2 decades of research has shown that hypertension, like heart disease, begins in the arteries and progresses in the following manner: 

  • Increased oxidative stress in the blood vessels
  • Inflammation in the blood vessels
  • Autoimmune dysfunction of the blood vessels
  • Abnormal vascular biology with endothelial dysfunction and abnormal vascular smooth muscle

Elevated blood pressure also increases the amount of inflammation and oxidative stress in the blood vessels, causing the thickening of the endothelium and increased autoimmune dysfunction of the arteries. Elevated blood pressure it is not only the result of these processes but it also contributes to the further exacerbation of these disease states, i.e., endothelial dysfunction can interfere with the arteries ability to contract and relax at the appropriate times, increasing the blood pressure. Increased blood pressure increases damage to the endothelium thus creating a negative feed forward cycle.

Therefore, hypertension is more than an individual disease, but rather a syndrome linked to problems in multiple body systems: 

  • Arteries (decreased arterial compliance, endothelial dysfunction)
  • Blood clotting mechanism changes
  • Accelerated atherogenesis
  • Change in the structure and function of the heart (left ventricular hypertrophy and dysfunction)
  • Abnormal blood sugar metabolism
  • Abnormal insulin metabolism
  • Kidneys function changes
  • Abnormal fat (lipid) metabolism
  • Obesity
  • Neurohormonal dysfunction

Most people have no idea that their blood vessels have been already affected. Also, they do not know how easy it is to avoid this fast track to hypertension and heart disease early on. Unfortunately, their doctors tell them how to prevent these degenerative and potentially fatal diseases.

Many people believe that such diseases are in their genes since their parents and/or grandparents have had or died from those conditions. This can’t be further from the truth. The genetic predispositions are not predeterminations; take corrective actions as soon as possible and you will not develop heart problems like other family members.

Some patients take one or more prescription drugs to maintain their blood pressure within normal limits. For some of those people these drugs are lifesavers, but for others may be the beginning to more medical problems. For example:

  • Diuretics, which are used as first line therapy in hypertension can cause elevated blood sugar, type 2 diabetes, and kidney insufficiency, increased uric acid and gout, low potassium and low vitamin B1. Examples of diuretics are: thiazide diuretics (Esidrix or Zaroxolyn), loop diuretics (Lasix, Bumex), which do not significantly lower blood pressure, and potassium-sparing diuretics (like Aldactone, Dyrenium). They are often prescribed in conjunction with the other two types of diuretics, but also do not significantly lower blood pressure
  • Beta-blockers can trigger fatigue, impotence, memory loss, insulin resistance, type 2 diabetes, low HDL (healthy, happy cholesterol), and more. Examples of betablockers are: Acebutolol (Sectral), Atenolol (Tenormin), Bisoprolol (Zebeta), Metoprolol, Nadolol (Corgard), Nebivolol (Bystolic), Propranolol (Inderal LA)

Due to genetic factors, many patients do not benefit much, if at all, from these medicines. If you have hypertension or any problem with blood pressure of flow, we recommend a customized program which includes the following:

  • An anti-inflammatory, heart-healthy diet low in salt (maximum 1500 mg per day)
  • Specific exercise for heart disease prevention
  • Lose body fat and increase lean muscle
  • Improve sleep; test and treat sleep apnea
  • Stop smoking (acupuncture is very helpful for smoke cessation)
  • Reduce or stop alcohol
  • Reduce stress, anxiety, depression using a natural approach for balancing neurotransmitters
  • Use specific dietary supplements that address the causes of hypertension and heart disease



  1. Wexler R, Pleister A, Raman SV, Borchers JR. Therapeutic lifestyle changes for cardiovascular disease. Phys Sportsmed. 2012;40(1):109-115.
  2. Gardener H, Rundek T, Wright CB, Elkind MS, Sacco RL. Dietarysodium and risk of stroke in the northern Manhattan study. Stroke. 2012;43(5):1200-1205.
  3. Ford ES, Bergmann MM, Kroger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009 Aug 10;169(15):1355-1362.
  4. Yusuf S, Hawken S, Ounpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-952.
  5. American College of Preventive Medicine. Lifestyle Medicine–Evidence Review. June 30, 2009. Available at: http://www.acpm.org. Accessed September 18, 2009.
  6. Kottler BM, Ferdowsian HR, Barnard ND. Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009 Oct 1;104(7):947-56.
  7. Micallef MA, Garg ML. Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals. Atherosclerosis. 2009 Jun;204(2):476-82.
  8. Becker DJ, Gordon RY, Halbert SC, French B, Morris PB, Rader DJ. Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med. 2009 Jun 16;150(12):830-9, W147-9.
  9. Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G. Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy. 2005 Feb;25(2):171-83. Review.
  10. Sood N, Baker WL, Coleman CI. Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis. Am J Clin Nutr. 2008 Oct;88(4):1167-75. Review.
  11. Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam A, Parker TL, Vidgen E, Lapsley KG, Trautwein EA, Josse RG, Leiter LA, Connelly PW. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA. 2003 Jul 23;290(4):502-10.