By Svetlana Kogan, M.D.
It would be nice if before people get to the point where they need blood pressure medications, they would have access to preventive checkups where the root causes of any potential future hypertension would be picked up and addressed. Functional Medicine, which is a modern holistic outgrowth of Internal Medicine, starts by looking for the reasons why the patient may be developing an elevated blood pressure. Some of the causes of Hypertension we investigate are:
Medications which patients happen to be taking, like non-steroidal anti-inflammatories (NSAIDs), Birth Control pills, PPIs, Steroids, some anti-depressants, certain nasal sprays, some weight loss medications, and medications used for attention deficit hyperactivity disorder.
We also look for and treat underlying medical conditions which can prompt high blood pressures, such as:
Sleep Apnea, Thyroid or Parathyroid disease, Kidney disease, Obesity, Hyperlipidemia, Environmental exposure to Lead, cadmium, or arsenic, and disease of the adrenal glands to name a few.
In functional medicine philosophy, oxidative stress poses a key clinical imbalance in the development of hypertension. What does that mean? Well, as our bodies work to disarm all the toxic substances which we encounter in our diet and environment, there are these very nasty characters forming in the blood called reactive oxygen species (ROS). It is the combination of the abundance of these nasty ROS and the shortage of our natural defenses against them which create oxidative stress.
Oxidative stress makes our blood vessels dysfunctional, promotes insulin resistance, creates inflammation everywhere and leads to higher blood pressures.
A functional medicine doctor can measure important markers of oxidative stress in your blood and nip the disease in the bud, before it has a chance to affect the end organs, like kidney, pancreas, heart, liver, etc. We also measure micronutrient levels to assess our patients’ defense antioxidant reserves. This gives us a chance to provide targeted supplementation of micronutrients to those who need it.
The result? Hypertension reversed.
Another thing that recently got functional doctors’ attention is how our inappropriately triggered immunity can lead to hypertension and vascular disease, Covid 19 being the best example. When they started looking into how exactly vascular disease develops, they noticed that it starts with the disturbance of the innermost layer called endothelium. One of the major disturbances is the decreased production of the vasodilating substance called Nitric Oxide, an increase in the production of its antagonist ADMA, and another is the excess of the endogenously produced substance called Homocysteine. We can measure all these markers with simple blood tests, to confirm that these issues are present in a particular patient. You must be thinking: but what can you do if you discover these early precursors of hypertension and vascular disease? The good news is that thanks to cutting-edge research, functional doctors work to address these disturbances with professional grade supplements, botanicals, nutritional interventions, and lifestyle modifications. Here is a real-life example from my own private practice: a new patient who had signed up with my practice, was discovered during her intake examination to have newly elevated blood pressures. While going through her medications list, I discovered that she has been taking over the counter Proton Pump Inhibitors (PPIs). These were recommended to her by her doctor years ago to help with her gastroesophageal reflux disease (GERD), and she was reflexively buying these pills over the counter for years.
On in-depth testing, I discovered high levels of ADMA in her blood and wisely remembered that PPIs increase ADMA and decrease Nitric Oxide causing an impaired ability of the blood vessels to expand to maintain normal BP levels. I then carefully and gradually weaned this patient off the PPI medication and made sure that it was ok with her gastroenterologist. As a result, her blood pressure and vascular dysfunction markers have normalized within several months. I also successfully treated her GERD with appropriate non-pharmaceutical functional supplements, changes in the foods she was eating, and tweaking her daily routine.
Indeed, folks, even changing your lifestyle routines are powerful natural medicines for the elevated blood pressure. For example, regular aerobic activity like brisk walking at least 30 minutes /day decreases blood pressure anywhere between 5-10 mm. By the same token, restricting sodium intake to 2.4 g/day decreases BP by another 2-8 mm. There are many more natural functional approaches to hypertension and my hope is that someday we can at best avert and at least reverse the public health burden of Hypertension which affects 116 million Americans.
Svetlana Kogan, M.D.
The author of ‘Diet Slave No More!’, Svetlana Kogan, MD is a Board-Certified Internal Medicine, Holistic & Functional Medical Doctor with 25 years of experience. She has appeared as a health expert on prime-time TV and radio stations and has authored hundreds of holistic health articles for internet and print. She moved her Concierge Practice from Manhattan NYC to Naples in 2019. Her Functional Medicine Primary Care Practice is focused on prevention and holistic approach to illness, and longevity.
720 Fifth Ave S, Unit 209, Naples , FL 34102
Phone: (239) 676-6883
www.customlongevity.com