Alternative Treatments for Hypertension

Hypertension (high blood pressure) has been around since ancient times but affects a growing number of people as life becomes more stressful. The effectiveness of pharmaceuticals for controlling hypertension is limited, and many people are turning to complementary and alternative medicine for better solutions. Oriental Medicine has been used for centuries to treat hypertension symptoms and has the ability to revolutionize hypertension treatment in the West. Acupuncture and Chinese Herbal Medicine might be more effective than pharmaceutical treatment with fewer side effects and a lesser cost, but more research is needed before these approaches can be implemented on a larger scale. 

Hypertension is a leading cause of death worldwide but can remain undetected for a long time. It’s considered a gateway to more serious heart and kidney disease; approximately 62% of strokes and 49% of myocardial infarctions (heart attacks) are caused by high blood pressure [1] Early warning signs include confusion, vertigo, headaches, nosebleeds, fatigue, blurred vision, headaches, chest pain, and an abnormal heartbeat. 

Of the 62 million Americans who have hypertension, only half are receiving treatment and of those, only half have it under control. [2] In fact, of those people being treated for hypertension worldwide, no more than 25% have achieved a normal blood pressure with SBP/DBP values under 140/90 mmHg [3].

Effective treatment is limited by availability, cost, and adverse effects from antihypertensive medications[4].  Concerned about the side effects of hypertensive drugs—extra urination, erectile problems in men, excessive hair growth, weakness, leg cramps, depression, sleep problems, dizziness, and fatigue—a growing number of people are turning to complementary and alternative medicine for solutions. The question is, what are the most effective ways to lower blood pressure with the fewest side effects? Are there alternatives to pharmaceuticals that are more effective, have less side effects, and are more cost effective? Should we have to sacrifice our sexuality or quality of life to prevent death from a heart attack?

As an acupuncturist I’ve experienced the healing power of acupuncture, herbal medicine, breathing techniques and other alternative approaches firsthand over and over again. As I ponder theories versus reality more questions arise than answers. What if these alternatives are also more cost-effective, have fewer side effects, and contribute to a better quality of life overall? Shouldn’t this knowledge be available to a broader audience?
-  Can the effectiveness of herbal medicine, acupuncture, and lifestyle changes be proven through clinical trials?  How effective are they compared to pharmaceuticals?
- Do these alternative approaches work on real people? If so what works best?
- Can these approaches be integrated into mainstream medicine care during routine doctors visits and help lower the overall cost of health care, creating healthier people and more stable communities?

 Following is an overview of the Oriental Medicine approach to the treatment of hypertension along with various studies that have shown their efficacy. More trials and research is needed but as you will see, there are effective alternatives available that are being used daily worldwide. Why would these methods exist for centuries and be used on such a broad scale if they didn’t work? There is no single cure for everyone, but working with an individual’s unique patterns to create balance within, from the source, can bring great results.

Universal Patterns

China’s ancient ancestors meticulously observed and documented patterns in nature, the human body and the cosmos to create their traditional medical practices. Oriental medicine (including acupuncture, Chinese herbal medicine, moxibustion, cupping, Qi Gong, diet, and exercise therapy) has been developing over the last 2500 years and is still evolving today to fit the needs of our changing lifestyles, culture, and environment [5][6]. Acupuncturists continue to draw from the same source of ancient information when diagnosing patients and forming treatment plans. Humans haven’t changed much over the past few thousand years, so while some treatments change to compensate for extra stress, environmental toxins, and lower food quality, many stay the same. 

The Oriental Medicine approach to hypertension is similar to its approach to all disease, where specific herbal formulas and acupuncture points are chosen to bring balance to the individual based on their internal patterns as revealed in the pulses, tongue, personality, symptoms, etc. Our energies (Qi) follow universal patterns, and these are matched with the patterns defined by Oriental Medicine. Herbs and acupuncture points affect the body in predictable ways based on observation and documentation over the last few thousand years.  If the correct formula or acupuncture points is used on the correct individual pattern, healing or achieving a greater state of balance is very likely to occur. 

Treatments change as the patient changes, and there is a spiral of healing that occurs on all levels. Physical pain affects the emotions and spirit, emotional pain can manifest physically, spiritual stagnation can cause physical disease, everything is connected. That’s why one specific treatment may work for some people but not others. And that’s why clinical trials and double blind studies are so difficult to perform in this medicine.

Hypertension can be divided into three major types based on the stages and symptoms. Fire syndrome, Phlegm-fluid retention syndrome, and deficiency syndrome.

Fire syndrome can be found in various stages of hypertension, and includes
1. Liver fire
   1.1 Heart fire
   1.2 Stomach Fire
   1.3 Intestinal Fire
Common herbal formulas for Fire syndromes hypertension are Luo Bu Ma Pian or  Tian Ma Gou Teng Yin San/Wan . 

Phlegm-fluid retention syndrome is usually found in later stages and can be divided into
1. Fluid retention in the upper jiao syndrome
   1.1 Fluid retention in the middle jiao syndrome
   1.2 Fluid retention in the lower jiao syndrome
A common herbal formula for phlegm-fluid retention hypertension isBan Xia Bai Zhu Tian Ma San.

Deficiency Syndrome
1. Spleen deficiency syndrome
   1.1 Kidney deficiency syndrome
A common herbal formula for deficiency syndrome hypertension is Du Zhong Pian.

Each pattern above causes various symptoms and can be treated with specific acupuncture points and herbs. The most common pattern I have seen in my clinic is a combination of Spleen and Kidney deficiency syndrome, possibly with fire present in the liver or heart. Symptoms may include tiredness, weakness, dizziness, low back pain, forgetfulness, knee pain, night sweats, feeling cold, indigestion, and anxiety/depression or a general sense of unease. The pulse will be weaker in the Spleen and Kidney positions and the tongue may be pale, thin or have teeth marks on the edges.  

Emotionally, a feeling of fear or lack of safety in the world is more common with Kidney deficiency, while Spleen deficiency may manifest as compulsive overthinking and trying too hard to impress others. Overall, stress & overwork with an inability to be creative and fulfill your life to the fullest potential (a Wood element imbalance) can also contribute to high blood pressure in the long run because the constant tension in the body constricts the blood vessels. Breathing techniques, yoga, qigong, and tai chi are all beneficial practices to help liberate the Wood element, attune your body with the Earth and let go of stress and tension. 

For this pattern of Kidney/Spleen deficiency with Liver heat or stagnation, a formula called Du Zhong Pian or Eucommia Combination tablets by Plum Flower is indicated.
 As a practitioner of Planetary Herbology, I integrate local herbs with Chinese, Ayurvedic, and other worldwide herbs when necessary. There are very few herbs that are known to reduce high blood pressure. Eucommia is one of the major ones, and appears in many of the herbal formulas prescribed for hypertension. I like Plum Flower brand because they test all of their herbs for quality and toxicity and guarantee them free from contaminants.


Du Zhong Pian (Eucommia Combination Tablets) by Plum Flower

Cost: $30-$45 monthly ($15/bottle)

Ingredients: 
Du zhong 50% (Eucommia ulmoides bark)
Gou teng 20% (Uncaria rhynchophylla twig & thorn)
Xia ku cao 20% (Prunella vulgaris spike) Self-Heal
Huang qin 10% (Scutellaria baicalensis root) Baical Skullcap Root

Functions: Strengthens Liver and Kidneys, Calms Internal Wind, Clears Heat, Drains Dampness, Calms the Spirit

Biomedical Applications: Hypertension, atherosclerosis, high cholesterol, low back pain, sciatica, edema, pre-eclampsia

Cautions: Use with caution in Spleen-deficient patients with a tendency to loose stools, diarrhea, poor appetite, or chronic digestive weakness.

Dose: Plum Flower brand, 5 tablets 3 times daily away from food

Eucommia bark (Du zhong), is a temperate rubber tree that is only native to Asia. It has been widely used as an “anti-aging” remedy nourishing the kidney essence and Jing, the root of life. It has a long history of being used to relieve low back pain, to prevent miscarriage, and to mend fractures and broken bones along with another herb Xu Duan. It also tonifies the Kidney Yang to help with impotence and urinary incontinence. (Remember that pharmaceuticals for hypertension are known to cause excessive urination and erectile dysfunction? Eucommia has the opposite effect.) Through animal studies, Eucommia was found to sedate the central nervous system creating a calming effect, and to possess immunostimulant and anti-inflammatory properties [7].

Eucommia’s effectiveness for treatment of hypertension has been a more recent discovery. It lowers the zinc/copper ratio, which is significantly high in people with hypertension. In the 1980’s there were several studies done that found Eucommia bark to effectively lower blood pressure, which was attributed to its effect to dilate the blood vessels. It was found that the water extract (tea) was more effective than the alcohol extract (tincture) and the effects were more powerful when it was dry-fried first. 
In one clinical study of 251 hypertension patients, they took a tea of either the bark or the leaf three times a day for 30 days. The people taking the bark, 80 showed moderate to significant improvement and 24 had no response (76.9% effective). Of the people taking the leaf, 125 had moderate to significant improvement and 22 had no response (85% effective) [8].

Eucommia has no known side effects nor are there any reports of toxicity due to overdose. However, do not use it if you have low blood pressure, and it should be used with caution in people with severe blood or spleen deficiency because of its drying nature. Taking it with honey can mitigate its drying effects. It’s best to see a qualified herbalist before trying this remedy.An interesting side note, Eucommia bark has also been used to treat sciatica. Here’s the remedy: Cook 30 grams of Eucommia with a pair of pig kidneys for a half an hour. Filter out the herbs and serve the soup and kidneys. Six patients with sciatica were successfully treated by eating this once a day for 7-10 days[9].  I’ve never tried this because I’m not sure where to find the pig kidneys, but you can find 7-10 pairs of pig kidneys I can supply you with a pound of Eucommia bark. 

[1]: Farsang C, Naditch-Brule L, Avogaro A, et al. Where are we with the management of hypertension? From science to clinical practice. The Journal of Clinical Hypertension. 2009;11(2):66–73. PubMed ()

[2]: Hudnut, Fritz. Our Medicine: What does hypertension really tell us? Acupuncture Today December, 2011, Vol. 12, Issue 12

[3]:  MacMahon S, Alderman MH, Lindholm LH, Liu LS, Sanchez RA, Seedat YK. Blood-pressure-related disease is a global health priority. The Lancet. 2008;371(9623):1480–1482. PubMed ()

[4]: Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–1252. PubMed ()

[5]: Chen KJ, Li LZ. Study of traditional Chinese medicine—which is after all the right way? Chinese Journal of Integrative Medicine. 2005;11(4):241–242. PubMed ()

[6]: Wang J, Xiong XJ. Control strategy on hypertension in Chinese medicine. Evidence-Based Complementary and Alternative Medicine. 2012;2012:6 pages.284847

[7]: Chen, John and Chen, Tina. Chinese Medical Herbology and Pharmacology. Art of Medicine Press, 2004.  

[8]: Xin Yi Yao Xue Za Zhi (New Journal of Medicine & Herbology) 1978;10:30.

[9]: 10. Zhong Yao Xue (Chinese Herbology) 1998;797:799