For many years high blood pressure has been defined based upon actuarial tables prepared by life insurance companies. By that definition, blood pressure of 140/90 is borderline hypertension in a person 40 years of age. The suppressed fact is that blood pressure should rise by 5 points for every decade of life. Therefore, 145/95 is borderline hypertension in a person of 50 years old; 150/100, in a person 60 years of age, etc. However, that standard is almost never applied in prescribing high blood pressure medications.

Recently, a new standard is being applied: 120/80 (for years the gold standard in blood pressure) has been redefined as "pre-hypertension," with the recommendation that medication be prescribed. And, there is no allowance for increasing age. So, we see headlines such as "Hypertension - An Emerging Epidemic" on WebMD.

Another very important fact is that most primary hypertension is diagnosed as "idiopathic," which basically means the doctors do not know what's causing it. We've had a variety of medical recommendations for years, but the overall impact has been minimal (as evidenced by the statistic in paragraph 1, above). These recommendations include: 1) drug therapy, 2) exercise, 3) dietary restrictions on salt and fat, 4) weight loss, and 5)avoidance of drugs, including tobacco and caffeine. The medical point of view is that lifestyle changes are inadequate.2

I would like to share with you the basic mechanism of "essential" or "idiopathic" hypertension. These terms are applied to primary hypertension unrelated to an underlying disease of the kidney or diabetes. Essential hypertension is the body's physiologic response to insuring an adequate blood supply to the brain.

For a moment, we need to digress so that you have a picture of how the circulatory system for the brain works. Inside the cranial vault, the blood reaches the brain through the carotid and vertebral arteries. It is drained out into the jugular vein through a system of sinuses which are actually formed by the meningeal membranes. The meningeal membranes (or dura) are the fibrous structures which separate the lobes of the brain and actually give the brain its shape. They include the falx cerebri (which divides the two cerebral hemispheres), the tentorium cerebelli (which separates the cerebellum from the occipital lobe of the cerebral hemispheres), the falx cerebelli (which divides the cerebellar hemispheres) and the diaphragma sellae (which covers the depression in the skull in which the pituitary resides).3 {You may visit my website RichardsFamilyHealth.com and view the articles on "Cranial" to view a cross section of these structures.}

Being membranous, the dura is affected by distortions in the cranial vault, resulting in twisting of the sinuses and restriction of the outflow of blood from the brain. Therefore, to bring in more fresh blood and oxygen, higher peripheral pressure is required to force through the blockage. While in school, I was privileged to see a dissection of an unpreserved cadaver, demonstrating the lines of stress in the dura due to cranial distortions. Strokes may occur when the cranium shifts, suddenly allowing a surge of high pressure through the fragile capillaries in the brain.

Interesting confirmation of this mechanism comes from veterinary medicine. A giraffe has a peripheral blood pressure of about 350/300 in order to get blood to the brain. Yet, their intracranial pressure is very similar to humans. They also have a specialized vascular structure at the base of their brain to compensate for changes in pressure as they raise and lower their heads while feeding and drinking. The critical point is that the higher pressure is necessary to pump the blood up into the brain.

So, the question becomes: What can be done about essential hypertension? Probably the most effective way to control it is through cranial adjusting, restoring normal motion to the cranial vault and removing the restrictions which cause the pressure to rise. I have spoken to many alternative health practitioners, and the consensus of opinion is that the effect of herbal interventions is minimal, compared to the benefits of cranial adjusting. As an added benefit, cranial therapy is completely free of side effects! {See my article on the side effects of high blood pressure medications at www.richardsfamilyhealth.com).}

Of course, if there is underlying pathology, either diabetes or renal disease, that process needs to be addressed as well. In many instances, that means herbal therapy or nutritional supplements.

References

1 The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, JAMA 2003:289- 2560-71

2 www.healthybp.com, sponsored by Novartis, a major manufacturer of blood pressure medications

3 Goss, C.M., MD, Gray's Anatomy, 29th Ed., 1973, p 880

Dr. Richards is a Diplomate of the American Board of Chiropractic Internists, a certified herbalist, and a Fellow of the International Academy of Clinical Acupuncture. She was recently awarded the distinction of being invited to become a Fellow in the International College of Chiropractors. Dr. Richards has been in practice for over eighteen years, teaches professionals, lectures, and is currently working on several books. Her website is http:// http://www.richardsfamilyhealth.com

Dr. Richards can be reached at Richards Family Health Center (626) 963-1678.