Hey, Doc, Is It Possible to Treat High Blood Pressure Without Medication?
David’s second son was born 8 months ago when I first met him in my office.
He looked so sleep deprived that I joked during the visit whether he would retain anything we talked about. David had mild hypertension for years, but he preferred to treat it naturally, and he had done well through diet and lifestyle.
In the last 3 months, he noticed frequent episodes of dizziness and headache. He went to see his PCP, and with his blood pressure measuring 172/102, David was immediately prescribed anti-hypertensive medication. However, he was unwilling to start medication because he thought that this high reading, as compared with much lower readings at home was due to white coat syndrome.
At his visit with me, I intentionally didn’t wear a white coat, but I did take his blood pressure.
It was 166/97, still a fairly high reading. David happened to bring his blood pressure machine, and we ran it on the same arm. The reading was 143/82. Disbelief spread over David’s face as he felt betrayed by his blood pressure machine. Older machines need to be recalibrated after a few years.
Rather than just blaming the faulty machine, I felt that we also needed to dig deeper.
David reported that he was doing well with his diet and lifestyle before his second son was born. He made sure that his diet was low in salt and rich with potassium-containing foods. As a vegetarian, eating lots of colorful vegetables and fruits was a no-brainer. Cardio exercises are particularly helpful for regulating blood pressure, and David did respond well to them. Even with a busy work schedule, he was able to squeeze in 30 minutes of high intensity exercise sessions a day. He also enjoyed a regular meditation and yoga practice.
However, work got increasingly busier when COVID started.
Occasional work-from-home days became always working at home. David would have 7am early morning meetings and 10pm late night meetings. Coupled with the concern of COVID and a newborn, he had been under significant stress and sleep deprivation for some time. He was also not eating as well, nor practicing meditation or exercising as frequently. Yet according to his blood pressure machine, David thought he was doing ok since his readings were still in the 120s/80s.
Looking at David’s situation, I recommended starting either herbal or pharmaceutical blood pressure treatment right away. Although it would be possible to bring the numbers down again by improving his diet and lifestyle, realistically it might take some time to rebuild healthy habits.
I often hear concerns about medication side effects or permanent organ damage.
Fortunately, most people tolerate the medication well and organ damage is quite rare. If side effects are problematic, there are herbal options that work well. There is also common concern of having to stay on medication once you’ve started. Clinically I haven’t seen this to be the case.
The most common reason people must continue to use medication is they can’t maintain the diet and lifestyle required. The optimal diet and lifestyle will vary among the individuals. Some will need to eat much more potassium than others. Some will need to lose weight. Some will need to exercise more. Some will need to focus on managing their stress.
The bottom line is that we should always treat hypertension without delay using a comprehensive set of tools.
Diet and lifestyle are always the preferred treatment, and a good starting point, but it is ok to use medication or herbal products temporarily while working to establish a consistent healthy diet and lifestyle. Diet and lifestyle are always important to maintain, even if the numbers are controlled by the medicine.