High Blood Pressure / Hypertension

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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A September 7, 2012 report by the U.S. Centers for Disease Control and Prevention (CDC) entitled Vital Signs: Awareness and Treatment of Uncontrolled Hypertension Among Adults - United States, 2003-2010 stated that prevalence of hypertension, or sustained high blood pressure, among U.S. adults is estimated at 30.4% of the population, and that 53.5% of these individuals did not have their hypertension controlled, despite 44.8% of these individuals being treated with standard medications. Another 15.8% of these individuals with uncontrolled hypertension chose not to take medication, largely due to lack of effectiveness and side effects, or adverse health effects. The problem with treatment was not lack of insurance of health care, as the report stated that 85.2% of these individuals with uncontrolled hypertension had health insurance, and 89.4% reported having a source of health care. The need for individualized diagnosis, identifying the underlying health problems causing or contributing to hypertension, and a more effective and comprehensive treatment protocol, utilizing sound advice with diet, exercise, lifestyle, and utilization of Complementary and Integrative Medicine (CIM/TCM) is urgently needed to reduce cardiovascular disease and mortality. The present system is obviously not working for over half of the patients.

An article in the New York Times Business section, November 27, 2008, illustrates the growing concern among physicians that we are prescribing too many pharmaceuticals unnecessarily to treat common conditions of risk, and thereby unnecessarily increasing the incidence of side effects and health risks from medications. The article cites the lack of impact of the ALLHAT study findings of 2002, funded by the National Institute of Health (NIH) and its National Heart, Lung and Blood Institute. ALLHAT, which stands for Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial, enrolled more than 42,000 patients over age 55 from 1994 to 2001, randomly assigning the various pharmaceutical choices for hypertension, diuretic (chlorthalidone), ACE inhibitor (lisinopril), calcium channel blocker (Norvasc), and alpha adrenergic blocker (doxazosin/Cardura). The findings showed that a simple diuretic alone outperformed all the other protocols, cost about 4 cents per day, and had much fewer side effects and health risks associated. In 1996, experts at the University of California San Francisco noted that research revealed that "data extrapolated from existing studies suggest that treatment of hypertension does not confer the same protection against CAD (coronary artery disease) and stroke in women as it does in men. In fact, a trend toward harm in young and middle-aged white women receiving stepped care for hypertension has been reported" (PMID: 8858082). For most patients, especially when there is no immediate high risk status for stroke or heart attack, adoption of a protocol integrating a simple potassium sparing diuretic with a holistic regimen in Complementary and Integrative Medicine (CIM) would not only insure better overall health but save the country a fortune on insurance policy costs and government deficit spending for rising healthcare costs. Today, abundant research shows how various protocols in Traditional Chinese Medicine (CIM/TCM) can accomplish this goal. The proof is provided at the end of this article in links to numerous health studies on quality databases such as the U.S. National Institutes of Health (NIH) PubMed.

The chairman of the steering committee of this ALLHAT study, Dr. Curt D. Furberg, a public health sciences professor at Wake Forest University, is very dismayed at the lack of change in prescription of antihypertensives since this study was published. He states that he expected prescription of a simple diuretic protocol to more than double, but that six years later it rose only about 5 percent, and that prescription of more profitable medications has grown faster than the prescription of generic diuretics. Experts in public health point to a number of disturbing facts that have dampened expectations. The pharmaceuticals have, of course, paid for studies that criticized the government study, heavily promoted their more expensive drugs, and paid huge consulting fees to key members of the government steering committee that continues to oversee published analysis of the government's public health recommendations based on this study. These facts are outlined in the article, which is accessible by clicking on the address at the end of this article. We find that guidelines for treatment of hypertension have not changed from the one-size-fits-all approach since the published findings that cardiovascular risk and normal blood pressure levels are different between men and women, and between age groups. In recent years, research has noted a comprehensive exclusion of female subjects in the early studies of cardiovascular risk and pathophysiology, and newer studies have noted that heart attacks, now the number one cause of mortality in the U.S. female population, involve a pathological mechanism different from coronary heart disease in a great percent of cases. Obviously, a different approach to cardiovascular risk should be integrated with standard care, and the integrated treatment protocols should be individualized. This should be a great concern for the population with the high incidence of cardiovascular disease.

Experts now agree that roughly half of all patients in the United States that are treated for sustained high blood pressure, or hypertension, still have high blood pressure, and conservative estimates state that 10-20 percent of hypertension patients treated with multiple drug therapies of 3-4 medications still have uncontrolled hypertension. For women especially, cardiovascular risk involves more than just blocked coronary arteries, and atherosclerosis pathology involves more important factors than cholesterol levels. In addition, normal blood pressure levels are different between men and women, and between young and old women. It is time to quit oversimplifying this subject. A more holistic approach is needed to really achieve the goals in reducing cardiovascular risk, individualizing the treatment protocol, and restoring the healthy homeostasis of blood pressure control in 100 percent of patients. Since cardiovascular disease is the number one cause of disease death in the United States this is an important consideration for us all.

In 2013, Dr. Samuel J. Mann, hypertension specialist at Weill-Cornell Medical College, stated that doctors are not individually tailoring drug regimens and comprehensive protocols, seriously considering side effects, or evaluating underlying causes of hypertension, leading to overprescription and many patients abandoning therapy. By 2015, the United States Preventive Services Task Force, an independent panel of medical experts appointed by the U.S. Department of Health and Human Services AHRQ to establish federal guidelines for effective medical care, published new guidelines for hypertension, or sustained blood pressure, that recommended that we stop prescribing medications simply due to a single, or a few readings of elevated blood pressure, and that if hypertension is suspected, that the patient utilize a 12-48 hour continuous monitoring device to realistically diagnose this condition. The task force noted that many large studies have found that blood pressure varies considerably in the normal individual, with many factors raising the blood pressure, and the current system has led to unnecessary prescription of medications for many patients, with adverse health effects.

By 2016, the issue of anxiety-driven spikes in blood pressure, long dismissed and ignored in standard medicine, and the well documented White Coat Syndrome of a high percentage of patients found to experience alarming rises in blood pressure when a Medical Doctor enters the room, creating a false diagnosis of hypertension, which is defined not by spikes of blood pressure but by a sustained and continuous state of high blood pressure, has become a significant issue. These findings show that a large number of patients have been prescribed blood pressure medications for no significant reason, and that decades of fear and anxiety concerning mild high blood pressure, often when no adequate explanation of cardiovascular risk is given, has actually been a significant factor in the array of causes of hypertension. Sustained high blood pressure and poor cardiovascular health are real problems, but for many, even with a real diagnosis of mild to moderate hypertension, the best course of care and prevention would be to utilize a healthy holistic protocol to prevent stroke and heart attack, with a more nuanced and comprehensive approach, rather than just relying on blood pressure medications and statin drugs to protect against cardiovascular threat. By integrating Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) into the treatment protocol the patient is able to treat the underlying health problems that cause sustained high blood pressure and achieve a healthy cardiovascular state in the long run, not just attempt to block the ability of the body to raise blood pressure with drugs. The human organism has shown that it is adaptive to these blocking drugs, and without addressing the real underlying health problems, the cardiovascular risks do not go away. Patients and medical doctors are also failing to understand that the reason to decrease high blood pressure is the underlying cardiovascular health risks, and that the high blood pressure is not the main cause of concern, but rather the health of the cardiovascular system. Better individualized pharmaceutical protocols integrated with Complementary Medicine will be able to achieve a true control of hypertension, as well as a true decreased risk for future stroke and heart attack.

Not only the failure of standard medicine to address the underlying cardiovascular health of the patient, but the growing concern of patients in both the failures of standard therapies and the long-term side effects, or adverse health effects, have prompted a call for a safer and more effective strategy. There is significant evidence that prescribing doctors are growing concerned about the research into long-term risks and side effects of anti-hypertensives, as well as the concern of their patients that frequently research these drugs themselves and are skeptical of the risks versus benefits. Prescribing habits are changing to address these concerns. For instance, angiotensin receptor antagonists are increasingly prescribed to alleviate concerns about the side effects of chronic use of ACE inhibitors (angiotensin converting enzyme inhibitors) and beta-blockers (beta-adrenergic antagonists). Unfortunately, a study in 2010 (reported in a New York Times article cited in the section of this article entitled Additional Information) found that this class of drugs increases overall cancer risk by 11 percent and lung cancer risk by 25 percent. Over 11 percent of men taking beta-blockers complain of significant loss of libido, or sex drive, and a high percentage of patients taking ACE inhibitors are bothered by dry cough, dizziness and fatigue. There is growing concern about the incidence of kidney impairment with ACE inhibitors as well, and the combination of ACE inhibitor with a diuretic, coupled with chronic NSAID use, has resulted in a high incidence of kidney impairment over time. Even for patients taking these medications, CIM/TCM integration into care is important to help alleviate and prevent adverse health effects from medications. The only "side effects" of CIM/TCM care is a better overall health, and perhaps a decrease in true cardiovascular risk that would allow you and your doctor to reduce the amount of medication.

To alleviate concerns about chronic effects of angiotensin receptor antagonists and ACE inhibitors, a new class of drug was introduced in 2007 called a direct renin inhibitor. Renin is an enzyme called angiotensinogenase that controls the rate of production of angiotensin, a vasoconstrictor that increases blood pressure. Experts were concerned that even when effective in controlling blood pressure, the ACE inhibitors and angiotensin receptor antagonists did not actually lower circulating renin levels, and that high renin levels due to adrenal stress syndrome could contribute to cardiovascular damage even when blood pressure was controlled. In fact, a concern is voiced by experts that chronic use of the ACE inhibitors and angiotensin receptor antagonists would stimulate increased renin production to counter the effects of the drugs. The long-term effects of excess renin secretion have not been well studied. The direct renin inhibitor drug was approved by the FDA in 2007, but doubts about the efficacy of the drug were immediately voiced by Dr. John Laragh, editor of American Journal of Hypertension and his wife, Dr. Jean Sealey, a hypertension researcher at Cornell University. The concern was that this new drug was no more effective than prior drugs, and that its ability to lower blood pressure may be limited by reactive renin secretion as well (see a discussion in Additional Information). Integrating therapy to treat the underlying health problems that stimulate excess renin secretion, such as adrenal stress syndrome, may be the most sensible approach to alleviating these concerns. Renin is a kidney hormone and protein enzyme that is increased by 3 conditions: 1. a decrease in the arterial blood pressure in the entryway of the kidneys; 2. a relative decrease in sodium chloride in the filtrate of the kidney juxtaglomerular tissues; 3. excess or chronic stimulation of the sympathetic nervous system. Normalizing these areas of homeostasis will result in a normalized renin-angiotensin metabolism, unless an underlying problem, such as a small adrenal tumor, or chronic kidney failure, is present. This normalization of renin homeostasis is where Complementary and Integrative Medicine, especially acupuncture with Chinese herbal medicine (CIM/TCM), may play a significant role. Hopefully soon, cardiologists will finally be allowed to actually integrate this care and suggest that the patient seeks help from a competent Licensed Acupuncturist and Herbalist, and take a more proactive approach with diet and lifestyle habits.

Given the recent concern about White Coat Syndrome of anxiety-driven spikes in blood pressure, and more and more reports of fluctuating blood pressure, we are seeing a difficulty in addressing these issues adequately in standard medicine. The 'spin' provided in this regard superficially addresses spiking blood pressure and fluctuation with studies designed to show that this may add cardiovascular risk, implying that we may need to just increase medication protocols! Overlooked in this analysis is the probability that standard polypharmacy for hypertension, as well as the inconsistency in taking the medications due to adverse health effects, and the rebound syndromes that result, are probably linked to increased incidence of fluctuating blood pressure. Studies have demonstrated that with White Coat Syndrome a much higher percentage of these patients will end up with a real hypertension syndrome within 10 years, driven by anxiety spiking fluctuations, and perhaps by over-prescription of medications with poor compliance that also contributes to fluctuating patterns of blood pressure. We may be ignoring a significant health threat to the population. Changing the treatment guidelines and insuring that more patients with mild to moderate high blood pressure are diagnosed realistically, given a clear and individualized cardiovascular risk assessment, and provided individualized guidance on the array of protocols that are safe and effective to normalize blood pressure homeostasis and decrease future cardiovascular risk would result in dramatic improvements in cardiovascular disease and mortality, and in the long-term reduce overall healthcare costs.

The role of Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) in control of hypertension - plus a true reduction of future cardiovascular risks, kidney failure, and peripheral vascular disease

Individual patients are starting to question whether they could achieve better results with less medication, and turning to Complementary Medicine to help them in this endeavor. The primary goal of Complementary and Integrative Medicine, and especially Traditional Chinese Medicine (CIM/TCM), in treatment of sustained high blood pressure, is not the immediate lowering of the blood pressure, but rather the elimination or correction of the underlying health problems that are the cause of a sustained high blood pressure, or hypertension, although a growing number of clinical studies are demonstrating the immediate effects of various herbal chemicals and acupuncture stimulation to reduce blood pressure as well. A growing number of Medical Doctors agree that this is a practical approach, and could be integrated into the standard treatment protocol without risk, potentially reducing the dependency on multiple drugs to control hypertension. Risk from hypertension occurs over long periods of time for almost all patients. Adjustment of the treatment protocol is thus safe, even with a transition period where blood pressure is less controlled, as long as this is monitored by your physician. To insure safety, the patient is encouraged to purchase a blood pressure monitoring device for home use, and this helps the patient to understand which parts of the Complementary protocol seem to work the best.

To offer the hypertension patients a more complete package of cardiovascular risk reduction, researchers have also shown that Chinese herbal formulas could improve the circadian hypertension profile, lowering night-time blood pressure, improve elasticity of major arteries, exert significant anti-inflammatory and antioxidant effects, improve lipid profiles, and reduce atherosclerotic plaque. A number of beneficial effects could be combined in a single Chinese herbal formula. While the blood pressure lowering effects of Chinese herbs may not be greater than pharmaceuticals, the overall benefits may address the underlying health concerns, and integrated with standard therapy, the potential for risk reduction is great. No clinical studies have shown actual negative drug interactions between these common Chinese antihypertensive formulas and standard phamaceuticals. As research progresses, more and more patients, and more and more medical doctors, are considering the integration of Chinese acupuncture and herbal medicine into the anti-hypertensive protocol.

Medical doctors are also alarmed at the statistics of the high percentage of patients that go off of the anti-hypertensive drug regimen against medical advice, and many medical doctors are thus open to trials of Complementary protocol and reduction in medication, as long as this is professionally monitored. A 2008 study at the Department of Family Medicine and Community Health, School of Medicine, University of Pennsylvania, found that Integrative Medicine was successful in achieving lower blood pressure and greater adherence to medication protocols in a study group of patients with both hypertension and clinical depression. Adherence to prescribed protocols increased from about 30 percent to 80 percent when an Integrated medical approach was utilized, and integrated interventions were recommended in future medical care. Part of this Integrative Medicine could involve the Licensed Acupuncturist and herbalist. When the patient takes a more proactive approach to their medical problems, greater success is sure to occur.

The National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) has conducted much research and recommended that patients with mild to moderate hypertension, generally considered lower than a sustained 160/100, try to control their blood pressure without medication. Patients with high cardiovascular risk should be concerned with sustained high blood pressure of over 140/90. Complementary and Integrative Medicine (CIM) provides these patients with a number of professional protocols that are individualized to help achieve this goal. The only side effect with CIM is better overall health.

The DASH dietary protocol (Dietary Approaches to Stop Hypertension) has been very successful in this regard. Much study has proven that a significant reduction in high blood pressure is achieved for most patients with a diet that is rich in fresh vegetables, whole grains, beans and legumes, and includes small daily portions of fresh fruit, nuts, seeds, and healthy dairy products. The DASH diet limits meat, poultry and fish to just one or two small portions per day, and restricts the consumption of sugar sweetened beverages and foods, as well as salty snacks and fast food. To achieve an improved potassium to sodium ratio, a more plant-based and fresh food diet is essential. The standard vegetarian diet provides a 5:1 ratio of potassium to sodium, whereas a typical American diet yields a 1:2 ratio of potassium to sodium. This electrolyte imbalance is integral to the pathology of hypertension. A variety of DASH books, with menus and recipes, have been created, and the NIH study found that adherence to this plan produced an average reduction in systolic blood pressure of 6 mm Hg, and diastolic of 3 mm Hg in normal patients, and 11 mm Hg systolic and 6 mm Hg diastolic in patients with moderate to severe hypertension. Other studies have demonstrated similar benefits from daily short aerobic excercise routines, and short periods of controlled breathing exercises and relaxation techniques. Combining these protocols should achieve a reduction in blood pressure greater than what is achieved with medications.

These types of studies and protocols show that experts in the field, and the most respected health organizations, find that it is important to try to control high blood pressure without chronic dependency on medications that have been proven to be less effective that we need them to be, and come with considerable long term side effects and risks themselves. With the addition of Complementary Medicine into this protocol, a great number of patients are finding success in controlling hypertension and creating better overall health and reducing future health problems and health risks. Complementary Medicine, in the form of acupuncture and herbal/nutrient medicines, will not only aid the immediate control of blood pressure, but get at the underlying causes in an individualized manner. The knowledgeable Licensed Acupuncturist will also be able to provide individualized guidance to help establish an efficient daily routine to reduce hypertension and regain cardiovascular health. Dietary changes, short aerobic exercise routines, changes in habits, such as walking to the grocery store, and 5-10 minutes of relaxed slow diaphragmatic breathing, will both achieve the desired results and improve quality of life. The measure of success occurs over a period of time, and a discussion with the prescribing medical doctor about gradually lowering dosages and going off of hypertension medications as the health improves and proven strategies are implemented, is very important.

Treating both consistently sustained high blood pressure and the underlying causes and individualized risk factors of cardiovascular disease is important. Complementary and Integrative Medicine provides many treatment tools to help achieve these goals in the healthiest manner possible. Standard drug medications to control high blood pressure do nothing to resolve the underlying health problems that caused the hypertension. Ignoring these underlying health problems may be the reason that yearly deaths from cardiovascular disease remain high, and why the number of deaths from heart failure have remained constant from their peak in 1993 to today, despite the large rise in the prescription of anti-hyptertensive drugs.

For patients with more severe hypertension, or sustained high blood pressure above 160/100, standard treatment protocol has failed to control this condition in a significant percentage of patients. Experts agree that for the roughly 70 million Americans treated for hypertension, about half still have blood pressure above normal. Dr. Gordon Tomaselli, a cardiologist at Johns Hopkins and president of the American Heart Association has stated that 10-20 percent of hypertension patients are unable to control their hypertension even with multiple drug therapy, and many consider this a conservative estimate. In 2012, medical experts are resorting to renal denervation to achieve results due to the high failure rate of multiple drug therapies for patients with true hypertension. In this procedure, a catheter is inserted through the arteries to the area of the kidney that reacts to chemical and hormonal imbalances, and stimulates increased vascular tension, the glomerular apparatus. The catheter contains a radio-frequency ablater that destroys the nerves in this kidney tissue, much in the way that radio-frequency ablation destroys the tissue nerves that control heart rate to stop episodes of tachycardia and fibrillation. As in the heart tissue, this is expected to reverse in time, though, with a regrowth of the normal tissue and nerves. In a June 6, 2012 New York Times article, entitled To Cut Blood Pressure, Nerves Get a Jolt, the director of the hypertension center at the University of Chicago medical center, and a principle investigator in the clinical trials to radio-frequency ablation for hypertension, reports that "A lot of people have viewed this superficially as a cure for hypertension, and it is not." This expert states that it will only allow some patients to take fewer medications or smaller doses, reducing adverse effects. The chief concern is that eliminating the normal mechanism to modulate blood pressure in the kidney will put the patient at risk when acute blood loss or other health problems need the kidney and adrenal apparatus to respond with higher blood pressure. What is largely overlooked in this discussion are the protocols to treat the underlying causes of the hypertension effectively, utilizing and integrating Complementary Medicine effectively. Once again, allopathic medicine fails to see the need to fix the problem, or problems, not just inhibit the body from what it is genetically programmed to do. Allopathic inhibition of the blood pressure mechanisms is just one tool in the box to protect the patient, not the complete solution.

In 2013, the American Heart Association Professional Education Committee finally released an opinion that medical doctors should integrate what they persist in calling "alternative approaches" beyond medications and diet in the protocol to lower blood pressure. The committee reluctantly admitted that a number of protocols have been understudied but nonetheless have produced reliable evidence of effectiveness. These proven treatments include, in the order of most evidenced to least, aerobic exercise, guided breathing techniques, acupuncture, resistance exercise, meditation, yoga and other relaxation techniques. Of course, none of these techniques involves any risk of harm to the patient, and certainly they could all easily be combined in a protocol that would be relatively inexpensive, take little time or effort, and integrate well with standard protocol, or drug therapy. These protocols of Complementary Medicine have been practiced for some time in Traditional Chinese Medicine, with short courses of acupuncture combined with guided breathing techniques, and the advice to the patient to adopt better exercise habits, utilize yoga, and take up either meditation or other relaxation techniques. This review of an expanded integrative protocol was published in the medical journal Hypertension, and the link to the review is found below in additional information. Surely such a protocol should be tried before kidney ablation surgery, and could potentially reduce the need for multiple prescription drugs and thus reduce the adverse effects of these pharmaceuticals, and improve quality of life.

In 2013, the American Heart Association Professional Education Committee finally recommended that treating Medical Doctors integrate Complementary Medicine into a thorough and holistic treatment protocol to control high blood pressure, or hypertension. A lack of large human clinical trials was cited as a problem, reflecting the widespread prohibition against such integration of therapies in the past. In addition, our system of clinical trials was created to evaluate safety of one treatment at a time, not an integrated course of therapy, and evaluation of manual therapies with a double-blinded and placebo-controlled human clinical trial presents obvious problems. Blinding the treating physician to whether one is using a real or so-called placebo manual treatment is absurd, and creating a so-called placebo manual treatment, especially where surgery, needle stimulation, or manual physiotherapy is involved, is absurd as well. Various medical organizations conducted meta-reviews to find out the actual research status of acupuncture, and the China Academy of Chinese Medical Sciences, in Beijing, China reviewed all such human clinical trials on all standard medical research databases. The findings included 35 high-quality randomized human clinical trial involving just 2539 patients, with acupuncture significantly reducing both systolic (averaged 7.47 point reduction) and diastolic pressure (average 4.22 point reduction), but the small size and study design did not adhere to standards of pharmaceutical trials (PMID: 24060112). In 2014, in response to this assessment, 4 University Medical Schools in China performed a meta-review of all published medical human clinical trials that met the proposed requirements, and found that only 4 clinical studies met this criteria. These studies consistently showed that short courses of acupuncture stimulation used within a broader treatment protocol with pharmaceuticals did significantly reduce chronic hypertension (PMID: 24723957). In response, Chengdu University School of Traditional Chinese Medicine announced in 2013 that they were sponsoring the first multicenter large-scale randomized controlled human clinical trial of acupuncture to treat essential hypertension that met the difficult criteria used to assess the efficacy and safety of pharmaceutical drugs.

In the United States, experts studying the physiological effects of acupuncture stimulation at the University of California at Irvine noted that their studies elucidate the physiological benefits of acupuncture as an adjunct integrated treatment for essential hypertension, with proof that sustained cardiovascular benefits and neurovascular modulation are achieved with repeated short course of acupuncture. These study summaries can be accessed in the section of this article entilted Additional Information. The patient must decide whether the lack of publication of large studies confirming direct effects of acupuncture in treatment of essential hypertension, and the difficulties with study design concerning so-called sham placebo acupuncture needle stimulation, that was systematically achieved over decades, is enough to discount the proof of effect. In addition, such meta-review of acupuncture alone does not reflect the positive treatment effects of the integrated array of treatments recommended, and routinely provided in Traditional Chinese Medicine, a holistic form of healthcare that usually combines multiple therapeutics to treat hypertension, as well as the underlying pathology. As of 2013, all we know from standard research is that these treatments appear to work but that there has been a successful prohibition of adequate study and clinical trials, and/or publication of these studies and clinical trials in standard medical journals. As this article and links to studies shows, there is abundant evidence of benefits, just no large well-funded human clinical trials that meet the absurd requirement of the trials designed for pharmaceuticals.

By 2015, a change in the study design for acupuncture human clinical trials was broadly accepted, and a number of additional studies showed proof of benefit. For instance, at the University of California at Irvine, Susan-Samueli Center for Integrative Medicine, a randomized controlled human clinical trial of 65 patients with hypertension but not receiving medication were randomly assigned to a studied acupuncture stimulation that was proven to achieve sustained lower blood pressure, electroacupuncture at P6-7 and ST36-37 with just one weekly treatment for 8 weeks, or acupuncture stimulation with electricity at alternate points of LI6-7 and GB37-39. After 8 weeks of this simple and inexpensive treatment the 33 patients assigned the primary treatment showed significantly decreased peak and average systolic and diastolic blood pressure, with much better outcomes than the alternate treatment. With an additional 4 weeks of this treatment in half of the main group, a sustained effect was noted, and treatments lowered circulating adrenaline (norepinephrine), renin (decreased by 67 percent), and aldosterone (decreased by 22 percent). Such study shows that this treatment with electroacupuncture stimulation for just 12 treatments is effective as integrative treatment for patients with hypertension, and works by affecting the renin-angiotensin and autonomic nervous systems. To see this study summary, click here: http://www.ncbi.nlm.nih.gov/pubmed/26392838 . A more comprehensive treatment protocol is achieved in actual clinical care, with benefits from other acupuncture stimulation, herbal and nutrient medicine, and even physiotherapy, providing a wealth of benefits to reduce cardiovascular risk and improve general health over the reduction in sustained blood pressure. This treatment course does not require long-term constant and chronic use of medications with harsh side effects, or adverse health effects, and could be used with a simple pharmaceutical approach to decrease the cost and adverse drug effects and risks.

The questions concerning the rise in sustained high blood pressure in children and young adults - starting a safe and holistic protocol early in life to address underlying causes and health risks

Numerous studies in the United States and Europe have shown that a significant percentage of children and young adults have mild hypertension, most studies showing that about 10 percent of these patients studied had mild hypertension. The implications for this sign are still unclear, though, and more emphasis should be placed on the underlying causes rather than a rush to treatment, as the cardiovascular systems of most youth are strong enough to make mild sustained high blood pressure an insignificant risk. Of course, a thorough evaluation of each individual child and young adult with hypertension should be performed to identify the actual cardiovascular risk of each individual, hopefully before starting medication protocols that have many adverse risks for children and young adults. The question of sustained high blood pressure is itself a serious concern, as so-called "white coat effect" has been shown to be more prevalent in youth than even in adults (disputed in some studies), with blood pressure rising merely due to the stress of being seen in a doctor's office. Responsible parents will utilize a series of blood pressure readings taken routinely at home to see what the actual blood pressure pattern is. In addition, physicians should take into consideration that systolic blood pressure is expected to be higher in youth than in adulthood. Diurnal fluctuation of blood pressure in youth is also an important consideration, with sleep disorders and hormonal changes with obesity linked to such diurnal fluctuation.

Most of the concern regarding hypertension in youth centers around the enlargement of a part of the heart called the left ventricle (left ventricular hypertrophy) in response to sustained high blood pressure, which may be a risk factor for adverse cardiovascular outcomes later in life. This is opposed to concern for adults with hypertension, which is centered on the individual with increased cardiovascular risk, especially with aging and such common problems as atherosclerosis, arrhythmia, vascular anomalies, and oxidative stress. Of course, associated health problems, such as obesity, Metabolic Syndrome, diabetes, and a history of excessive cigarette smoking, as well as alcoholism, are also a concern with aging and cardiovascular risks, although recent studies now show that hormonal changes in moderate obesity may confer some protection against cardiovascular disease, as well as the obvious risks. The total picture for children and young adults is also less than clear. A large German study, published in the May 2012 issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, reported that although teens with high blood pressure were more likely to be obese and less physically fit than those with normal blood pressure, and spent more sedentary time with the computer and television, that they were also more likely to be more academically successful, scored higher in quality of life measurements, such as healthy family interactions and self-esteem, and were less likely to problems with hyperactivity. The head author of this study, which examined about 7700 teenagers across Germany, Dr. Angela Berendes, of the University of Gottingen, Germany, surmised that high blood pressure perhaps triggered various stress-dampening effects in the brain, but that additional study was needed to fully explain these findings. These findings do make the assessment of treatment protocol for hypertension in youth more complex. The need to address more than just reduction of blood pressure with medication is apparent.