High Blood Pressure Treatment: The Conventional Approach

Benefits of blood pressure medications often don’t outweigh the risks

Conventional physicians are quick to treat high blood pressure with prescription drugs. I would never suggest that you not take medication if alternative treatments have not worked for you. However, I do insist that you make sure you truly need a drug before going ahead with it, because you may be putting yourself at risk unnecessarily.

Drugs No Better Than Lifestyle Changes

Especially in cases of mild hypertension, studies have shown that blood pressure medications perform no better than natural approaches.

• One study found that when combined with lifestyle modifications, a placebo worked just as well as medication in lowering mildly elevated blood pressures. In addition to either a placebo or medication, participants took part in an exercise program, lost an average of around 10 pounds, and lowered their salt intake. Of the five classes of hypertensive drugs tested, all performed about the same. Diuretics, however, caused an increase in the LDL cholesterol levels. (Read more about the specific risks associated with diuretics.)
• A study at the University of Southern California showed that using relaxation techniques could dramatically contribute to lowering high blood pressure. All participants were instructed to decrease salt and foods high in saturated fats, exercise, and loose weight, but only half were taught relaxation techniques to use for 10 to 20 minutes, three times day. After three months, the relaxation group lowered their blood pressure twice as much as those who didn't. In fact, most (70 percent) had lowered it more than 7 percent, which is as good as most medications are able to do.

These results provide an incentive to try natural approaches to treat high blood pressure before resorting to medications.

Additional Medication Dangers

In addition to having minimal to no benefit for people with mild hypertension, blood pressure drugs also pose other dangers.

• Blood pressure lowered too far raises heart attack risk. A study at the Albert Einstein Medical College of Medicine in New York found that when medication dropped blood pressure too much (more than 18 points in those with mild or moderate hypertension), participants experienced more heart attacks. The general attitude of most doctors—which is, the lower the blood pressure the better—may be a dangerous perception.
• Taking blood pressure medication at night may contribute to vision loss. Also, doctors' recommendations to take blood pressure medications at bedtime may increase risk of blindness. While this suggestion is usually made to minimize side effects this nocturnal drop in blood pressure can be disastrous for patients with glaucoma or "stroke" of the optic nerve. Research in these individuals found that they already experience abnormal drops in blood pressure at night. It is thought that the loss of blood pressure reduces blood flow to the optic nerve, causing damage. Taking blood pressure medication only aggravates the problem and speeds up the degeneration process.

What You Should Do

Everyone must be evaluated on an individual basis when it comes to treatment of hypertension. Your doctor should take into consideration things like your—

• Gender (studies seem to indicate that drug therapy for hypertension in women rarely produces much benefit in reducing heart attacks, especially before menopause)
• Lifestyle
• Diet
• Exercise routine
• Stress factors
• Other factors, such as cholesterol and triglyceride levels

I would also advocate using an ambulatory monitor to determine if you even need medication. It's possible that a change in your job or lifestyle may be what's really needed to correct the problem, instead of just treating the symptoms.

More Dr. Williams Advice on Blood Pressure

• Which foods to eat and which foods to avoid for lowering blood pressure
• Lifestyle habits that lower blood pressure naturally
• Vitamins and minerals that complement blood pressure–lowering programs
• The dangers of using diuretics to control high blood pressure