Hypertension: balancing blood pressure through functional medicine
High blood pressure is more than a numbers game - it reflects deeper imbalances. Functional medicine identifies the root causes, helping to regulate blood pressure and improve cardiovascular health.
Alternative treatment for hypertension
Looking for a natural treatment for high blood pressure (hypertension), or find out more about how to treat high blood pressure naturally? This page covers:
At Melbourne Functional Medicine, we’ll work alongside you to identify the cause of your hypertension, and provide a comprehensive alternative to conventional treatment through our award winning approach.
What is hypertension?
Understanding your condition
Hypertension (also known as high blood pressure) is diagnosed when a person has a sustained elevated blood pressure of 140mmhg (Systolic) over 90mmhg (diastolic) or higher. There are 2 main forms of hypertension:
Essential (primary) hypertension is an elevated blood pressure that has no known or specific cause. Essential hypertension is the most common form of high blood pressure, and one of the most common symptoms of cardiovascular and cardiometabolic disease.
Secondary hypertension is when there is a known cause for the blood pressure to be elevated. Often this is associated with kidney disease, adrenal disease, thyroid dysfunctions or obstructive sleep apnoea, or it can be a side effect of some medications.
What is hypertension?
Understanding your condition
Hypertension (also known as high blood pressure) is diagnosed when a person has a sustained elevated blood pressure of 140mmhg (Systolic) over 90mmhg (diastolic) or higher. There are 2 main forms of hypertension:
Essential (primary) hypertension is an elevated blood pressure that has no known or specific cause. Essential hypertension is the most common form of high blood pressure, and one of the most common symptoms of cardiovascular and cardiometabolic disease.
Secondary hypertension is when there is a known cause for the blood pressure to be elevated. Often this is associated with kidney disease, adrenal disease, thyroid dysfunctions or obstructive sleep apnoea, or it can be a side effect of some medications.
Hypertension indicates a deeper issue
Many people believe that taking medication to treat blood pressure is all that’s required. While medications can be effective for reducing blood pressure, they don’t address the underlying root cause for hypertension. If medication is the only approach used to control blood pressure, a person may be at risk of developing chronic cardiovascular and cardiometabolic disease.
An alternative treatment for hypertension is the functional medicine approach. By detecting and treating any underlying imbalances that contribute to hypertension, health can be restored and cardiovascular disease risk can be reduced.
Symptoms of hypertension and high blood pressure
More than one third of Australians over the age of 18 have high blood pressure. Unfortunately most people who develop hypertension will have no overt signs and symptoms of high blood pressure, and elevated blood pressure is only discovered by chance when blood pressure is checked. This is why it’s vitally important to have your blood pressure checked regularly especially if you are/have:
- 40+ years of age
- Overweight or obese
- A smoker
- Excessive alcohol intake
- A diet high in saturated fats and low in fibre
- A sedentary lifestyle, or;
- A family history of hypertension or cardiovascular disease
Indigenous persons or those of African heritage also have a hereditary predisposition to developing hypertension and cardiovascular disease, so should be proactive in having their blood pressure checked regularly.
In some cases, people may experience some general or non-specific symptoms that may indicate a need to have their blood pressure checked. These may include:
- Mild headaches
- A flushed appearance to the face, or;
- Clearly visible blood vessels in the white parts of the eye
In men, erectile dysfunction has also been linked to hypertension and cardiovascular disease.
If significant symptoms such as breathlessness, loss of body functions, severe headaches, heart palpitations or reduced urine output occur, you should immediately seek the advice of your doctor, as these signs and symptoms may indicate a rare but serious condition known as hypertensive crisis.
Diagnosing hypertension
The gold standard for diagnosing hypertension is by 24hr ambulatory blood pressure monitoring, where an automatic digital blood pressure machine is fitted and worn by the person for 24hrs, during which time the machine measures blood pressure twice per hour during waking hours, and at least once per hour during the night. The mean wake and sleep blood pressures, along with a number of other blood pressure values are calculated to determine hypertension.
There are 2 parts to a blood pressure reading:
Systolic blood pressure
Systolic blood pressure is the highest number shown on a blood pressure reading, and reflects the maximum pressure created when the heart contracts. Systolic blood pressure is what is felt through the pulse.
Diastolic blood pressure
Diastolic blood pressure is the minimum pressure in the arteries when the heart is at rest in between beats.
A healthy blood pressure is around 120/80mmhg +/- ~20mmhg. The lower the diastolic blood pressure is, the better, as long as it does not become too low as to become symptomatic of hypotension.
The mechanisms of controlling blood pressure
The body uses 3 main, complex physiological mechanisms to control blood pressure:
Heart contractions
Myocardial contractile force is the strength of the heart’s muscle contraction when the heart beats. The higher the force the more blood is ejected from the heart into the arteries, with each beat resulting in a short term rise in blood pressure. The body will generally use this to adjust to sudden changes in posture such as moving from a lying to standing position.
Vasodilation and vasoconstriction
The second way the body can adjust blood pressure is by dilating and contracting the blood vessels, known as vasodilation and vasoconstriction. When blood vessels dilate there is more space for the total blood volume resulting in a drop in blood pressure. When the blood vessels contract, there is less room for blood, and therefore a rise in blood pressure. The body will use this mechanism to adjust to sudden or short term changes in blood pressure, as well as to regulate blood pressure through longer periods of rest or physical activity.
Blood volume regulation
Thirdly, the body controls blood pressure over a longer period of time by regulating total blood volume, by increasing or decreasing the fluid (water) component of blood. If a higher blood pressure needs to be sustained for a period of time, the body will reabsorb fluid from the kidneys and other parts of the body to increase blood volume. When blood pressure needs to reduce, the body will filter water out of the circulating blood volume via the kidneys, or by sending fluids to other parts of the body.
These three mechanisms don’t work independently, but collectively to regulate blood pressure within normal parameters.
Primary hypertension occurs when there is an interruption or dysregulation to the neuro-endocrine and other structural and physiological processes underlying these complex mechanisms.
Forget pills that mask symptoms. Treat the cause instead
Root causes of hypertension
A common misconception about hypertension is that it is a chronic disease. Instead, hypertension should be viewed as a sign of disruption and dysregulation of a number of complex neuro-endocrine and immuno-inflammatory pathways in the body.
The functional medicine perspective considers primary hypertension as a sign that there is a chronic and progressive interruption and dysregulation of the complex neuro-endocrine physiology that regulates blood pressure, and in most cases, this will be driven by an underlying immuno-inflammatory process affecting the heart and blood vessels.
The root cause of these disrupted processes will in most cases be influenced by modifiable diet and lifestyle factors as well as a number of psycho-social and physiological determinants. These include:
- Prolonged stress
- Gut health
- Thyroid disorders
- Food allergies and sensitivities
- Heavy metal and environmental toxicities
- Autoimmune and inflammatory conditions
Complications of hypertension
Hypertension or high blood pressure is a serious risk factor for developing a number of complications if it is not properly managed through appropriate diet and lifestyle measures, and in some cases medication.
If left untreated, hypertension increases the risk of:
- Heart attack
- Changes to the structure of the heart including hypertrophy and valve damage
- Stroke
- Vascular malformations such as aneurysms
- Chronic kidney failure due to the damage to the fine blood vessels in the kidney
- Damage to the fine blood vessels in the eyes affecting vision
- Development of more serious cardio-metabolic diseases related to the systemic inflammation
- In some cases, chronic hypertension can damage the microvasculature of the brain and increase the risk for cognitive decline and dementia.
Early intervention to prevent hypertension or reduce elevated blood pressure is critical for reducing the risk of developing chronic complications.
The conventional approach to treating hypertension
According to the Australian guidelines for the diagnosis and treatment of hypertension, hypertension (high blood pressure) is defined by a sustained elevated blood pressure of 140mmhg (systolic) over 90mmhg (diastolic).
Once hypertension has been diagnosed, treatment will usually consist of lifestyle advice to address physical activity, weight management, diet, smoking cessation and alcohol intake.
If the above strategies are not sufficient to reduce blood pressure to lower risk levels, then prescription medications are used either selectively or in combination. The types of medications used include:
- Angiotensin Converting Enzyme (ACE) inhibitors, Angiotensin Receptor Blockers (ARB) and Calcium Channel Blockers that dilate veins and arteries, thereby reducing blood pressure
- Beta-blockers, which are used to reduce the strength of the heart’s contraction force
- Diuretics, which may also be used to reduce circulating fluid volume
Up to 3 different medications may be used in combination to help control blood pressure in some people.
Whilst early intervention to reduce blood pressure and risk of adverse events is necessary, these strategies alone do not address the underlying factors that have resulted in hypertension. Addressing the neuro-endocrine and inflammatory dysregulation for effective risk reduction and reversal of hypertension is essential.
The Melbourne Functional Medicine approach to natural treatment for high blood pressure
Alternative treatment for hypertension
Functional medicine practitioner and hypertension specialist Mark Payne provides a more natural treatment for high blood pressure and takes into consideration that hypertension is a sign of dysregulation in the neuro-endocrine system, alongside lifestyle and dietary factors, a person’s health history and lab markers to develop a personalised plan to regulate blood pressure and improve cardiovascular health.
Functional testing may be used to assess underlying and contributing factors, such as:
- Gut health – bacterial dysbiosis
- Thyroid disorders
- Food allergies and sensitivities
- Insulin resistance and diabetes
- Heavy metal and environmental toxicities
- Autoimmune and inflammatory conditions
- Cardiovascular health e.g. cholesterol
Once a clear picture has been established, a holistic treatment protocol for hypertension will be recommended that may include:
- Dietary interventions like the Mediterranean diet
- Nutrient interventions such as potassium, calcium and magnesium to restore electrolyte balance, or targeted nutrients like magnesium or omega 3 fats to improve vasodilation
- A targeted detoxification protocol to reduce toxin load
- An elimination diet and gut healing protocol to address food sensitivities
- Stress management support
Alongside the clinical advice of your practitioner, in our clinic, your health coach will guide you through implementing your healthcare plan, making your journey back to health more enjoyable, while fast-tracking your path back to good health.
Case study
See how our approach helps our patients achieve better health and richer lives.
Alex was 40 years old when he came to see us after being recently diagnosed as having hypertension with a blood pressure of 155/105 at rest.
His GP had ordered a 24hr blood pressure monitor as well as an echocardiogram as Alex mentioned he frequently has heart palpitations, particularly when physically active at work. The echocardiogram showed a mild enlargement of the left ventricle of the heart with mild mitral valve regurgitation.
Read Alex’s story by hitting the button below
Alex’s story
Alex was 40 years old when he came to see us after being recently diagnosed as having hypertension with a blood pressure of 155/105 at rest. Alex was overweight which was normal for him since childhood, although he admits that over the last couple of years he has been carrying more weight than usual.
His GP had ordered a 24hr blood pressure monitor as well as an echocardiogram as Alex mentioned he frequently has heart palpitations, particularly when physically active at work. The echocardiogram showed a mild enlargement of the left ventricle of the heart with mild mitral valve regurgitation.
An in-depth analysis of the problem
During the initial consultation Alex was found to have a significant family history of cardiovascular disease on both his mother’s and father’s side, including hypertension, hypercholesterolaemia and myocardial infarction.
In the clinic, his blood pressure was found to be 160/103mmHg.
Recent blood results were reviewed during the consultation which showed that total cholesterol was elevated at 9.1mmol/L (HDL: 1.2mmol/L LDL: 7.2mmol/L TRIG: 1.5mmol/L).
At 185cm tall and a weight of 103kg, Alex’s BMI measured at 30, which is in the range for obesity. A waist/hip ratio of 1.1 is suggestive of central obesity which is associated with cardiovascular disease.
Dietary analysis showed a typical western diet which was high in refined carbohydrates, saturated fats, and low in fresh fruits, vegetables and fibre. Water intake was suboptimal at approximately 500-750ml per day, with most fluids coming from coffee, soft drinks and alcohol. Alcohol intake averaged 2-4 standard drinks per day, usually beer, or occasionally bourbon and coke.
Alex was reasonably physically active with his work as a sales and client manager for retail pharmacy. Dedicated exercise included weekend walks or bike rides with the family.
Functional testing using a comprehensive cardiovascular profile including lipoprotein subfractions was undertaken. The results demonstrated elevated lipoprotein levels consistent with the elevated cholesterol results previously reviewed. Further analysis of the lipoprotein subfractions determined elevated lipoprotein (a) often seen in people with a genetic or familial predisposition to hypercholesterolaemia, or in people with a low vegetable, low fibre diet. Lipoprotein subfractions profile indicates a mean particle size in the low end of the normal ranges, although still indicative of a lower risk for coronary artery disease, the trend to the lower end of the ranges indicated the need to be responsive to these findings.
Fasting blood glucose was normal indicating there was no risk of blood sugar dysregulation, insulin resistance or development of Type II Diabetes Mellitus.
Other markers such as homocysteine and c-reactive protein were within normal ranges indicating a low risk for cardiometabolic disease, considered a much more serious chronic disease.
Over all these results indicated potential for early intervention preventative strategies to correct modifiable lifestyle factors, reduce body weight and central adiposity, and reduce blood pressure, thereby reducing risk for heart attack, stroke, or more serious chronic cardiometabolic disease progression.
Implementing the solution
Modifiable lifestyle factors have been consistently shown to have a significant effect on improving a person’s cardiovascular risk profile. The 4 pillars of eat, sleep, move and de-stress were used to implement a number of strategies to improve Alex’s cardiovascular health.
A modified version of the DASH (Dietary Approaches to Stop Hypertension) diet was introduced. This included a diet that was abundant in fruits, vegetables and wholefoods, with a moderate amount of good quality lean meats and proteins. The diet was modified to remove dairy products as Alex had reported having some symptoms when consuming dairy, particularly milk. In addition, his health coach worked with Alex to increase his daily water intake and reduce daily alcohol intake.
As Alex was known to snore in his sleep, he was referred for a sleep study to check for obstructive sleep apnoea, a known risk factor for hypertension and development of cardiovascular disease. The results of the sleep study did not identify obstructive sleep apnoea, so with the guidance of his health coach, effective sleep hygiene strategies were used to improve the quality of Alex’s sleep.
Alex was encouraged to increase his dedicated exercise time to the recommended minimum threshold of 5hrs moderate to high intensity exercise per week. For Alex this included brisk walking for 30mins on most days of the week, and including muscle strengthening or resistance training on at least 2 days per week for a total of 1 hour. The health coach worked with Alex to help this become a regular part of his daily life.
As Alex had identified stress related to his work as having an impact on his energy levels and mental wellbeing, he worked closely with his coach to implement simple breathing exercises that he could perform throughout the day to offset the effects of stress. He also used a phone app to help him with guided mindfulness exercises.
A nutritional compound of Arginine and citrulline was prescribed to help improve endogenous nitric oxide production and improve blood vessel compliance. Fish oils which contain eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and have been shown to be effective in lowering blood pressure and assisting to correct the blood lipid profile, were prescribed. A high tocotrienol containing form of vitamin E was prescribed as it has been shown to be effective in lowering total cholesterol and LDL-c.
Achieving an incredible result
By working closely with his health coach, Alex was able to progressively introduce the various lifestyle strategies that were recommended. By the end of the 1st month his blood pressure was measured in the clinic at 140/85mmhg, placing it in the high normal range. Additionally Alex had lost 2 kgs in weight reducing his BMI to 29.5, representing a shift from the obese to the overweight range.
By the 3rd month Alex was completely comfortable with and enjoying his new diet and found that his family were now all eating much better then they had previously. The family were now a lot more active and exercising regularly together.
Alex continued to lose weight, reducing a further 9 kilos over 6 months to achieve a BMI of 26.9, slightly above his healthy weight for his height, but still representing a significant reduction in cardiovascular risk. Additionally his waist hip ratio had improved to 0.96 indicating that he was successful in reducing his central abdominal adiposity, considered a significant risk factor for cardiometabolic disease.
Alex’s blood pressure reduced further and stabilised around 135/80mmhg considered normal for a male his age. Over a period of 1 month he was weaned off the arginine compound with no rebound rise in blood pressure.
Follow up testing to check his cholesterol levels showed that total cholesterol had reduced 7.14 due an increase in HDL-c, reduction in LDL-c and triglycerides. This represents a significant improvement in lipid profile over 6 months, and with the changes Alex has made, it is expected to continue improving over time.
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Frequently
Asked
Questions
How to prevent hypertension?
The most effective strategies to prevent hypertension include:
- Eating a predominantly plant based whole food diet, rich in a variety of fruits and vegetables, low in saturated and trans fats, including good quality lean meats (if preferred) and with adequate water to stay well hydrated.
- Lead an active lifestyle which includes dedicated exercise for at least 150mins (2.5hrs) per week divided into regular sessions of at least 30mins.
- Engage with effective stress management strategies such as mindfulness, meditation, yin yoga or hobbies.
- Smoking cessation and avoid regular passive smoking.
- Moderate alcohol intake to no more than 2 standard drinks for males and 1 standard drink for females in a day, and include 3 or more alcohol free days each week.
- Maintain a healthy body weight.
- Maintain a social connection to family, friends and peers to avoid social isolation. In some cases companion pets have been shown to improve cardiovascular health in humans.
Is hypertension hereditary?
There are certain populations of people, such as indigenous persons or those with an African heritage, who have a hereditary predisposition to developing hypertension and cardiovascular or cardiometabolic disease. For most people, a family history of hypertension, cardiovascular, or cardiometabolic disease increases their risk for developing these types of conditions, and therefore it is important for these people to lead a health promoting lifestyle including a healthy diet, exercise, effective stress management, and avoiding smoking and excessive alcohol intake.
More rarely there are certain genetic factors that can lead to hypertension. Some of these include genetic factors that affect the renin-angiotensin-aldosterone pathway, Liddle’s syndrome, and certain tumours known as paragangliomas.
What are the four stages of hypertension?
The four stages of hypertension are:
- Stage 1: A normal blood pressure with a systolic pressure below 130mmhg and a diastolic pressure below 80mmhg.
- Stage 2: Pre-hypertension, which is seen as a systolic pressure between 130-139mmhg and a diastolic pressure between 80-89mmhg.
- Stage 3: Hypertension with a systolic pressure between 140-159mmhg and a diastolic pressure between 90-99mmhg.
- Stage 4: Severe hypertension with a systolic pressure of 160mmhg or above and a diastolic pressure of 100mmhg or above.
Hypertensive urgencies and hypertensive emergencies occur when the systolic pressure rises above 180mmhg and the diastolic pressure rises above 110mmhg. In these cases immediate medical attention is required.
How to treat hypertension naturally without medication?
Having an experienced practitioner assess your personal health status and detecting any underlying causes, particularly in the systems that regulate blood pressure alongside inflammation and immune activation.
An alternative treatment to hypertension starts with understanding that the root cause of these disrupted processes will in most cases be influenced by modifiable diet and lifestyle factors as well as a number of psycho-social and physiological determinants.
Prolonged stress, gut health, thyroid disorders, food allergies and sensitivities, heavy metal and environmental toxicities, and autoimmune and inflammatory conditions have all been associated with hypertension.
How to prevent hypertension headaches?
Headaches caused by hypertension can be resolved by treating the underlying cause of hypertension with a hypertension specialist, which will in turn address the headaches.
How does hypertension cause atherosclerosis?
Hypertension or high blood pressure means there is an increased hydrostatic pressure within the blood vessels. If this increased pressure continues over a long period of time it can lead to micro-trauma of the delicate cells that line the inside surface of the arteries creating systemic vascular inflammation.
Once this inflammatory process is established within blood vessel tissues, immune cells begin to collect in the tissues, progressively leading to atherosclerotic plaque formation.
The combination of hypertension and dyslipidaemia presents a significant risk for atherosclerosis and cardiovascular disease.
Is hypertension a risk factor for diabetes?
Hypertension is a significant risk factor for all forms of cardiovascular and cardio-metabolic diseases. The presence of hypertension, in most cases, is a result of diet, lifestyle and other modifiable risk factors such as smoking, obesity and excessive alcohol intake, all of which are also risk factors for insulin resistance and diabetes.
For many people, hypertension will be the first sign that the cardiovascular and cardio-metabolic systems are not functioning optimally and addressing important diet and lifestyle factors to correct hypertension is critical in reducing the risk for the development of diabetes and serious cardiometabolic disease.
How does a naturopathic treatment for hypertension compare to the functional medicine approach?
While finding the root cause of a health issue through holistic, personalised assessment is an approach of both naturopathic and functional medicine treatments, functional medicine practitioners are trained to a high standard in the latest scientific evidence and clinical tools like functional pathology tests to address conditions like hypertension. Therefore, the functional medicine approach to hypertension is a more advanced, investigative approach to treating hypertension that typically leads to better health outcomes.
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