For treating high blood pressure, my fundamental recommendation is for a change in diet…and then, judicious use of medication (usually chlorthalidone) for people with a sustained blood pressure of 160/100 mmHg or greater. My target blood pressure with medication is no lower than 140/90 mmHg.
How I Treat Patients with Elevated Blood Pressure
From the November 2009 McDougall Newsletter
Elevated blood pressure, or hypertension, is associated with serious health problems, such as strokes, heart attacks, and kidney failure. Most people believe the problem with hypertension is that the elevated pressure damages the arteries and the body’s organs. Actually, it is more often the other way around. The rise in blood pressure is a response to a sick body—the blood pressure goes up as a natural and proper adaptation—as an attempt to compensate for a plugged up cardiovascular system. After years of consuming the rich Western diet, the blood vessels develop blockages referred to as atherosclerosis, the artery walls stiffen, and the blood itself becomes viscous. All this change creates a resistance to flow, resulting in a decrease in the ability to deliver nutrients to the tissues. The body responds, as it should, with a rise in blood pressure.
The correct action for the patient
to take is to
decrease the
resistance to
flow by eating
a healthy diet
and exercising.
Most people
who follow the
McDougall diet
find their blood
pressure
decreases
within a few
days. Based on
several
collections of
results from my
clinic, the
average
reduction of
blood pressure is about 14/11 mmHg in seven days, and at the same time medications used for treating hypertension are usually stopped. My customary protocol is to stop all blood pressure-lowering medications the first day of the Program, except for beta-blockers, which I slowly discontinue by cutting the dosage in half every two to three days. Unfortunately, not every patient experiences the reduction in numbers they desire. Despite their best efforts some people may need medications.
These blood-pressure-lowering drugs function by poisoning the body in various ways. “Poison” is the correct word. In chemistry poison means to inhibit a substance or a reaction. Beta-blockers inhibit the action of adrenalin on the heart muscle, calcium channel blockers inhibit the contraction of the blood vessels, ACE inhibitors and angiotensin receptor blockers do just that (inhibit and block) the blood pressure regulating hormones produced by the adrenal glands, and diuretics poison the water and electrolyte conserving functions of the kidneys.
These five major classes of medications are discussed in more detail below.
Take Measurements at Home for Months before Starting Drugs
Before starting medications in non-emergency situations, people with concerns about their blood pressure should first, buy a good quality blood pressure cuff (an oscillometric monitor for $50 to $100) and use it to monitor their blood pressure at home.1 I suggest they then record the values several times a week and take these numbers to their private doctor for further discussion.
A sustained elevation of blood pressure to 160/100 mmHg or greater over months suggests the need for treatment with medication.2 A word of caution: If you do start blood pressure-lowering medications, avoid overly aggressive treatment. In general, reducing blood pressure below 140/90 mmHg with medication is not beneficial and actually will increase the risk of heart attacks, strokes, and death.3,4 A recent review by the well-respected Cochrane Collaboration concluded with: “Treating patients to lower than standard BP targets, ≤140-160/90-100 mmHg, does not reduce mortality or morbidity.”5