Uncovering the Hidden Causes of High Blood Pressure

Recently, I have had several patients in my office who have been on inappropriate blood pressure medications for different reasons.

Alex was given medication which didn’t seem to be working. Basic testing showed that he was given the wrong medication. His problem was not in the kidneys, it was in the adrenals that caused vascular constriction, so the kidney medication didn’t work. We found the underlying cause because his blood pressure was consistently around 200/100 morning and evening, except for two nights when it was 120/75 – normal! I asked about that, and he said, “Yeah, I noticed that. I don’t know, except that it seems to happen whenever I have wine with dinner.” He hadn’t told me this, so I asked him to drink wine and check his blood pressure. It was normal. He asked, “What am I supposed to do, become a wino?” No. He was given a different medication, and his blood pressure was normal. Ultimately, he would do much better to reduce stress and get off the medication.

Recently, a woman who is 87 years old was given blood pressure medication by her cardiologist and then started getting dizzy spells. She almost passed out a few times because her blood pressure dropped too low. I recommended she get off the medication and she did, and within three days, it was back to normal. However, when she went back to her cardiologist, he gave her another blood pressure medication – and the same thing happened. After stopping the drugs, I had her monitor her blood pressure for a couple of weeks. The blood pressure in the morning was higher, 160/78 to 188/80, but the evening blood pressures was in the range of 140/75.

This brings up a very important point. The ideal blood pressure in young men (where all the original studies were done) is around 120/80, but as we age, the blood vessels are less compliant, and we need more pressure to get adequate circulation.

This means that for people over 70, the ideal blood pressure is 140/75.

This woman’s blood pressure was perfect in the evening when her cortisol was low, so the blood pressure medications caused her go get hypotension (low blood pressure) which is more dangerous than hypertension (high blood pressure).

Sometimes blood pressure is only high in the office. I make sure all my patients who have a potential problem with blood pressure take their blood pressure morning and evening for at least two weeks before diagnosing hypertension (that’s 28 readings 😊). If the blood pressure is normal sometimes, then we can ask the question, “Why?” Really, if the blood pressure is normal when you are quiet and relaxed, you don’t have a blood pressure problem. You only need to be concerned if your blood pressure is continually elevated.

There are hundreds of different conditions that can raise blood pressure. For this reason, most doctors will not look for the cause, and they will call it “essential hypertension.” Then they will randomly pick a blood pressure medication to give. If that doesn’t work, they will add another without stopping the one that didn’t work. It’s kind of a ridiculous system all the way around – from start to finish. Most people are not aware that they have “secondary hypertension,” so this requires an explanation.

Primary Hypertension

“Essential Hypertension” is what most of the doctors diagnose when someone has elevated blood pressure. That means they don’t know what is causing it. One of my professors in medical school used to tell us, “It’s idiopathic – that means we’re idiots because we don’t know what causes it.” The fact is, there is no such thing as primary hypertension, which would mean it’s just high for no reason. Doctors who use the diagnosis of “primary hypertension” are not doing their work to find the cause. There is ALWAYS a reason, which means all hypertension is secondary.

Secondary Hypertension:

Secondary hypertension refers to high blood pressure caused by an underlying condition. Some common causes include:

• Nephritis, inflammation of the kidneys
• Sleep problems such as sleep apnea
• Hormone imbalances
• Tumors
• Cancers
• Medications, including over-the-counter like decongestants
• Thyroid disorders
• Vascular diseases
• Brain diseases
• Autoimmune disorders
• Genetic conditions
• Metabolic derangements like diabetes
• Lifestyle issues such as diet
• Supplements
• Toxins
• Sensitivities to environmental chemicals

As you can see, there are hundreds of things that might cause hypertension. This is why doctors diagnose “primary hypertension;” it’s too hard to find the cause. However, just scanning the list, it would be important to know if you have hypertension due to cancer, a neuroendocrine tumor, kidney failure, toxicity, or brain disease. Finding the underlying cause is the only way to resolve the issue.

One way to look at high blood pressure is to start with the first level of why the pressure goes up. There are four basic categories:

1. Inflammation
2. Metabolism
3. Stress
4. Vasoconstriction

Inflammation

Inflammation anywhere in the body may cause the blood pressure to go up. People with arthritis, colitis, and even gingivitis may increase blood pressure. The chemicals that are produced by inflammation cause the local area to have enlarged blood vessels, which is why the area of inflammation gets hot, red, and tender. However, the rest of the blood vessels are constricted, increasing blood pressure.

This category includes people who have chronic infections such as mold, Lyme, Epstein-Barr Virus (EBV), or even gum disease.
The key to reducing inflammation is to find the underlying cause. Once you know why, you can take appropriate action to reduce inflammation and lower blood pressure.

How to lower inflammation:

Find the source of inflammation (infection, autoimmune, omega 6, allergies, etc.) and remove it.

Supplements:

• Fish oil 2 grams of omega 3 daily
• Add Selenium 200mcg because it is a common deficiency.
• Turmeric 500mg twice per day (with black pepper)
• Boswellia 500mg twice per day

Metabolism

The primary metabolic problem that causes the blood pressure to go up is insulin resistance, or “pre-diabetes.” Human beings normally produce about sixty percent of their energy from fat. Yes, we are told that sugar is our primary energy source, but ideally, fat is. Fat is the perfect fuel for the day-to-day running of the metabolism. It is “low-octane,” meaning it doesn’t create a lot of heat, or inflammation, and the ketone bodies that are produced from burning fat can also be used in the brain as a “low-octane” fuel. The excess insulin in those with insulin resistance suppresses fat-burning metabolism, causing less energy, and requiring the cells to use more glucose. Glucose is a great source of quick energy, but it also causes inflammation – raising the blood pressure.

Also, there are three organs that are very sensitive to energy production: kidneys, heart, and brain. The other muscles and organs are not so picky about their energy source. When these three do not have enough energy because they can’t burn fat due to high insulin, they cause a rise in blood pressure. For example, the brain feels a lack of energy and assumes it is because there isn’t enough oxygen due to a lack of blood flow, so it causes vasoconstriction in the body to increase blood flow to the brain. The only way the brain can get more nutrients (oxygen, glucose, fat, and so forth) is to raise the blood pressure. Kidneys also have this same issue, raising blood pressure to improve energy production. The problem is that this works well for low oxygen, such as when you have anemia, but it does not work well for insulin resistance. Thus, people with metabolic syndrome just continue to have hypertension despite medications to lower blood pressure.

The best way to deal with metabolic problems is to change your metabolism. If nothing changes, then nothing is going to change. This is where blood pressure medications are not useful and may even cause harm. It is like putting a bandage over a melanoma skin cancer. Sure, you don’t see it, but it’s still there – and growing! Worse, the blood pressure medications starve the tissues (brain, kidneys, heart) for energy by decreasing blood flow, which may cause more damage.

How to improve your metabolism:

Diet: A change in diet is essential. Change from carb (sugar, or glucose) to fat-burning metabolism by restricting sugars. Avoid the taste of sweets. Eat only 2 meals per day, breakfast and lunch, and skip dinner. (no food after lunch) Fasting is a great way to cleanse from a glucose metabolism. When we don’t eat we stop making insulin and the body naturally changes to a fat-burning metabolism.

Supplements:

• Take Chromium 200mcg per day (add Vanadium 50mcg)
• Get enough Vitamin D – about 5,000 IU per day
• Berberine 500mg twice per day.
• Exercise. The best exercise is the one you like. This is good to change, using different methods such as the following:
• HIIT 30 minutes
• 10,000 steps per day
• Gym, weights, Pilates, and so forth.
• Yoga

Stress

When people are under stress, the adrenal glands make norepinephrine and epinephrine, causing vasoconstriction. Both affect blood vessels, but they work on different receptors of the body. Epinephrine mostly affects the heart by dilating blood vessels and the lungs by dilating the airways, whereas norepinephrine causes more vasoconstriction, raising blood pressure.

While the adrenal glands make four times as much epinephrine (adrenaline) as norepinephrine, chronic stress changes this ratio. Over time, high levels of cortisol cause less epinephrine and more norepinephrine to be made. This has the effect of causing high blood pressure. Unless this cause is addressed, the effects of stress and hypertension will not be resolved, even if the blood pressure is controlled with medications.

What to do to lower blood pressure:

• Ashwagandha lowers stress hormone levels (use according to the label)
• Phosphatidylserine (PS) 100mg twice daily
• Exercise daily in the morning before eating.
• Sleep from 10:00 PM to 6:00 AM
• Skip dinner (no food after 6:00 PM)
• Eat breakfast by 8:00 AM

This program rejuvenates your adrenal glands, giving you a good circadian rhythm, which will increase your stress tolerance and change the norepinephrine to epinephrine ratio.

Vasoconstriction

Ultimately, almost all blood pressure elevation is related to the constriction of blood vessels. As we discussed, inflammation, metabolic problems, and stress all cause vasoconstriction, but for different reasons. There is also a separate category of vasoconstriction because the blood vessels may be constricted for other reasons not discussed above.

For example, toxins of various kinds may raise blood pressure. There is evidence that heavy metals, dioxins, NO2, SO2, and other toxins can raise blood pressure. Nutrient deficiencies such as CoQ-10, potassium, magnesium, and omega-3 fats, are all associated with hypertension. Also, a lack of exercise falls into this category.

Those who do not have specific causes such as pre-diabetes, stress, or inflammation, may want to seek the cause by looking for toxins, nutrients, and using vasodilators.

The treatment for this is: adequate nutrition, detoxification, cleanse, and exercise.

DETOX:

The best detox program is long-term fasting. This can take the form of a “cleanse” such as a drink like sixteen ounces twice per day of juice, broth, or soup, but is ideally just water – and no food. A cleanse such as the “master cleanse” normally goes for about 30 days, but some do shorter times. It may be important to consider low blood sugar, dehydration, and the fact that you will lose about a pound of fat per day (some people don’t want to lose 30 Lbs). This has worked very well for most of my patients who have hypertension due to toxicity.

Supplements:

• L-arginine is an amino acid that helps make nitric oxide to dilate blood vessels. Citrulline is made into arginine. The best way is to take citrulline 2 grams twice per day.
• Antioxidants such as fruit and vegetables.
• Bioflavonoids including fruit and vegetables, and horse chestnut seed extract.
• Beet root contains nitrates that relax blood vessels.

Finding the cause of High Blood Pressure

Seeking the underlying reason for hypertension is essential because blood pressure is only a symptom of some illnesses that could lead to problems. Just lowering blood pressure without dealing with the cause is potentially devastating. However, finding the cause and lowering your blood pressure is not an easy task. It may take the help of a physician who is experienced in finding the root causes. This outline will give you some ideas of where to start, and what to do about it.

 

 

 

 

Sources:
Hypertension targets in the elderly; British Medical Journal BMJ Posted on November 9, 2010; https://blogs.bmj.com/heart/2010/11/09/hypertension-targets-in-the-elderly/
https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/symptoms-causes/syc-20355465
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360873/
https://www.healthline.com/health-news/common-medications-can-damage-kidneys#Which-common-medications-can-damage-kidneys?
https://www.americansportandfitness.com/blogs/fitness-blog/chromium-the-hidden-helper-in-glucose-metabolism#:~:text=Chromium%20is%20an%20important%20mineral%20that%20is%20involved,glycogen%20%28the%20form%20of%20carbohydrate%20stored%20in%20muscles%29.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016376/#:~:text=Several%20mechanisms%20have%20been%20proposed%20to%20explain%20the,receptors%20in%20muscles%20and%20liver.%205%20%E2%80%93%207
https://www.ncbi.nlm.nih.gov/books/NBK537259/
https://www.ezmedlearning.com/blog/beta-receptors
https://healthmatters.io/understand-blood-test-results/norepinephrine-epinephrine-ratio
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.17295#:~:text=Heavy%20metals%2C%20including%20arsenic%2C%20cadmium%2C%20mercury%2C%20and%20lead,whereas%20results%20have%20been%20mixed%20for%20other%20metals.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367997/
https://www.dietvsdisease.org/4-nutrient-deficiencies-every-high-blood-pressure-patient-needs-to-know/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683098/
https://www.peoplespharmacy.com/articles/how-can-you-use-beets-for-better-blood-pressure