Hypertension (High Blood Pressure) - Symptoms, Indications and Actions


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Hypertension (High Blood Pressure)

	Other Names
	Hypertensive, Hypertension, High Blood Pressure, Blood Pressure, Elevated Blood Pressure. View products
	Description
	Also known as: Elevated Blood Pressure, High Blood Pressure. Hypertension is the medical term for high blood pressure. Approximately 90% of people with high blood pressure have "essential" or "idiopathic" hypertension, for which the cause is poorly understood. The terms "hypertension" and "high blood pressure" as used here refer only to this most common form and not to pregnancy-induced hypertension or clearly linked to a known cause, such as Cushing's syndrome, pheochromocytoma, or kidney disease. Hypertension must always be evaluated by a healthcare professional. Extremely high blood pressure (malignant hypertension) or rapidly worsening blood pressure (accelerated hypertension) almost always requires treatment with conventional medicine. People with mild to moderate high blood pressure should work with a doctor before attempting to use the information contained here, as blood pressure requires monitoring and in some cases the use of blood pressure-lowering drugs. As with conventional drugs, the use of natural substances sometimes controls blood pressure if taken consistently but does not lead to a cure for high blood pressure. Thus, someone whose blood pressure is successfully reduced by weight loss, avoidance of salt, and increased intake of fruits and vegetables would need to maintain these changes permanently in order to retain control of blood pressure. Left untreated, hypertension significantly increases the risk of stroke and heart disease. What are the symptoms of hypertension? Essential hypertension is usually without symptoms until complications develop. The symptoms of complications depend on the organs involved. Conventional treatment options: Essential hypertension has no cure, but treatment can modify its course. Many drugs are used to treat hypertension, including diuretics. Several classes of diuretics exist, including thiazide diuretics (e.g., chlorthalidone [Hygroton], chlorothiazide [Diuril], hydrochlorothiazide [Esidrixr, HydroDIURIL]), loop diuretics (e.g., bumentanide [Bumex], ethacrynic acid [Edecrin], furosemide [Lasix], torsemide [Demadex]), and potassium-sparing diuretics (e.g., amiloride [Midamor], spironolactone [Aldactone], triamterene [Dyrenium]). Diuretics are usually combined with beta-blockers (e.g., propranolol [Inderal], metoprolol [Lopressor], atenolol [Tenormin], timolol [Betimol], bisoprolol [Zebeta]) or ACE inhibitors (e.g., captopril [Capoten], benazepril [Lotensin], lisinopril [Prinivil], enalapril [Vasotec]). Alternatively, calcium channel blockers (e.g., amlodipine [Norvasc]) may be combined with diuretics. Healthcare practitioners may also recommend lifestyle modifications, such as moderate weight reduction and a decrease in salt intake. Dietary changes that may be helpful: Primitive societies exposed to very little salt suffer from little or no hypertension.1 Salt (sodium chloride) intake has also been definitively linked to hypertension in western societies.2 Eliminating salt from the diet lowers blood pressure in most people.3 The more salt is restricted, the greater the blood pressure-lowering effect.4 Individual studies sometimes come to differing conclusions about the relationship between salt intake and blood pressure, in part because blood pressure-lowering effects of salt restriction vary from person to person, and small to moderate reductions in salt intake often have minimal effects on blood pressure-particularly in young people and in those who do not have hypertension. Nonetheless, dramatic reductions in salt intake are generally effective for many people with hypertension. With the prevalence of salted processed and restaurant food, simply avoiding the salt shaker no longer leads to large decreases in salt intake for most people. Totally eliminating salt is more effective, but is quite difficult to achieve. Moreover, while an overview of the research found "There is no evidence that sodium reduction . . . presents any safety hazards,"5 reports of short-term paradoxical increases in blood pressure in response to salt restriction have occasionally appeared.6 Therefore, people wishing to use salt reduction to lower their blood pressure should consult with a doctor. Vegetarians have lower blood pressure than do people who eat meat.7 This occurs partly because fruits and vegetables contain potassium-a known blood pressure-lowering mineral.8 The best way to supplement potassium is with fruit, which contains more of the mineral than do potassium supplements. However, fruit contains so much potassium that people taking "potassium-sparing"diuretics can consume too much potassium simply by eating several pieces of fruit per day. Therefore, people taking potassium-sparing diuretics should consult the prescribing doctor before increasing fruit intake. In the Dietary Approaches to Stop Hypertension (DASH) trial, increasing intake of fruits and vegetables (and therefore fiber) and reducing cholesterol and dairy fat led to large reductions in blood pressure (in medical terms, 11.4 systolic and 5.5 diastolic) in just eight weeks.9 Even though it did not employ a vegetarian diet itself, the outcome of the DASH trial supports the usefulness of vegetarian diets because diets employed by DASH researchers were related to what many vegetarians eat. The DASH trial also showed that blood pressure can be significantly reduced in hypertensive people (most dramatically in African Americans) with diet alone, without weight loss or even restriction of salt.10 Nonetheless, restricting salt while consuming the DASH diet has lowered blood pressure even more effectively than the use of the DASH diet alone.11 Sugar has been reported to increase blood pressure in animals12 and humans in short-term trials.13 Though the real importance of this experimental effect remains unclear,14 some doctors recommend that people with high blood pressure cut back on their intake of sugar. Right after consuming caffeine from coffee or tea, blood pressure increases briefly.15 16 In trials lasting almost two months on average, coffee drinking has led to small increases in blood pressure.17 The effects of long-term avoidance of caffeine (from coffee, tea, chocolate, cola drinks, and some medications) on blood pressure remain unclear. A few reports have even claimed that long-term coffee drinkers tend to have lower blood pressure than those who avoid coffee.18 Despite the lack of clarity in published research, many doctors tell people with high blood pressure to avoid consumption of caffeine. Several double-blind trials have shown that adding 6.5-7 grams of fiber per day to the diet for several months leads to reductions in blood pressure.19 20 21 However, other trials have not found fiber helpful in reducing blood pressure.22 23 The reasons for these discrepant findings is not clear. Food allergy was reported to contribute to high blood pressure in a study of people who had migraine headaches.24 In that report, all 15 people who also had high blood pressure experienced a significant drop in blood pressure when put on a hypoallergenic diet. People who suffer migraine headaches and have hypertension should discuss the issue of allergy diagnosis and elimination with a doctor. Exposure to lead and other heavy metals has been linked to high blood pressure in some,25 but not all, research.26 If other approaches to high blood pressure prove unsuccessful, it makes sense for people with hypertension to have their body's burden of lead evaluated by a healthcare professional. Lifestyle changes that may be helpful: Smoking is particularly injurious for people with hypertension.27 The combination of hypertension and smoking greatly increases the risk of heart disease-related sickness and death. All people with high blood pressure need to quit smoking. Consumption of more than about three alcoholic beverages per day appears to increase blood pressure.28 Whether one or two drinks per day meaningfully increases blood pressure remains unclear. Daily exercise can lower blood pressure significantly.29 A 12-week program of Chinese T'ai Chi was reported to be almost as effective as aerobic exercise in lowering blood pressure.30 Progressive resistance exercise (e.g., weight lifting) also appears to help reduce blood pressure.31 At the same time, blood pressure has been known to increase significantly during the act of lifting heavy weights; for this reason, people with sharply elevated blood pressure, especially those with cardiovascular disease, should approach heavy strenuous resistance exercise with caution. In general, people over 40 years of age should consult with their doctors before starting any exercise regimen. Most people with high blood pressure are overweight. Weight loss lowers blood pressure significantly in those who are both overweight and hypertensive.32 In fact, reducing body weight by as little as ten pounds can lead to a significant reduction in blood pressure.33 Weight loss appears to have a stronger blood pressure-lowering effect than dietary salt restriction.34 Nutritional supplements that may be helpful: Both preliminary35 36 37 and double-blind38 39 trials have reported that supplementation with Coenzyme Q10 (CoQ10) leads to a significant decrease in blood pressure in people with hypertension. Much of this research has used 100 mg of CoQ10 per day for at least 10 weeks. EPA and DHA, the omega-3 fatty acids found in fish oil, lower blood pressure, according to an analysis of 31 trials.40 The effect was dependent on the amount of omega-3 oil used, with the best results occurring in trials using unsustainably high levels: 15 grams per day-the amount often found in 50 grams of fish oil. Although results with lower intakes were not as impressive, trials using over 3 grams per day of omega-3 (as typically found in ten 1,000 mg pills of fish oil) also reported significant reductions in blood pressure. One double-blind trial reported that DHA had greater effects on blood pressure than EPA or mixed fish oil supplements.41 DHA is now available as a supplement separate from EPA. Potassium supplements in the amount of at least 2,400 mg per day lower blood pressure, according to an analysis of 33 trials.42 However, potassium supplements greater than 100 mg per tablet require a prescription, and the low-dose potassium supplements available without a prescription can irritate the stomach if taken in large amounts. Moreover, some people, such as those taking potassium-sparing diuretics, should not take potassium supplements. Therefore, the use of potassium supplements for lowering blood pressure should only be done under the care of a doctor. Some,43 but not all,44 trials show that magnesium supplements-typically 350-500 mg per day-lower blood pressure. Magnesium appears to be particularly effective in people who are taking potassium-depleting diuretics.45 Potassium-depleting diuretics also deplete magnesium. Therefore, the drop in blood pressure resulting from magnesium supplementation in people taking these drugs may result from overcoming a mild magnesium deficiency. Calcium supplementation-typically 800-1,500 mg per day-may lower blood pressure. However, while an analysis of 42 trials reported that calcium supplementation led to an average drop in blood pressure that was statistically significant, the actual decrease was small (in medical terms, a drop of 1.4 systolic over 0.8 diastolic pressure).46 Results might have been improved had the analysis been limited to studies of people with hypertension, since calcium has almost no effect on the blood pressure of healthy people. In the analysis of 42 trials, effects were seen both with dietary calcium and with use of calcium supplements. A 12-week trial of 1,000 mg per day of calcium accompanied by blood pressure monitoring is a reasonable way to assess efficacy in a given person. Five double-blind trials have found that vitamin C supplementation reduces blood pressure, but the reduction was statistically significant in only three of the five, and in most cases reductions were modest.47 48 Some doctors recommend that people with elevated blood pressure supplement with 1,000 mg vitamin C per day. A deficiency of the amino acid, taurine, is thought by some researchers to play an important role in elevating blood pressure in people with hypertension.49 Limited research has found that supplementation with taurine lowers blood pressure in animals50 and in people (at 6 grams per day),51 possibly by reducing levels of the hormone epinephrine (adrenaline). The amino acid, arginine, is needed by the body to make nitric oxide, a substance that allows blood vessels to dilate, thus leading to reduced blood pressure. Intravenous administration of arginine has reduced blood pressure in humans in some reports.52 In one controlled trial, people not responding to conventional medication for their hypertension were found to respond to a combination of conventional medication and oral arginine (2 grams taken three times per day.)53 Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions. Herbs that may be helpful: In a double-blind trial, people with mild hypertension took a tincture of Achillea wilhelmsii, an herb used in traditional Persian medicine.54 Participants in the trial used 15-20 drops of the tincture twice daily for six months. At the end of the trial, participants experienced significant reductions in both systolic and diastolic blood pressure compared to those who took placebo. No adverse effects were reported. Garlic has a mild blood pressure-lowering effect, according to an analysis of ten double-blind trials.55 All of these trials administered garlic for at least four weeks, typically using 600-900 mg of garlic extract per day. Onions-closely related to garlic-may also have a mild blood pressure-lowering effect, according to preliminary research.56 European mistletoe (Viscum album) has reduced headaches and dizziness associated with high blood pressure, according to preliminary research.57 Mistletoe may be taken as 0.5 ml tincture three times per day.58 The blood pressure-lowering effect of mistletoe is small and may take weeks to become evident. Due to possible serious side effects, European mistletoe should only be taken under the careful supervision of a physician trained in its use. Indian snakeroot (Rauwolfia serpentina) contains powerful alkaloids, including reserpine, that affect blood pressure and heart function. Indian snakeroot has been used traditionally to treat hypertension, especially when associated with stress and anxiety.59 Due to possible serious side effects, Indian snakeroot should only be taken under the careful supervision of a physician trained in its use. In animal studies oleuropein, one of the constituents of olive leaf, has decreased blood pressure and dilated arteries surrounding the heart, when given by injection or intravenously.60 Olive leaf has been used traditionally to treat people with hypertension,61 but controlled human trials are needed before a blood pressure-lowering effect can be established. A double-blind trial reported that reishi mushrooms significantly lowered blood pressure in humans.62 The trial used a concentrated extract of reishi (25:1) in the amount of 55 mg three times per day for four weeks. It is unclear from the clinical report how long it takes for the blood pressure-lowering effects of reishi to be measured. Hawthorn leaf and flower extracts have been reported to have a mild blood pressure-lowering effect in people with early stage congestive heart failure.63 This effect has not been studied in hypertensive people with normal heart functioning. Human trials investigating the use of Coleus forskohlii in blood pressure reduction have yet to be conducted. However, forskolin, the active ingredient in Coleus forskohlii, has lowered blood pressure in a small, preliminary trial with people suffering from cardiomyopathy.64 Extracts of coleus standardized to contain 15-20% forskolin are available, but further trials are needed to determine effective levels for treating people with hypertension. Most herbal reference books suggest that ginseng should not be used by people with hypertension. However, the results of a preliminary trial suggest that red ginseng root (Panax ginseng radix rubra) has either no effect on, or may actually slightly lower, blood pressure in hypertensive people.65 However, many herbalists continue to believe that people with hypertension should avoid Asian ginseng and American ginseng, and, while not a true ginseng, Siberian ginseng (eleuthero) as well. In a controlled trial, people with hypertension received either Hibiscus tea (Hibiscus sabdariffa) or ordinary tea daily.66 Two tablespoons of dried herb were boiled in one cup of water for 20 to 30 minutes and consumed daily for 12 days. By the final day, blood pressure was 11% lower in the treatment group, compared to only 4% in the control group. Are there any side effects or interactions? Refer to the individual herb for information about any side effects or interactions. Other integrative approaches that may be helpful: Anxiety in men (but not women) has been linked to development of hypertension.67 Several research groups have also shown a relationship between job strain and high blood pressure in men.68 69 70 Some researchers have tied blood pressure specifically to suppressed aggression.71 Although some kind of relationship between stress and high blood pressure appears to exist, the effects of treatment for stress remain controversial. An analysis of 26 trials reported that reductions in blood pressure caused by biofeedback or meditation were no greater than those seen with placebo.72 Though some stress management interventions have not been helpful in reducing blood pressure,73 74 those trials that have reported promising effects have used combinations of yoga, biofeedback, and/or meditation.75 76 77 Some doctors continue to recommend a variety of stress-reducing measures, sometimes tailoring them to the needs and preferences of the person seeking help. Preliminary laboratory studies in animals78 and humans79 80 81 suggest that acupuncture may help regulate blood pressure. Most,82 83 84 85 86 87 but not all,88 preliminary trials also suggest that acupuncture may be an effective way to lower blood pressure. Whether blood pressure goes back up after acupuncture is discontinued remains an unsettled question. Auricular (ear) acupressure has been reported to be an effective treatment for hypertension,89 90 91 though in one case the improvement was not significantly better than use of traditional herbal medicines.92 Spinal manipulation may lower blood pressure (at least temporarily) in healthy people, according to most preliminary93 94 95 and controlled96 trials. However, some research suggests the effect is no better than the blood pressure-lowering effect of sham ("fake") manipulation.97 In hypertensive people, temporary decreases in blood pressure have also been reported after spinal manipulation.98 99 100 However, most,101 102 103 but not all,104 trials suggest that manipulation produces only short-term decreases in blood pressure in hypertensive people. References: 1. Page LB, Damon A, Moellering RC Jr. Antecedents of cardiovascular disease in six Solomon Islands Societies. Circulation 1974;44:1132-46. 2. Stamler J, Rose G, Elliott P, et al. 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Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, Phase II. Ann Intern Med 2001;134:1-11. 34. He J, Whelton PK, Appel LJ, et al. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension 2000;35:544-9. 35. Folkers K, Drzewoski J, Richardson PC, et al. Bioenergetics in clinical medicine. XVI. Reduction of hypertension in patients by therapy with coenzyme Q10. Res Commun Chem Pathol Pharmacol 1981;31:129-40. 36. Langsjoen P, Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;15 Suppl:s265-72. 37. Digiesi V, Cantini F, Oradei A, et al. Coenzyme Q10 in essential hypertension. Molec Aspects Med 1994;15 Suppl:s257-63. 38. Digiesi V, Cantini F, Brodbeck B. Effect of coenzyme Q10 on essential arterial hypertension. Curr Ther Res 1990;47:841-5. 39. Singh RB, Niaz MA, Rastogi SS, et al. 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Calver A, Collier J, Vallance P. Dilator actions of arginine in human peripheral vasculature. Clin Sci 1991;81:695-700. 53. Pezza V, Bernardini F, Pezza E, et al. Study of supplemental oral l-arginine in hypertensives treated with enalapril + hydrochlorothiazide. Am J Hypertens 1998;11:1267-70 [letter]. 54. Asgary S, Naderi GH, Sarrafzadegan N, et al. Antihypertensive and antihyperlipidemic effects of Achillea wilhelmsii. Drugs Exp Clin Res 2000;26:89-93. 55. Silagy C, Neil AW. A meta-analysis of the effect of garlic on blood pressure. J Hypertension 1994;12:463-8. 56. Louria DB, McAnally JF, Lasser N, et al. Onion extract in treatment of hypertension and hyperlipidemia: A preliminary communication. Curr Ther Res 1985;37:127-31. 57. Bowman IA. The everlasting mistletoe and the cardiovascular system. Texas Heart Inst J 1990;17(4):310-4 [review]. 58. British Herbal Medicine Association. British Herbal Pharmacopoeia. West Yorks, UK: BHMA, 1983. 59. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin, TX. Integrative Medical Communications, Boston, MA: 1998, 152-3. 60. Petkov V, Manolov P. Pharmacological analysis of the iridoid oleuropein. Arzneimittelforschung 1972;22:1476-86. 61. Weiss RF. Herbal Medicine. Gothenburg, Sweden: AB Arcancum, 1988, 160-1. 62. Jin H, Zhang G, Cao X, et al. Treatment of hypertension by ling zhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Nimmi H, Xiu RJ, Sawada T, Zheng C (eds). Microcirculatory Approach to Asian Traditional Medicine. New York: Elsevier Science, 1996, 131-8. 63. Schmidt U, Kuhn U, Ploch M, H�bner W-D. Efficacy of the hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomed 1994;1(1):17-24. 64. Kramer W, Thormann J, Kindler M, Schlepper M. Effects of forskolin on left ventricular function in dilated cardiomyopathy. Arzneimittelforschung 1987;37:364-7. 65. Han KH, Choe SC, Kim HS, et al. Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. Am J Chin Med 1998;26:199-209. 66. Haji Faraji M, Haji Tarkhani A. The effect of sour tea (Hibiscus sabdariffa) on essential hypertension. J Ethnopharmacol 1999;65:231-6. 67. Markovitz JH, Matthews KA, Kannel WB, et al. Psychological predictors of hypertension in the Framingham Study. Is there tension in hypertension?JAMA 1993;270:2439-43. 68. Schnall PL, Schwartz JE, Landesbergis PA, et al. Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension 1992;19:488-94. 69. Matthews KA, Cottington EM, Talbott E, et al. Stressful work conditions and diastolic blood pressure among blue collar factory workers. Am J Epidemiol 1987;126:280-91. 70. Pickering TG. 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Patel C, Marmot MG, Terry DJ, et al. Trial of relaxation in reducing coronary risk: four year follow up. BMJ 1985;290:1103-6. 78. Lee HS, Kim JY. Effects of acupuncture on blood pressure and plasma renin activity in two-kidney one clip goldblatt hypertensive rats. Am J Chin Med 1994;22:215-9. 79. Chiu YJ, Chi A, Reid IA. Cardiovascular and endocrine effects of acupuncture in hypertensive patients. Clin Exper Hypertens 1997;19:1047-63. 80. Peng L, Feng-yen S, An-zhong Z. The effect of acupuncture on blood pressure: the interrelation of sympathetic activity and endogenous opioid peptides. Acupunct Electrother Res 1983;8:45-56. 81. Zhou Y, Wang Y, Fang Z, et al. Influence of acupuncture on blood pressure, contents of NE, DA and 5-HT of SHR and the interrelation between blood pressure and whole blood viscosity. Chen Tzu Yen Chiu 1995;20:55-61 [in Chinese]. 82. Radzievsky SA, Lebedeva OD, Fisenko LA, Majskaja SA. Function of myocardial contraction and relaxation in essential hypertension in dynamics of acupuncture therapy. Am J Chin Med 1989;17:111-7. 83. Williams T, Mueller K, Cornwall MW. Effect of acupuncture-point stimulation on diastolic blood pressure in hypertensive subjects: a preliminary study. Phys Ther 1991;71:523-9. 84. Weihai Y, Hongxu L. Clinical observation on the immediate hypotensive effect of zanzhu point. J Tradit Chin Med 1996;16:273-4. 85. Utsunomiya N, Shigematsu Y, Ikeda K, et al. Fall in high blood pressure after applying acupuncture to SHR. Jpn Heart J 1978;19:594. 86. Yiping Z, Qiong C, Zhengming H, Yinong C. Experimental research on treatment of hypertension with acupuncture. J Tradit Chin Med 1993;13:277-80. 87. Tam K-C, Yiu H-H. The effect of acupuncture on essential hypertension. Am J Chin Med 1975;3:369-75. 88. Kraft K, Coulon S. Effect of a standardized acupuncture treatment on complains, blood pressure and serum lipids of hypertensive, postmenopausal women. A randomized, controlled clinical study. Forsch Komplementarmed 1999;6:74-9 [in German]. 89. Rongxing Z, Yanhua Z, Lu Y. Hypotensive effect of ototherapy in relation to symptomatic and dispositional types of patients. J Tradit Chin Med 1992;12:124-8. 90. Kangmei C, Shulian Z, Ying Z. Clinical application of traditional auriculoacupoint therapy (continued). J Tradit Chin Med 1993;13:152-4. 91. Rongxing Z, Yanhua Z, Jialiang W, et al. Anti-hypertensive effect of auriculo-acupoint pressing therapy-clinical analysis of 274 cases. J Tradit Chin Med 1991;11:189-92. 92. Peng Y, Fenglan L, Xin W. Treatment of essential hypertension with auriculopressure. J Tradit Chin Med 1991;1117-21. 93. Tran T, Kirby J. Effects of upper cervical adjustments upon the normal physiology of the heart. ACA J Chiro 1977;XI:S58-62. 94. McGuiness J, Vicenzino B, Wright A. The influence of a cervical mobilization technique on respiratory and cardiovascular function. Manual Therapy 1997;(2):216-20. 95. Vicenzino B, Cartwright T, Collins D. Cardiovascular and respiratory changes produced by lateral glide mobilization of the cervical spine Manual Therapy 1998;3(2):67-71. 96. Dulgar G, Hill D, Sirucek A, et al. Evidence for possible anti-hypertensive effect of basic technique apex contact adjusting. J Chiro 1980;14:S97-S102. 97. Nansel D, Jansen R, Cremata E, et al. Effects of cervical adjustments on lateral-flexion passive end-range asymmetry and on blood pressure, heart rate and plasma catecholamine levels. J Manipulative Physiol Ther 1991;14:450-6. 98. Fichera AP, Celander DR. Effect of osteopathic manipulative therapy on autonomic tone as evidenced by blood pressure change and activity of the fibrinolytic system. J Am Osteopath Assoc 1969;68:1036-8. 99. McKnight M, DeBoer KD. Preliminary study of blood pressure changes in normotensive patients under chiropractic care. J Manipulative Physiol Ther 1988;11:261-6. 100. Yates RG, Lamping DL, Nancy LA, Wright C. Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial. J Manipulative Physiol Ther 1988;11:484-8. 101. Morgan JP, Dickey JL, Hunt HH, Hudgins PM. A controlled trial of spinal manipulation in the management of hypertension. J Am Osteopath Assoc 1985;85(5):308-12. 102. Mannino J. The application of neurologic reflexes to the treatment of hypertension. J Am Osteopath Assoc 1979;79:225-31. 103. Wagnon RJ, Sandefur RM, Ratliff CR. Serum aldosterone changes after specific chiropractic manipulation. Am J Chiropr Med 1988;1(2):66-70. 104. Goodman R. Hypertension and the atlas subluxation complex. Chiropractic: J Chiropractic Res Clin Invest 1992;8(2)30-2. Source: NOW Foods Blood-Pressure is that pressure which must be applied to an artery to stop the pulse beyond the point of pressure. It may be roughly estimated by feeling the pulse at the wrist, or more accurately measured using a sphygmomanometer. It is dependent on the pumping force of the heart, together with the volume of blood, and on the elasticity of the blood vessels. The blood pressure is biphasic, being greatest (systolic pressure) at each heartbeat and falling (diastolic pressure) between beats. The average systolic pressure is around 100 mm Hg in children, 120 mm Hg in young adults, and generally rises with age as the arteries get thicker and harder. Diastolic pressure in a healthy young adult is about 80 mm Hg, and a rise in diastolic pressure is often a more sure indicator of hypertension than a rise in systolic pressure. The latter is more labile and sensitive to changes of body position and emotional mood. hypertension has various causes, most important of which are kidney disease and mental stress. Systolic pressure may well be over 200 mm Hg. Abnormal hypertension is often accompanied by arterial disease, with an increased risk of strokes, heart attacks, and heart failure. Various antihypertensive drugs are available; they should be carefully evaluated, considering the patient's full clinical history, before use. Hypotension may result from superficial vasodilation (for example, after a bath, or in fevers) and in weakening diseases or heart failure. The blood pressure generally falls on standing, leading to temporary postural hypotension - a particular danger in elderly people. View products
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Berry Berry Tea (Loose)	Berry Berry Tea (Loose)	Berry Berry Tea	Berry Berry Tea	Blue Eyes Tea (Loose)	Blue Eyes Tea (Loose)
Blue Eyes Tea	Blue Eyes Tea	Blue Lagoon Tea (Loose)	Blue Lagoon Tea (Loose)	Blue Lagoon Tea	Blue Lagoon Tea
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Cherrybana Big Fruit Tea	Cherrybana Big Fruit Tea	Cranberry Apple Black Tea (Loose)	Cranberry Apple Black Tea (Loose)	Cranberry Apple Black Tea	Cranberry Apple Black Tea