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Approaching Hypertension

Western medicine refers to elevated blood as essential hypertension, which is a somewhat confusing term, but it means that a patient has a high blood pressure of unknown cause.

Approaching hypertension appropriately requires uncovering why a person has high blood pressure before assuming it’s due to an unknown cause. Here is our approach.

Essential Hypertension

The most common form of hypertension is idiopathic hypertension which Western Medicine calls essential hypertension.

This distinguishes it from secondary hypertension, which has various other causes:

  • kidney disease
  • hormone imbalances
  • pregnancy-induced

However, many clinicians will argue that most of this essential hypertension, in fact, has other known causes that aren’t addressed.

Managing Hypertension

We address hypertension by reviewing its major risk factors. Both in terms of what can cause it and the major risks of living with elevated blood pressure.

Our goal is in the neighborhood of 120/80, depending on various risk factors and family history.

1. Obesity

Liposuction won’t solve obesity-induced hypertension. The lifestyle changes leading to weight loss seem to be the curative factors for bringing blood pressure back to normal.

2. Elevated Uric Acid

Diets high in fructose and meat tend to elevate uric acid. Even if there are no problems with gout, a lower uric acid is desirable.

Alcohol, especially regular alcohol use, tends to elevate uric acid levels as well.

Some experts recommend keeping this value under 6 mg/dl; others want it as low as 4.

3. Elevated Blood Sugars

It’s hard to know whether elevated blood sugars or elevated insulin levels are the main cause of elevated blood pressure. Either way, we recommend our clients have optimal levels before considering that the blood pressure problem is idiopathic.

4. Sleep Apnea

Sleep apnea goes undiagnosed quite frequently. Good home tests are available these days, but the treatment – sleep apnea device – often has a low compliance rate.

Sleep apnea can cause elevated blood pressure, fatigue, headaches, and difficulty focusing.

5. Fatty Liver

Visceral fat, in general, especially fat around the liver, seems to disrupt the normal hormone cycles of the body.

Non-alcoholic fatty liver disease (NAFLD) is bidirectionally associated with other metabolic disorders. Therefore, we screen for NAFLD in our decision algorithm.

Measuring Improvements

In most, doing even some work towards improving the factors above is likely to yield good blood pressure improvements.

The obvious method is regularly checking blood pressure numbers, focusing on a daily average called ambulatory blood pressure.

A secondary method is to monitor kidney function levels, called glomerular filtration rate (GFR), which creatinine or cystatin C measures.

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