DrRic Hypertension (slide share edition)

The Low down on

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Enrique Saguil, MD

High Blood Pressure

The First Health Approach

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Your TeamRic Saguil, MD

Jason Gruss, MDTom Jordan, RD

Katrina Christie, LCPCMike Blumberg, LCPC

Jennifer Green, NDJoe Musolino, DCAmy Iaquinta, DCNick Nowicki, DC

Emery Paredes, PTCourtney Day, EPAimee Weber, EPYu Zhu, MD China

You

nutrition

movemen

t grounding

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

First Health Associates

2010 S. Arlington Heights RdLL Suites

Arlington Heights, IL

Ric Saguil, MD

“Hypertensive?….I feel fine doc!”

…more like this.

Let stress be your mantra

• Don’t have enough time to sit down• Don’t have enough money• Don’t have any cooking skills• Don’t have the will power right now• Don’t have a secure job • Don’t have medical insurance to cover• Don’t have any “medical problems”

American Heart AssociationBlood Pressure

CategorySystolic

mm Hg (upper #)Diastolic

mm Hg (lower #)

Normal less than 120 and less than 80

Prehypertension 120 – 139 or 80 – 89

High Blood Pressure(Hypertension) Stage 1 140 – 159 or 90 – 99

High Blood Pressure(Hypertension) Stage 2 160 or higher or 100 or higher

Hypertensive Crisis(Emergency care

needed)Higher than 180 or Higher than 110

Fact

• Obesity leads to hypertension. • Hypertension lead to heart disease• Heart disease leads to coronary artery

clogging• Clogging leads to sudden death

Physiology – The PumpMuscle contracts and squeezes blood out

How it all beganSodium potassium pump

-Pump pushes sodium out-Potential is created-At threshold, channels open -Negative is “depolarized” -Action potential created-Electricity gradient started-Action potential spreads

Impulse waves travels one direction

Think of a snake swallowing food

Arteries push/Veins flow

First medical intervention – -blockers , , , a b ab calcium

a = alpha receptorb = beta receptorab = bothCalcium = channelACE = angiotension c e inhibitr

(Dr Ric Quicky = relax smooth muscle)

RX

• Inderal/Propranolol….• Prazosin• Nifedipine/Plendil/Norvasc….• Lotensin/Capoten/Lisinopril/Vasotec….• Avapro/Cozaar/Diovan……

alternatives

• Magnesium• Relaxation response• Lose weight • Warm climate• Decrease blood vessel muscle resting tone• Decrease relative volume inside the blood

vessel……..

Physiology – The Fluid

• Total volume 6L• Relative to the pump = preload/after load (preload is what we just discussed)

Diuretics/water pills

(Dr Ric Quicky – DASH diet)

RX

• Loop diuretics – furosemide/lasix• Thiazides – hydrocholorothiazide• Potassium Sparing – spirololactone/ triampt

• All work on the kidney

alternatives

• Green Tea• Dandelion leaf• Push fluids (high volume initially gives a

diuretic effect)• Fluid restrict• Lymphedema massage• Blood letting with leaches

Physiology – The Brain

• Sympathetic tone “fight or flight”• Excellent for survival• Not good for procreation• Dangerous for long term function/balance

CatapressAldomet

(Dr Ric Quicky – Calm)

RX

• Catapress• Aldomet

alternatives

• Valerian• 5HTP (peak x –eosinophilia myalgia syndrome)• Magnesium• Breath exercise• Meditation and cultivating stillness• Exercise (cardio)• Nature • Aromatherapy

HTN Summary

• High blood pressure caused by: -blood vessels clamping down -tissue pushing on blood vessels -too much volume -over active neural tone

TX RX

• Drugs/ Dash+/-

Alternative Treatments

• Herbals• Supplements• Lose wt• Move to warm climate• Relaxation response• Fluid restrict• Massage• Breath/Meditation/RR• Exercise• Aromatherapy

Untreated

• Crisis escalation or chronic end organ damage

The “End Organs”

Damages – eye(slow)

Damages – brain(sudden)

Damages – kidney(chronic)

Damages – blood vessels(chronic but sudden)

Damages – heart(slow)

Damages – heart(fast)

Role of the MD

• Review numbers• Determine Causes/Diagnosis (rule out secondary

HTN)• Identify and Assess Risk Factors• Instruct patient on how to self-monitor BP• Review and Assess abpm record in 3 months • Keep safe with meds until 6-12 months• Oversee team care plan (Refer to special forces…)• Special Mention: TCM and Ayurveda

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Live Long and Prosper!!!

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Next Lecture:Whole Foods Market Schaumburg

Managing Holiday Fatigue….an Integrative Medicine Approach

December 8th 530-630pm

QUESTIONS?

COMMENTS?CONCERNS?