resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
February, 2002, Vol. 02, Issue 02
Reducing High Blood Pressure with Natural Therapies
By James P. Meschino, DC, MS
In day-to-day practice, many practitioners encounter patients with hypertension problems that are not being managed effectively. Some patients in fact discontinue with their prescribed medications because of the undesirable side effects, or for other reasons.
As natural health practitioners, we are often asked if there are any dietary supplements or nutritional therapies that can lower blood pressure in a more natural way without producing unwanted side effects.Research studies conducted over the past 15 years support the use of specific dietary and supplementation practices, and participation in physical activity as natural interventions to reduce high blood pressure. In some cases these natural solutions are all that are required to control blood pressure; in other cases theses practices can significantly lower the requirement for medication, helping to reduce the likelihood of adverse side effects occurring from the use of these drugs.
Trends in Hypertension
High blood pressure affects approximately 25 percent of the adult population in developed countries such as the U.S. and Canada. In up to 75 percent of these cases, hypertension manifests in a mild form, which is highly sensitive to nutrition, supplementation and lifestyle practices.1,22 Even the most current medical literature stresses that people with documented hypertension should receive intensive nonpharmacologic therapies to improve control of their condition and reduce the risk of developing further cardiovascular disease.23
Hypertension, hypercholesterolemia and cigarette smoking are considered the cardinal risk factors for cardiovascular disease. Studies indicate that lowering a patient's blood pressure from 160/90 to 140/80 mmHg may decrease risk of heart disease by more than 30 percent.
From a medical standpoint, the use of anti-hypertensive drugs dominates the management of these conditions, and little attention is often given to nutrition and lifestyle approaches. However, many patients discontinue their drug regiment due to side effects from these drugs, which can include fatigue; male impotence; elevated cholesterol levels; light-headedness; dizziness; and skin eruptions.4 In Canada, 22 percent of adults have hypertension, but only 16 percent of this population is treated and controlled. This leaves 84 percent of hypertensive patients uncontrolled and sometimes unaware that this silent killer is even present.5,6 In general, hypertension across the population is not well controlled. An effort by alternative health care providers to help remedy this situation is urgently needed, as cardiovascular disease continues to be the leading cause of premature death in our society.
Effective Nutritional Therapies and Lifestyle Interventions
Weight loss: Hypertensive patients who are overweight experience a drop to normal in their readings in approximately two-thirds of cases by simply losing 10-15 pounds.7,8 Overweight patients tend to display insulin resistance, especially in cases where there is a propensity for abdominal weight gain (android obesity). Insulin resistance results in higher secretion rates of insulin to help overcome the resistance to insulin displayed by peripheral body cells.
One of the consequences of hyperinsulinemia is increased retention of sodium by the kidneys, which tends to drive up blood pressure in sodium-sensitive individuals. Thus, moderate weight loss helps to reverse insulin resistance, lowering basal and postprandial insulin blood levels. This, in turn, encourages less sodium retention and a natural lowering of blood pressure. It is estimated that in up to half of adults in the U.S. whose hypertension is being pharmacologically managed, the need for drug therapy could be alleviated with only modest reductions in body weight.9
In conjunction with dietary advice to help reduce excess weight, engaging in regular endurance-based exercise (at least 40-60 minutes of brisk walking four to five times per week) has been shown to help reduce high blood pressure. Exercise further increases insulin sensitivity, accelerates weight loss and induces other changes within the cardiovascular system to lower blood pressure.6,10 Clearly, health practitioners should become more involved in providing patients with safe and effective nutrition and lifestyle practices that reverse weight gain and enhance the patient's overall level of cardiovascular fitness.
Lower alcohol consumption: Studies indicate that excess alcohol consumption is a culprit in hypertension. Restricting alcohol consumption to two or fewer drinks per day, (fewer than 14 weekly for men, and nine for women) has been shown to help lower blood pressure in individuals who consume alcohol.7
Sodium restriction: Approximately 40-50 percent of hypertensive patients are thought to be sensitive to sodium intake, which is at least a partial cause of their problem. Salt sensitivity appears to be more common among blacks, diabetics and the elderly. Reducing sodium intake to 2000 mg per day is a prudent step in the global management of hypertension. This requires restricted use of discretionary salt, and avoiding heavily salted processed foods. (e.g., prepared soups, pickles, salted snack foods, foods containing MSG, etc.)7,11,12,13
Calcium supplementation: A number of well-designed human intervention trials reveal that calcium supplementation (1,000-1,500 mg calcium per day as calcium carbonate or citrate) can lower blood pressure, particularly in sodium-sensitive hypertensive patients. Calcium encourages sodium excretion by the kidneys and, in concert with magnesium, helps to relax the smooth muscle lining of arterioles, lowering diastolic pressure.11,14,35 Calcium and magnesium supplements are best taken with meals for this purpose, and to enhance their absorption.33
Magnesium supplementation: Supplementation with 600 mg per day of magnesium has been shown to lower blood pressure in some, but not all, studies. Presently, a greater body of evidence exists for calcium supplementation than for magnesium. However, there is no risk in including 600 mg of magnesium in the management of hypertension (unless severe kidney disease is present).15
Omega-3 Fat Supplementation: Over 60 double-blind studies have demonstrated that either fish oil or flaxseed oil supplementation can be effective in lowering blood pressure. One tablespoon per day of flaxseed oil can lower systolic and diastolic blood pressure by up to 9 mm Hg.16 I generally recommend 1,000 mg of flaxseed oil (in capsule form) twice a day with meals.
Garlic extract supplementation: Supplementation with a garlic extract product that yields 4,000 mcg of allicin (between a half and a whole clove of garlic) may help to lower blood pressure. Reductions of 20-30 mm Hg systolic and 10-20 mm Hg diastolic pressure have been demonstrated. However, this effect varies greatly among hypertensive subjects.2,17
Coenzyme Q10 supplementation: In recent years, a number of randomized, double-blind trials have demonstrated that Coenzyme Q10 (CoQ10) supplementation can effectively and consistently lower blood pressure in hypertensive subjects. CoQ10 is directly involved in the bioenergetic pathways of ATP production in heart muscle (myocardium). Research reveals that 39 percent of patients with high blood pressure have a deficiency of CoQ10. Supplementation with CoQ10 appears to correct this deficiency, correcting the underlying metabolic abnormality that leads to high blood pressure development.
Most experts in this field believe that CoQ10 is able to lower blood pressure through its favourable influence on heart bioenergetic mechanisms and possibly relaxing vascular smooth muscle. Because CoQ10 corrects an underlying metabolic defect that leads to high blood pressure, lowering of blood pressure usually requires four to 12 weeks of CoQ10 supplementation.18-21
In a recent randomized, double blind trial among patients receiving antihypertensive medications, the addition of 60 mg of CoQ10, twice daily was shown to markedly reduce both systolic and diastolic blood pressure. CoQ10 supplementation also reduced other risk factors for cardiovascular disease, including a lowering of fasting and two-hour plasma insulin, glucose, triglycerides, lipid peroxides and blood levels of malondialdehyde - a marker of free radical damage.
The authors of the study conclude that CoQ10 decreases blood pressure (possibly by decreasing oxidative stress, i.e., free radical generation) and insulin response in hypertension patients receiving conventional antihypertensive drugs. This study and others provide evidence that CoQ10 can be taken safely in conjunction with antihypertensive drugs to produce better blood pressure lowering outcomes. 22-24
The daily dosage of CoQ10 to aid in lowering blood pressure is usually 60 mg twice per day.22 A dosage of 100 mg once per day has been tested.16 In mild cases of hypertension, 30-75 mg once per day may be sufficient to normalize blood pressure.23,24
Hawthorn extract supplementation: The hawthorn plant and its berries are a rich source of a unique strand of bioflavonoids, known as procyanidins. Like CoQ10, these procyanidins have been shown to reverse congestive heart failure by enhancing bioenergetic pathways in the heart muscle (myocardium). More recently, we have seen a number of intervention trials that demonstrate that hawthorn extract supplementation can also effectively reduce high blood pressure.
The procyanidins in hawthorn act as cardiac glycoside agents that increase cyclic AMP and produce a vasodilatation effect on arteries. The daily dosage required to lower blood pressure ranges from 100-250 mg, up to three times daily if taken as a sole antihypertensive agent. To ensure sufficient levels of its active constituents (procyanidins), the product must be standardized to five-percent flavanoid content (1-2% vitexin content). Usually two to four weeks is required to see a significant decline in blood pressure in hypertensive patients.27 Hawthorn is contra-indicated in patients taking digitalis or digoxin.34
The World Health Organization has promoted lifestyle modification as an effective method of reducing high blood pressure and overall cardiovascular risk.24 A summary of effective natural antihypertensive interventions include:
Weight loss - Usually, only 10-15 lbs. of weight loss (in overweight subjects) will produce a significant blood pressure reduction in hypertensive patients.
Salt intake - Limit to 2-3 grams per day. Limit alcohol consumption to less than two drinks per day and even less for women. (maximum of nine drinks per week)
Exercise - endurance exercise 30-60 minutes per session a minimum of four times per week.
Calcium supplementation - 1,000-1,500 mg per day (calcium carbonate or citrate), taken in divided doses of 500 mg per dose (with food).
Magnesium supplementation - 600 mg per day (all at once or in divided doses, with food).
Flaxseed Oil - 2,000 mg per day (two 1,000-mg capsules with meals).
Coenzyme Q10 - 60 mg twice per day is a popular treatment for hypertension.
Hawthorn - 75 mg twice per day (standardized to five percent flavanoid content) can be used provided the patient is not also taking digitalis or digoxin.
Garlic extract supplementation (optional) - yielding 4,000 mcg of allicin content.
Fruits and vegetables - at least five servings per day.
The preceding recommendations can be used in conjunction with standard antihypertensive drugs, if necessary. At present, there is sufficient evidence from well-designed medical intervention trials to show that lifestyle interventions are successful in reducing or eliminating the need for pharmacologic therapy in a high percentage of hypertensive patients.29-32
For more information on this or other related topics, go to Dr. Meschino's website at: www.renaisante.com.
Click here for previous articles by James P. Meschino, DC, MS.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.