You just went to see your doctor and were told that “you have high blood pressure or hypertension”. You have joined almost 30% of American adults with this diagnosis.
High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
You can have high blood pressure for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
Blood pressure measurements fall into 4 general categories:
- Normal blood pressure – below 120/80 mmHg.
- Prehypertension – systolic pressure (the top number) ranging from 120 to 139 mmHg or a diastolic pressure (the bottom number) ranging from 80 to 89 mmHg. Prehypertension tends to get worse over time.
- Stage 1 hypertension – systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mmHg.
- Stage 2 hypertension – systolic pressure of 160 mmHg or higher or a diastolic pressure of 100 mmHg or higher.
Both numbers in a blood pressure reading are important. But after age 60, the systolic reading is even more significant. Isolated systolic hypertension is a condition in which the diastolic pressure is normal (less than 90 mmHg) but systolic pressure is high (greater than 140 mmHg). This is a common type of high blood pressure among people older than 60. 
What is your next step after hearing this shocking news?
The diagnosis needs to be confirmed. The best way to do this is to buy yourself a present (WOW who doesn’t like presents! – a blood pressure monitor). Measure your blood pressure at home during different times of the day. Please sit down, relax, wait for at least 5 minutes before checking it. Record the readings and note any symptoms, as well as what you were doing just prior, such as exercising, watching an exciting movie, etc. Bring your monitor and blood pressure log to your next doctor’s appointment for a review of the numbers and the way that you apply the cuff.
If your numbers are still high, do not panic and start taking care of yourself.
First and most important approach is lifestyle modifications.
Healthy diet should include:
- 5-7 servings (cups) of vegetables and 2 servings of fruits a day
- whole grains
- healthy fat, like nuts, fish, eggs, avocado, olives, milk, etc.
- lean meat
- food rich in potassium and magnesium, like avocados, spinach, nuts, etc.
- food rich in antioxidants, like dark chocolate
- no added salt
- no processed food
- no trans fats
- no high fructose corn syrup or soda
- limit fried, smoked, charred food
- limit alcohol to 1 drink for a woman and 2 drinks for a man per day
For example, DASH combination diet significantly lowered both systolic blood pressure (SBP) and diastolic blood pressure (DBP), with an overall decrease in SBP of 11.4 mmHg and DBP of 5.5 mmHg in hypertensive individuals. The DASH combination diet is rich in fruits, vegetables, and low-fat dairy products. 
The Paleolithic diet, that is low in cereals and dairy products, and high in fruits, vegetables, meat and eggs, has been found to be as beneficial. 
Exercise!!! At least 5-10 minutes of high intensity intermittent or 30 -45 minutes moderate intensity exercise a day. Can also practice Tai Chi or Qi Gong.
Stress reduction!!! Meditation. Relaxation. Deep breathing or yoga. Heart Rate Variability or RESPeRATE that harnesses the therapeutic power of slow paced breathing to relax constricted vessels and bring blood pressure down.
Sleep!!!. Restorative sleep for at least 7-8 hours a day.
Weight loss!!! That will come if you stay with the lifestyle changes!
If you are still not at a goal for your blood pressure readings, talk to your doctor regarding your options. You can start medications and/or add natural products:
Coenzyme Q10 (CoQ10) – can bring SBP down by up to 17 mmHg & DBP by 9 mmHg. 
Garlic – it’s active ingredient, Alliin, can decrease in SBP by 7.7 mmHg & DBP by 5 mmHg. 
Fish oil – decreases SBP by 6-15 mmHg & DBP 5-8 mmHg, depending on dose and quality of the product. 
Vitamin C – affects mostly SBP, down by 13 mmHg, with no change in DBP. 
L-arginine – thru supplementation or l-arginine rich diet (nuts, dry legumes) can lower SBP by 6 mmHg & DBP by 5 mmHg, but it is even more effective in patients on hemodialysis, decreasing SBP by 28.7 mmHg. 
Multiple herbs have been proven to be beneficial in controlling blood pressure; some of which are:
- Prickly Custard Apple
- Celery, seeds or juice
- Black and green tea
- Black bean
- Coffee weed
- Soy bean
- and many others 
You must realize that “natural” products are not necessarily “safe.” The right dose of a supplement has to be determined by a qualified doctor.
Self-treatment with dietary supplements without the supervision of a healthcare provider can be potentially dangerous. Because these agents do exert pharmacologic effects on the body, they are capable of producing adverse effects and supplement-drug interactions.
Significant variations have been noted between manufacturer label claims and actual product content. [10, 11]
Please follow with your healthcare provider for more advice on treatment and monitoring of your blood pressure!
For more detailed information on a holistic approach to your health, please schedule an appointment with Dr. Koganski at 215-750-7000 or www.NewtownInternalMedicine.com
 www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/tests-diagnosis/con-20019580 (accessed 10/14/2017).
 Appel LJ, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med.1997;336:1117-1124.
 Jönsson T, et al, Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009; 8: 35.Published online 2009 Jul 16.
 Singh RB, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens. 1999;13:203-208.
 Ackermann RT, et al. Garlic shows promise for improving some cardiovascular risk factors. Arch Intern Med.2001;161:813-824.
 Yosefy C, et al. The effect of fish oil on hypertension, plasma lipids and hemostasis in hypertensive, obese, dyslipidemic patients with and without diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids. 1999;61:83-87.
 Khosh F, Khosh M. Natural approach to hypertension. Altern Med Rev. 2001;6:590-600.
 Kelly BS, et al. Oral arginine improves blood pressure in renal transplant and hemodialysis patients. JPEN J Parenter Enteral Nutr. 2001;25:194-202.
 Nahida Tabassum. Role of natural herbs in the treatment of hypertension. Pharmacogn Rev. 2011 Jan-Jun; 5(9): 30–40.
 Glisson JK, et al. Dietary supplements: important concerns for the clinician. J Miss State Med Assoc.2003;44:35-38.
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