Hypertension is a common condition that affects the body's arteries. With high blood pressure, the force of the blood pushing against the artery is too high, leading the heart to pump harder. Untreated hypertension may lead to serious health conditions such as stroke, and heart attack, which are the leading causes of death in the United States. According to the CDC, 47% of adults in the United States have hypertension, not including those less than 18 years of age.
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Blood Pressure
The American College of Cardiology and the American Heart Association have divided blood pressure into four general categories:
Normal Blood Pressure
Blood pressure is 120/80 mm Hg or lower.
Elevated Blood Pressure
The top number ranges from 120 to 129 mm Hg, and the bottom number is below, not above, 80 mm Hg.
Stage 1 Hypertension
The top number ranges from 130 to 139 mm Hg, or the bottom number is between 80 and 89 mm Hg.
Stage 2 Hypertension
The top number is 140 mm Hg or higher, or the bottom number is 90 mm Hg or higher.
CC: Hypertension, Pre-diabetes, Hyperlipidemia
Michael was a 75-year-old male who had high blood pressure for years. He was on 2 different blood pressure medications but wanted to see if there was anything that could be done naturally. His energy was poor, rated 5/10 at its best (0=none, 10=best), and he suffered from headaches daily. He would get random bouts of dizziness and was not sleeping through the night. He had headaches constantly. His blood pressure was managed by his cardiologist, and at his first functional medicine appointment, his blood pressure was 150/90 with medication. He suffered from heartburn, joint pain, and bloating and even had issues swallowing at times. He was on 10+ prescription medications daily. Michael was looking for a change.
Additional History
Michael didn't eat a particular diet. He ate whatever his wife cooked. He was Italian, so he loved pasta. He lived a very sedentary lifestyle. He used to be a truck driver but was not retired.
Initial Lab Work
CBC: Normal
Heavy Metals Profile II Blood: arsenic, cadmium, lead, mercury:Normal
Lab Analysis
Michael's labs showed some concerns. His labs showed prediabetes (HbA1C), hyperlipidemia (NMR panel, ApoB), high inflammation (GlycA, C4A), and other high metabolic numbers such as glucose and insulin. Although the patient was on various medications to control cholesterol, high blood pressure, etc., labs still showed plenty of room for improvement.
His labs did show normal thyroid panel and autoimmune numbers.
Free testosterone and total testosterone were functionally low. Low testosterone can be due to stress, medications, inflammation, thyroid imbalances, alcohol or THC, sleep disturbances, inactivity, obesity, and even toxin overload. Low testosterone could be aiding in Michael's fatigue.
Although some values were in the normal ranges, Michael did have low nutritional status values. His labs showed low omegas, low vitamin D, and high homocysteine, which can be related to borderline normal B12. Iron and ferritin were normal. Low nutritional levels can be due to a lack of dietary intake or absorption. Low omegas can lead to higher levels of inflammation, and low vitamin D can lead to symptoms such as fatigue.
Interventions
Michael started a mixture of the Paleo diet and the Mediterranean diet. The main focus was to eliminate inflammatory foods such as gluten and dairy, keeping minimal grains, but to also eat whole foods with plenty of healthy fats. Michael was encouraged to switch to as many anti-inflammatory options as possible, such as eliminating seed oils and using oils such as avocado oil. This was a dramatic change for Michael as he was a truck driver for years and lived off of "road foods." Although in his retired years, he ate mostly his wife's cooking, and his diet was rich in carbohydrates and sweets. He loved Diet Coke and sweet teas.
Michael was given nutritional support and started taking omegas (2 g daily), vitamin D (10,000 IU daily for 2 weeks, then 5,000 IU daily), and magnesium (500-1,000 mg with dinner).
Michael was given sleep support, Circadian PM from Researched Nutritionals, which contained a blend of valerian, glycine, turmeric, lemon balm, magnolia, 5-HTP, L-theanine, and GABA. Although there are many root causes of sleep disturbances, the goal was to get Michael on a regular sleeping pattern after being a truck driver for years so that it could regulate his endocrine and hormonal systems.
Michael was encouraged to move his body more. This was in the form of lifting weights a few days per week (5-pound dumbbells), taking his dog for a walk daily, and even participating in community events or golfing with friends, or riding his bike with his wife.
Follow Up 6 Months Later
CBC: Normal
Heavy Metals Profile II Blood: arsenic, cadmium, lead, mercury: Did not rerun
Michael was ready for change. At his follow-up, his diet was completely different, and he was moving daily. He had lost 25 pounds and had no more bloating, joint pain, heartburn, or issues with swallowing. His headaches were minimal and were taken care of with regular chiropractic care. Michael was off of his omeprazole as he did not feel the need to take it as his heartburn was gone. His blood pressure in the office was 108/70 at the follow-up visit, and he is still on medication.
Labs showed tremendous improvement. Cholesterol, insulin, HbA1C, glucose, and inflammatory markers all decreased. Michael was no longer prediabetic, insulin resistant, or had high cholesterol. He had follow-ups scheduled with his cardiologist and PCP and had the full intention of decreasing his blood pressure medication and stopping his statin. Based on his recent labs, he was completely supported.
Michael's testosterone had improved with lifestyle changes alone, but pregnenolone and DHEA were also tested as they are precursors to testosterone. With low levels, the patient was given mitochondrial support and DHEA with the hopes for energy continuing to improve and increased testosterone levels.
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Summary
Hypertension is a very common condition, but sometimes in functional medicine, hypertension is a symptom. There are many root causes of hypertension. This includes sleep apnea, insulin resistance, inflammation, exposure to heavy metals, stress, nutritional deficiencies, medications (like PPIs), poor dietary choices, etc. Michael was able to change his diet dramatically, get off of a few medications, support his body nutritionally, and exercise, which all led to a dramatic improvement in labs and lowered his blood pressure, naturally.
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