Womens Health

Controlling Hypertension Without Medicine

Frederick R. Jelovsek MD

"How does taking calcium supplements affect the calcium channel blocker I take for high blood pressure?

I am a 48 yr old Native American woman. I really want to stop taking blood pressure medicine. I think the medicine causes as much harm as it does good. There has to be another way. " GDP

Our blood vessels are made up of smooth muscle and when calcium gets into the smooth muscle, it contracts. Calcium channel blockers lessen that amount of calcium that can be rapidly injected into smooth muscle contractile elements. As a result, with use of calcium channel blockers there is less chronic contracting and hypertonus of the blood vessels, thus lowering blood pressure.

Hypertension has different causes and while one woman may respond well to a calcium channel blocker, others may not get that same good response. They may have to take different types of antihypertensive medications such as beta blockers, alpha blockers or medicines with still other mechanisms of action.

Will calcium supplements affect a calcium channel blocker anti-hypertensive medicine?

You would think that calcium supplements might make the smooth muscle contract even more and worsen hypertension but it depends upon the type of hypertension. Women with essential hypertension, a profile of low renin (a kidney hormone), and lower blood calcium, are actually quite sensitive to dietary salt but their blood pressure lowers with calcium supplementation and with taking calcium channel blockers such as nifedipine (1).

On the other hand, women with " the opposite metabolic profile--higher renin activity, higher serum ionized calcium, and lower 1,25D levels--are relatively insensitive to the blood pressure effects of either dietary salt loading or nifedipine, and show no significant hypotensive response to calcium supplements "(1).

I would hesitate to tell you to stop your calcium channel blocker because until you get your blood pressure down from other natural ways, you do not want your heart to work extra hard against the blood pressure. It sounds as though you probably have the type of essential hypertension with low renin levels that will respond to taking the calcium supplements since that is what your doctor put you on. Therefore continuing to take the calcium supplements is likely to be beneficial.

What other dietary changes help lower blood pressure?

Using monounsaturated fats instead of polyunsaturated fats often has a direct effect on lowering your blood pressure and allowing you to lower the dose of antihypertensive medications ( 2). This means that using olive oil or canola oil instead of sunflower oil or other polyunsaturated oils can improve your blood pressure. There is an exception to this in that fish oil is a special polyunsaturated fat that also shows reduction in blood pressure (3).

Salt restriction does not have very much effect upon lowering blood pressure (4). but every individual is different and you should be able to check your own blood pressure and how it responds to restricting or not restricting salt. Salt may be worse for you the older you get (5).

Any diet that improves upon the typical American diet will lower blood pressure. A combination diet that emphasized fruits, vegetables, and low-fat dairy products and included whole grains, poultry, fish, and nuts, and was reduced in fats, red meat, sweets, and sugar-containing beverages, has been shown to reduce blood pressure (6). As you are aware, diabetes is quite common among Native Americans and diabetes in combination with hypertension can cause quite a few health problems. I think a low carbohydrate diet is almost mandatory for you at this point even if you do not have any diabetes or abnormal glucose tolerance.



Is weight loss or exercise more effective in reducing hyper tension?

Many studies have demonstrated that weight loss (about 10% or more) or exercise improves blood pressure in people who are hypertensive. It has not always been clear if the benefit from exercise was from the weight loss that went with it or the exercise itself. In a study from the University of California, it appears that the dietary weight loss component along with mild 3-4 time a week exercise is the most effective blood pressure lowering strategy (7). Even a weight loss of only 7 lbs (3.2 kg) on the average can result in the need for less blood pressure medication (8).

While exercise is helpful in hypertensive people, there may be genetic differences such that some people benefit more from exercise than others do (9). Exercise will help both obese and lean people with high blood pressure (10). It should almost go without saying now that all use of tobacco and any used of alcohol of more than once a day should be discontinued in order to really improve hypertension.



What other type of non traditional therapies might I try to lower blood pressure?

Many alternative medical therapies are directed at lowering blood pressure but not many have been scientifically tested. One randomized study examined the use of acupuncture in postmenopausal women. It found that that some menopausal complaints were reduced but neither blood pressure nor serum lipids were significantly changed (11). Relaxation therapy can have an effect in lowering blood pressure (12) and thus any alternative medical treatment such as massage therapy or various aromatherapies, for example, should be able to lower blood pressure.

Many herbal and essential oil therapies are currently being examined for their components that seem to act as smooth muscle relaxants. Right now most of the testing is in animals but the promising ones should get to clinical trials in humans fairly soon. Regular ingestion of garlic is one herb very likely to reduce blood pressure (13). It is even available in capsules as you may be aware.





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