One of the most common reasons people give for coming to our practice is to see if there’s “something other than all these pills” they’ve been prescribed for a medical problem. I frequently hear sentences such as, “I read the side effects of this drug and think: but those are the symptoms I’m being treated for,” or “I take all these pills and I feel pretty much the same.”
Treating high blood pressure can be especially annoying because patients often take anywhere from one to four separate meds, two or three times a day, for a condition that has no symptoms. Many people can drive down their high blood pressure with a combination of improved diet (no junk food, plenty of veggies and fruits, lean protein, limited salt), managing weight, quitting tobacco, and exercising regularly.
But can everyone with high blood pressure quit their medications using natural therapies and lifestyle changes? Definitely not. Some people make all the lifestyle changes required and still have high blood pressure. Generally, this is genetic and you’re stuck with it. Just be glad the meds exist.
However, many people do take high blood pressure meds as a consequence of the lives they lead, and sometimes due to a doctor who may have been too quick on the prescription pad. For lots of folks, just being in an exam room with a doctor is enough to ramp up blood pressure.
So let me tell you about an interesting patient we had about a year ago. “Laura” was an extremely successful businesswoman near 50.
When we met she tossed down in front of me, gauntlet-style, four bottles of blood pressure drugs. “I am really sick of these and they don’t help. My blood pressure is still insanely high and nobody knows what to do. Every time I see my doctor, I get another prescription.” Even taking the drugs, Laura’s blood pressure was 240/140, a number high enough to considerably shorten her life due to susceptibility to stroke, heart attack, or kidney failure. I said I hated to think what her numbers were without the meds. “Pretty much the same,” she replied.
Laura and I talked at length about her life, and she told me she was an angry person who rarely let her emotions show. I observed, but didn’t remark on, a deep angry crease between her eyebrows. She told me that in situations where other people might feel sadness, disappointment, or impatience, she felt anger. Also, that every morning when she was just waking, before she had time to get angry, her blood pressure tested almost normal.
Since she didn’t have a history of high blood pressure in her family, I told her I thought her anger might be triggering a constant fight-or-flight stress response, with an endless outflow of adrenalin (the stress hormone from your adrenal gland), which could certainly raise her blood pressure.
I suggested we re-frame the issue in two ways:
• First, she should consider seriously getting a handle on the stress in her life and find ways to deal with it more productively than being angry.
• Second, we should check the level of her serotonin stress buffer to see if biochemically she was more vulnerable to stress than other people. The usual emotions when stress exceeds your stress buffer are depression and anxiety, but a very strong third contender is anger. Psychiatrists often treat chronic anger with antidepressants to raise the serotonin stress buffer, but we wouldn’t go that route just yet.
We agreed to an eight-week trial of non-drug therapy. Along the way, if her blood pressure was coming down, we’d reward her efforts by dropping one blood pressure medication at a time. Right up front, Laura was eager to embark on this approach. She really wanted it to work. I ordered tests to measure her serotonin level and her adrenal function. Other tests weren’t needed as she’d already undergone extensive testing with other doctors.
On that day, right after her visit with me, she had a lengthy acupuncture treatment with Tanuja Jagernauth in our offices. I took her blood pressure at the end of the session and it had fallen to 170/100. Bringing it down even further and keeping it down would be another issue altogether.
Laura also scheduled an appointment with nutritionist Marla Feingold and another with Dr Larry Stoler to discuss the stressors in her life. He would also teach her an at-home daily relaxation ritual called Chi-Lel.
She left the office with a biofeedback device called RESPeRATE, shown in several clinical studies to reduce stress-induced high blood pressure.
When her serotonin level results came back extremely low, I started her on St John’s wort and 5HTP to boost it. Not surprisingly, the test results also showed her adrenal glands were chronically stressed, a result of the fight-or-flight response she was triggering near-constantly with her anger.
At the end of eight weeks, Laura told me she’d learned a great deal about herself, and that family members and friends were voicing concern “because she’d been so relaxed.” We chuckled over that one. The deep crease between her eyebrows had eased and she told me she’d actually discovered she had a sense of humor, which she was putting to use in the executive offices to help defuse her anger response. She was also working out regularly.
Laura’s current blood pressure? 140/70 on one pill a day (she says it’s even lower when she takes it at home). That pill is a very specific choice, a class of medications called beta blockers, which block the effect of excess adrenalin from elevating her blood pressure.
Success like this requires a truly dedicated patient. At WholeHealth Chicago, our hats are off to Laura for her sheer diligence. Daily Chi-Lel, daily RESPeRATE, hitting the gym, and eating like a farmers market poster child take real commitment. Her high blood pressure was a message from her body begging for change. She responded and will likely be rewarded with years of healthful longevity.
David Edelberg, MD