Dr. Victor Emanuel MD

Dr. Victor Emanuel MD

When we talk about chronic non-communicable diseases (CNCD’s), we’re talking about high blood pressure first and foremost, because it’s top among them in Dominica. Sad that it doesn’t get the top-billing from the public sector, but that’s for another forum.

Many readers probably think that the only method we doctors have for treating high blood pressure is to force pills down your throat. Granted, this may be the primary method, but some of us recognize and respect that there are alternative treatments. We do not ridicule them because we may not know all about them, or were not taught about them at school (medical school).

Scientific evidence indicates that a diet low in saturated fat and salt and rich in complex carbohydrate (vegetables, whole grains, legumes, and fruits), increased physical activity, and regular practice of relaxation techniques such as yoga, can help to lower high blood pressure.


A healthy diet is one of the simplest and most effective ways to lower your blood pressure. Your may be familiar with the DASH diet. Doctors recommend:
• Eating more fruits, vegetables, and low-fat dairy foods.
• Cutting back on foods that are high in saturated fat, cholesterol, and total fat.
• Eating more whole grain products, fish, poultry, and nuts.
• Eating less red meat and sweets.
• Eating foods that are rich in magnesium, potassium, and calcium.


Evidence shows that men and women of all age groups who are physically active have a decreased risk of developing high blood pressure. Exercise can lower blood pressure as much as some drugs can. People with mild to moderately increased blood pressure who exercise 30 to 60 minutes three to four days per week (walking, jogging, cycling, or a combination) may be able to significantly decrease their blood pressure readings.


Emotional stress and tension increase a person’s blood pressure, but it’s not certain whether psychological interventions to reduce stress can lower blood pressure in patients in whom it is high. Anyhow, studies suggest that ancient relaxation methods that include controlled breathing and gentle physical activity, such as yoga, Qigong, and Tai Chi, are beneficial. Mild hypertensives who practiced these healing techniques daily for two to three months experienced significant decreases in their blood pressure, had lower levels of stress hormones, and were less anxious.

A recent small study showed that a daily practice of slow breathing (15 minutes a day for 8 weeks) resulted in a substantial reduction in blood pressure. However, larger, better-designed studies are needed to confirm these findings before they can be officially recommended as effective non-drug approaches to treating high blood pressure. Still, possible benefits, coupled with minimal risks, make these gentle practices a worthwhile activity to incorporate into a healthy lifestyle.

Remember it is important that inactive older people or those with chronic health problems should be evaluated by a doctor before starting any activity such as yoga or Tai Chi.


The safety and efficacy of herbal therapies for treating high blood pressure have not been extensively studied. These include Rauwolfia serpentina (snakeroot), Stephania tetranda (tetrandine), Panax notoginseng (ginseng) and Crataegus species (hawthorn). Due to potential health risks associated with these herbs, it is key that you inform your doctor if you plan to use or are already using them. This is even more important if these herbs are used in combination with high blood pressure drugs. Some herbs, such as licorice, ephedra (Ma Huang), and yohimbine (from the bark of a West African Tree) should not be used by people with hypertension, because they can actually increase blood pressure. And there’s always the chance that the ingredients in herbs may interact in an adverse way with blood pressure medication.


Some supplements have been evaluated as blood pressure-lowering options, including:

• Coenzyme Q 10 (CoQ10). Mild hypertensives taking CoQ10 experienced a pretty good drop in their blood pressure without appreciable side effects. Further, CoQ10 seems to lower blood pressure by a different mechanism from major blood pressure-lowering (antihypertensive) drugs.

• Omega-3 fatty acids. Some studies show that EPA and DHA may drop blood pressure in mild hypertensives. However, other studies have shown conflicting results. Current evidence suggest that modest reductions of blood pressure may occur with significantly higher doses of omega-3 fatty acids.

• Amino acids. The diet supplement L-arginine apparently may lower blood pressure. The few studies done to date which suggest this were small and not well-controlled, and suggest that L-arginine may lower blood pressure for only a short period of time. Another amino acid, L-taurine, may also have blood pressure-lowering qualities.

Be sure to talk to doctor before starting any medication, including these supplements, which may be available without a prescription. The risks and benefits of every medicine (including over-the-counter drugs) must be carefully weighed on an individual basis.


Extensive research on the effectiveness of acupuncture as an antihypertensive has been reported, but many studies have considerable weaknesses. Moe extensively controlled research is needed to determine the value of acupuncture as a treatment for hypertension. Right now, there is no evidence that acupuncture reliably lowers high blood pressure.

Take care. See you next week.