Heart disease and stroke are the first and third causes of death, respectively, in the United States. Hypertension is the major risk factor for heart disease and stroke.1 According to the American Heart Association's Heart Disease and Stroke Statistics, 2005 Update, high blood pressure killed nearly 50,000 Americans in 2002 and was listed as a primary or contributing factor in 261,000 deaths.
The guidelines issued in 2003 by the National Heart, Lung and Blood Institute state that nearly half of all American adults have blood pressure readings that are too high! Fifty percent of these have hypertension, meaning greater than 139 (systolic) over 89 (diastolic) mmHg. The other half of us have pre-hypertension, a condition which makes high blood pressure and its sequela, cardiovascular and renal disease, more likely. Any patient with a systolic reading higher than 119 or a diastolic reading above 79 has pre-hypertension by definition.2 For chiropractors truly interested in wellness care and services designed to promote longevity, it is clear that any "wellness care approach" that does not at least monitor and counsel on blood pressure is inadequate.
Risky Business
Above 115/75, the risk of heart attack and stroke doubles for every 20-point jump in systolic blood pressure or every 10-point rise in diastolic blood pressure. People with pre-hypertension, blood pressure greater than 119/79 (levels once considered normal), face twice the risk of heart disease as those with normal blood pressure. People with frank hypertension (blood pressure greater than 139/89) have four times the risk of heart disease as people with low blood pressure.3
According to NaturalStandard.com's "Monograph on High Blood Pressure," evidence suggests that reduction of the blood pressure by 5-6 mmHg can decrease the risk of stroke by 40 percent, of coronary heart disease by 15 percent to 20 percent, and reduces the likelihood of dementia, heart failure, and mortality from vascular disease.4
What to Do?
Unless there are other predominant risk factors, such diabetes or kidney disease, heavy smoking, alcoholism, a personal history or strong family history of heart and kidney disease, many doctors are reticent to prescribe medications for pre-hypertension, usually diuretics, given their potential for side effects.5 However, lifestyle factors should be addressed. The Mayo Clinic provides lifestyle guidelines, some of which include the following:6
Though not mentioned by the Mayo Clinic in its guidelines as such, the need for adequate deep sleep and correction of sleep apnea has become more apparent.7 Of course, all these concerns are also basic to the anti-aging and wellness lifestyle, regardless of blood pressure.
Nutraceutical Potential
Fortunately for chiropractors, there are also many OTC nutraceuticals that show potential in significantly lowering blood pressure.9 These include phytonutrients (grape seed extract, quercitin, cocoa, green tea extracts, hawthorne berries, hibiscus tea, lycopene extracts, soy isoflavones), zoonutrients (milk and whey peptides and even peptides formed in fried eggs!) and fats (olive oil, flax oil, fish oil), though the latter to a lesser degree.10-21
John Zhang, MD, PhD of Logan Chiropractic College, has authored two human studies on physician strength nutraceuticals and pre-hypertension and hypertension.22-23 These studies included testing a multi-ingredient phytonutrient "greens" powdered drink mix, a multi-ingredient whey- and colostrum-based zoonutrient powdered drink mix, and the two nutraceutical powders together. In 90 days, the phytonutrient formula lowered blood pressure 12.4 systolic and 7.1 diastolic. The zoonutrient formula lowered blood pressure 13.4 and 8.2, respectively. The combined group lowered blood pressure 10.9 and 13.9, systolic and diastolic. These preliminary studies showed an average decrease in systolic blood pressure of 12.6 points and a decrease in diastolic blood pressure of 9.7. Results match the DASH diet plus a low sodium diet combined (DASH II diet) and the effect of any one commonly prescribed blood pressure medication.24-25
Most of these nutraceuticals will show efficacy in essential pre-hypertension in 60 days. If not, as there are several different mechanisms by which they are proposed to work, and there are different genetic phenotypes in any patient population, trying another nutraceutical approach or two it is likely worth a try, considering the potential morbidity of high blood pressure.
Testing for High Blood Pressure
First, know that one study showed that almost half the sphygmomanometers in a teaching hospital group had defects in the control valve, which interfered with accurate blood-pressure reading.8 Second, "white coat syndrome" describes individuals who become nervous about their blood pressure test. They tend to get higher readings at the office as compared to readings taken at home.
Have patients empty their bladder before the test if needed. They should not drink coffee or smoke cigarettes 30 minutes before having their blood pressure taken. Also, it is best if they get to sit and rest for five minutes before the test. The arm should be at heart level. Bare arm is best. Two readings should be taken. If high blood pressure is found, secondary causes need to be eliminated before essential or primary hypertension is diagnosed.
Check for Medications
Researchers at Boston's Brigham and Women's Hospital found that older men using NSAIDs or acetaminophen (Tylenol) daily were at a 38 percent and 34 percent higher risk for hypertension, respectively. According to Joe Graedon, a pharmacologist, and Tersa Gordon, PhD, co-authors of The Best Choices from The People's Pharmacy, both HRT and decongestants can be culprits. Also, many headache pain pills contain caffeine. Decongestants that contain pseudoepinephrine, like Sudafed, need to be considered. The side effects panels on any prescription medications should be reviewed to see if hypertension is a possible side effect.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
