High Blood Pressure

Hypertension Diagnosis:

(western definition): is generally a symptom less condition in which abnormally high pressure in the arteries increases the risk of problems such as stroke, aneurysm, heart failure, heart attack, and kidney damage.

Normal blood pressure is slightly different with age: Average - systolic under 130, diastolic under 85 mm Hg

*over 160/90 should be checked again and be treated *over 180/100 make sure patient is safe before they leave your clinic, treat or hospitalize (fear of stroke) High diastolic is more dangerous and effects the right heart more, high systolic pressure effects the left heart more.

Types of Hypertension:

1. Primary hypertension 85% +/-

2. Secondary hypertension (caused by other disease) 15% +/-

3. White coat hypertension (fear of getting blood pressure checked). It is normal for blood pressure to rise after a person reaches +/- 60 years old 60 – 135/88 65 – 140/88 70 – 145/90 75 – 150/92 80 – 160/95 85 – 165/98 *Do not try to reduce high blood pressure too much or too quickly, this may lead to embolisms and strokesLook for family and personal history

Chinese Mediicne Symptoms & associated organ system:

1. Liver – headache, dizziness, eye disorders, numbness

2. HearTongue - palpitations, irritability, poor memory, insomnia

3. Kidney – Tinnitus, ankle edema, poor memory

- Most important: headache, dizziness, numbness, when BP very high can cause nausea and vomiting, these are signs of possible stroke.

In Chinese Medicine there are 2 types of high blood pressure:

1. Liver – if liver Qi goes up too much there is possibility of stroke (i.e. 220/140), this can happen from Liver problems, or Yangming not being able to descend (this explains nausea and vomiting from brain edema). 80% are this type.

Symptoms: headache, dizziness, red/dry eyes, palpitations (heart)

Herbal Formula: Long Dan Xie Gan Tang, Tian Ma Gou Teng Yin, Qi Ju Di Huang Wan

Emergency - use Da Huang to bring down pressure by relieving acute water pressure in the brain (use high dosage to ensure movement), or try Senna (Fan Xie Ye), Aloe Vera (Liu Hui).

2. Lung – Lung Qi cannot descend. This is usually later in life, or late stage hypertension (following Liver HBP).

Symptoms: shortness of breath, cough, wheezing, fatigue, quiet voice, edema (kidney)

Herbal Formula: Sheng Mai San, Si Jun Si Tang, Du Qi Wan, Liu Wei Di Huang Wan + Sheng Mai San, Jing Sheng Shen Qi Wan (Jin Gui Shen Qi Wan + Niu Xi, Chuan Xian Zi)

Stages of hypertension

1^st degree (early stage)

Liver Yang rising distended throbbing headache, red face, dry mouth, bitter taste, Pulse wiry, irritable, insomnia

Herbal Formula: Tian Ma Gou Teng Yin, Bai Hu Tang, Qing Wen Bai Du Yin - Dizziness- Xia Ku Cao, Ye Ju Hua - Insomnia, Irritable- Mai Men Dong, Zhen Zhu Mu, Long Gu, Ge Gen

Liver Fire red eyes, bleeding, headache

Herbal Formula: Xie Qin Wan, Dang Gui Long Hui Wan, Long Dan Xie Gan Tang 2^nd degree (mid stage)

Yin deficiency with Fire body fluids damaged

Herbal Formula: Zhen Gan Xie Gan Tang, Ming Mu Di Huang Wan (Liu Wei Di Huang Wan + Shi Jue Ming) - Phlegm- Wen Dan Tang - Blood Stasis- Tao Hong Si Wu Tang, Liang Xue Si Wu Tang (cold, change Shu Di to Sheng Di) 3^rd degree (late stage)

Yin and Yang deficiency

Herbal Formula: Er Xian Tang, Jin Gui Shen Qi Wan, Ji Sheng Shen Qi Wan, You Gui Wan, Zou Gui Wan, Liu Wei Di Huang Wan

Prevention

Start meditation now, do not excessive exercise, put formula inside a pillow for sleep (Ju Hua, Shi Chang Pu, Xia Ku Cao, Suan Zao Ren, magnets- Ci Shi coordinates Heart and Kidney)

Principles of Treatment

1. Promote bowel movements (remove stagnation)

2. Promote urination (relieve water pressure within vessels)

3. Promote circulation

4. Nourish the Liver, Lung, and most of all Kidney or any other applicable organ, balance.

Emergency points for hypertension: LR 3 + KI 1, Du 14 + BL 34, ST 8, KI 1, Du 20, LR 3, LI 4, GB 34, 39 auricular (bleed HBP), if Du 20 is painful moxa can be used, if not, only needles are used, ear seeds. groups of points

- LR GB meridian, Yangming meridian, (both with Du 20 and KI 1)

* do not lower blood pressure too low or too quickly

Notes *When Fire and Wind combine, stroke may ensue (this damages the Yin- not as high a temperature) *When Yang and Wind combine, stroke may also ensue (this damages the Body fluids- causing a high temperature)

Herbal Formula: Bai Hu Tang, Qing Wen Bai Du Yin

Empirical Herbal Formula: Qing Nao Jiang Ya Tang (Zhen Zhu Mu 25g, Shi Jue Ming 25g, He Shou Wu 50g, Ju Hua 15g, Gou Teng 15g) - Early to mid stage modification herbs: Xuan Shen, Bai Zhu, Niu Xi, Bai Ji Li (Liver Headache), Di Long, Huang Qin, Xia Ku Cao - Mid to late stage modification herbs: Yin Yang Huo, Jin Ying Zi, Ba Ji Tian, Huang Qi, Fu Ling, Du Zhong, Shu Di Huang

Dr. Liu Feng Herbs: Ge Gen, Dan Shen, Yi Mu Cao (Blood and Water circulation), Xia Ku Cao (Liver Qi circulation), Xian He Cao, Xi Xian Cao, Shan Zha

Caution: If patient is on Western medicine (ACE inhibitors, Beta blockers, Calcium channel blockers, Diuretics), be extremely cautious of herbal and acupuncture treatments, if blood pressure is brought down too fast stroke may also ensue. Explain risks and allow patient to make an informed decision, drugs, TCM, or a careful balance of the two. Balancing the drug side effects could also be a good approach.

Western Prescription Medicine:

(ABCD)

ACE inhibitors: angiotensin converting enzyme causes the bodies blood vessels to relax. - side effects: dry cough (Lung Qi cannot descend)

Beta blockers: slows down the heart output volume - side effects: slows the heart beat, asthma

Calcium: less calcium to the vessels walls muscles causing them to become more flaccid. - side effects: water retention in ankle, headache, red face

Diuretics: promotes urination - side effects: after long term use, Gout may show.

Combinations commonly in use:

A & B: younger persons

C & D: elder patients

A & D: for both young and old Long term use of western medication

causes: - deficiency - Phlegm - Kidney Qi deficiency