Treating Hypertension 'Naturally'
WebMD Feature Archive
"Meditation. not medication," is the advice Robert Schneider, MD, gives when it comes to high blood pressure treatment. It's not his only advice, but it's right up there at the top of his list.
Schneider, dean of the College of Maharishi Vedic Medicine at the Maharishi University of Management in Fairfield, Iowa, is also director of the university's government-sponsored Center for Natural Medicine and Prevention, one of 16 such centers in the country. Schneider has been researching the positive effects of the ancient medical science of maharishi vedic medicine -- of which transcendental meditation (TM) is key --for the past 15 years.
Citing statistics from the National Heart. Lung. and Blood Institute (NHLBI), Schneider says that about 50 million adults in the United States suffer from high blood pressure. If left untreated, high blood pressure can damage the kidneys and lead to stroke. heart attack. and heart failure. Heart disease and stroke are the first and third leading causes of death, respectively, in the U.S. (Cancer is second.)
High blood pressure (hypertension) is defined as systolic blood pressure -- the top number -- averaging 140 mmHg or greater, and/or diastolic blood pressure -- the bottom number -- averaging 90 mmHg or greater. The systolic pressure is the pressure of blood in the vessels when the heart contracts. Diastolic pressure is the pressure of the blood between heartbeats when the heart is at rest.
In the past 30 years, says Schneider, approximately 600 studies have been conducted worldwide on the effects of transcendental meditation on blood pressure. "TM is a simple mind-body technique that allows you to gain a unique state of restful awareness or alertness," says Schneider. Studies have repeatedly shown it to be effective in easing stress, one of the major risk factors for heart disease. Though there are many kinds of meditative techniques, it is only TM, says Schneider, that has been studied and been proved to be effective in improving a range of risk factors for heart disease. Researchers believe that the deep rest achieved through TM sparks biochemical changes that help the body and mind reach a more balanced state, in turn triggering the body's own self-repair mechanism.
TM involves the repetition of a word or phrase (known as a mantra) while seated in a comfortable position with the eyes closed. Most TM practitioners suggest it be practiced for 20 minutes a session, twice a day.
In a study led by Schneider and reported in 1995 in the journal Hypertension, TM was compared with progressive muscle relaxation as a means of controlling stress in older African Americans with high blood pressure. Of the 197 men and women (out of 213) who completed the screening, the reductions in blood pressure in the TM group were significantly greater than those in the progressive muscle relaxation group. TM reduced systolic blood pressure by more than 10 points and diastolic pressure by more than 6 points (compared with a 5 point reduction for systolic and a 3 point fall for diastolic with progressive muscle relaxation).
Schneider is conducting a study on the use of TM in the prevention of high blood pressure in African Americans (a population at significant risk for high blood pressure). The study is not yet complete, but preliminary evidence indicates that TM is useful for high blood pressure treatment and prevention, too.
Learning TM is not difficult, says Schneider, but it should be learned from a qualified instructor. "You need someone there to guide you, and to give you feedback," he says. "Otherwise, you won't get the full effect." To find an instructor near you, call 1-888-LEARN-TM.
TM is not the only non-drug approach to high blood pressure treatment. The role of diet comes into play, too, says Lawrence J. Appel,
MD, MPH, professor of medicine, epidemiology, and international health at the Johns Hopkins Medical Institutions in Baltimore. Of these therapies, most are related to diet and include reducing your salt intake, drinking alcohol in moderation, increasing your potassium intake, and overall, eating a healthy diet that emphasizes fruits, vegetables, and low-fat dairy products.
Most evidence to date indicates that a diet high in salt can have an adverse effect on blood pressure, says Appel. Recent studies have also shown that a reduced salt diet can prevent high blood pressure in persons at risk for the condition, can help control high blood pressure in elderly persons who are on blood pressure medication, and can potentially prevent heart problems in overweight individuals.
According to Appel, salt intake should be limited to 2,400 mg per day; less sodium will reduce blood pressure even more in many people. To reduce the amount of salt you consume, the National Heart, Lung, Blood Institute suggests these tips:
- Buy fresh, plain frozen, or canned no-salt-added vegetables.
- Use fresh poultry, fish, and lean meat, rather than canned or processed foods.
- Use herbs, spices, and salt-free seasonings in cooking and at the table.
- Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt.
- Choose "convenience" foods that are lower in sodium. Limit frozen dinners. pizza, packaged mixes, canned soups or broths, and salad dressings.
- Rinse canned foods, such as tuna, to remove some of the sodium.
- When available, buy low- or reduced-sodium, or no-salt-added versions of foods.
- Choose ready-to-eat breakfast cereals that are lower in sodium.
The NHLBI also suggests eating at least 3,500 mg of potassium a day, from foods such as yogurt, cantaloupe, spinach, and bananas. Potassium may help rid the body of too much sodium by acting as a diuretic.
Chiropractor Peter Cox, director of the Chiropractic Care Center of Charlotte in North Carolina, suggests chiropractic therapy as another means of controlling stress, and by extension, blood pressure.
Though chiropractors cannot directly affect high blood pressure treatment, many of the conditions they see -- including misalignment of the C1 (or first) vertebra -- can affect blood flow to the head and result in symptoms of high blood pressure, says Cox. "In treating misaligned vertebrae," he says, "the treatment itself can often result in lowered blood pressure."
However, not all experts agree chiropractic is an effective treatment. "From a clinical perspective, from what we know today, chiropractic care will have no direct bearing on lowering blood pressure," says Henry Punzi, MD, FCP, author of Hypertension, Clinical Cardiovascular Therapeutics: Vol. 1. and a principal investigator in more than 60 cardiovascular clinical trials .
"There's a misconception that hypertension is related only to stress, and that's not always the case," he says. While decreasing stress and anxiety may help overall general well-being, these measures are not going to be a specific treatment for blood pressure. "Hypertension occurs when pressure is high inside the arteries. Misaligned spines or blood flow to the brain. don't really have an impact on blood pressure," Punzi says.
Finally, if you want to lower your blood pressure -- or keep it from getting high in the first place -- get moving! A study published in the April 2, 2002, issue of the Annals of Internal Medicine reported that aerobic exercise (such as 30 minutes of brisk walking a day) reduced blood pressure in people who already have high blood pressure as well as in people who don't.
Researcher Seamus P. Whelton of Princeton University and colleagues concluded that an "increase in aerobic physical activity should be considered an important component of lifestyle modification for prevention and treatment of high blood pressure."