Your Blood Pressure Is Elevated: What You Need to Know and What We Are Going to Do About It
If you are reading this, there is a good chance we have recently identified that your blood pressure is elevated.
First, I want you to understand something important:
This is not something to ignore.
At the same time, this is not something to panic about.
One of the most common scenarios I see in clinical practice goes something like this:
A patient has a blood pressure reading of 142/88.
They are told:
"Let's just keep an eye on it."
Six months later, it is 146/90.
Again:
"Let's continue to watch it."
A year later, it is 150/92.
Still no intervention.
Two years later, the patient has established hypertension, progressive arterial damage, increasing cardiovascular risk, and has missed a significant opportunity to address the problem early.
That is not the approach we take.
The earlier we identify elevated blood pressure, the greater our ability to prevent long-term complications and potentially reverse the underlying causes.
Our goal is not simply to lower a number.
Our goal is to understand why your blood pressure is elevated and develop a plan to improve it.
What Is Blood Pressure?
Blood pressure is the force exerted by circulating blood against the walls of your arteries.
Every time your heart beats, blood is pumped through your vascular system.
The pressure created by this process is measured using two numbers:
- Systolic pressure (top number)
- Diastolic pressure (bottom number)
For example:
120/80 mmHg
- 120 = systolic pressure
- 80 = diastolic pressure
The systolic pressure reflects arterial pressure when the heart contracts.
The diastolic pressure reflects arterial pressure between heartbeats.
What Blood Pressure Levels Get Our Attention?
Many people are surprised to learn that cardiovascular risk begins increasing long before blood pressure reaches what most people consider "high."
Optimal Blood Pressure
Less than 120/80 mmHg
Elevated Blood Pressure
120-129 systolic and less than 80 diastolic
Stage 1 Hypertension
130-139 systolic or 80-89 diastolic
Stage 2 Hypertension
140 systolic or greater OR 90 diastolic or greater
Hypertensive Crisis
180/120 mmHg or higher
At our clinic, we generally begin paying close attention when blood pressure consistently exceeds:
120/80 mmHg
This does not necessarily mean medication is needed.
It means investigation is needed.
Why Hypertension Matters
One of the biggest challenges with hypertension is that most people feel perfectly fine.
High blood pressure is often called:
"The Silent Killer."
That is because damage can occur for years without obvious symptoms.
Persistently elevated blood pressure increases the risk of:
- Heart attack
- Stroke
- Heart failure
- Atrial fibrillation
- Kidney disease
- Vision loss
- Dementia
- Peripheral vascular disease
The Statistics Are Sobering
According to the American Heart Association:
- Nearly half of U.S. adults have hypertension
- Only about one in four have it adequately controlled
- Hypertension contributes to hundreds of thousands of deaths annually
Studies demonstrate that every 20 mmHg increase in systolic blood pressure above 115 mmHg approximately doubles cardiovascular mortality risk.
Even modest improvements matter.
Reducing systolic blood pressure by just 10 mmHg significantly lowers the risk of:
- Stroke
- Heart attack
- Heart failure
- Cardiovascular death
The Most Important Thing I Want You to Understand
Hypertension is rarely the disease.
It is usually a symptom.
Blood pressure rises because something is driving it higher.
The question becomes:
What is causing your blood pressure to increase?
What Causes High Blood Pressure?
Most patients are told they have "essential hypertension."
This is medical terminology for:
"We know you have hypertension, but we do not know why."
Functional and integrative medicine approaches hypertension differently.
We actively look for root causes.
Insulin Resistance and Metabolic Dysfunction
One of the most common causes of elevated blood pressure is insulin resistance.
High insulin levels promote:
- Sodium retention
- Fluid retention
- Sympathetic nervous system activation
- Arterial dysfunction
Many patients with hypertension also have:
- Prediabetes
- Metabolic syndrome
- Abdominal obesity
- Fatty liver disease
This is one reason we frequently evaluate metabolic health when investigating hypertension.
Visceral Fat and Blood Pressure
Visceral fat is not simply stored energy.
It functions as an inflammatory endocrine organ.
Excess visceral fat produces:
- Inflammatory cytokines
- Insulin resistance
- Hormonal disruption
- Vascular dysfunction
This contributes directly to hypertension.
One reason we frequently use DEXA body composition testing is to accurately measure visceral fat burden.
Sleep Apnea
Many patients with hypertension have undiagnosed sleep apnea.
During sleep apnea:
- Oxygen levels repeatedly drop
- Stress hormones rise
- Inflammation increases
- Blood pressure rises
Treating sleep apnea often produces substantial improvements in blood pressure control.
Stress and Cortisol Dysfunction
Chronic stress is not merely emotional.
It has measurable physiological consequences.
Persistent stress may contribute to:
- Elevated cortisol
- Increased sympathetic nervous system activity
- Vascular constriction
- Blood pressure elevation
This is one reason we often evaluate cortisol patterns rather than relying solely on a single cortisol blood level.
Kidney Function
The kidneys play a central role in blood pressure regulation.
Kidney dysfunction may contribute to:
- Fluid retention
- Sodium retention
- Elevated blood pressure
This is why kidney function is routinely evaluated when hypertension is identified.
The Importance of Renin and Aldosterone Testing
One of the most important evaluations we perform involves measuring:
- Plasma renin activity
- Aldosterone
These hormones help determine:
- Whether hypertension is high-renin or low-renin
- Potential underlying mechanisms
- The most effective treatment strategy
In our experience, this testing is dramatically underutilized.
Yet it often provides some of the most actionable information available.
Environmental Toxins and Heavy Metals
Environmental exposures may contribute to hypertension.
Examples include:
- Lead
- Cadmium
- Mercury
- Arsenic
- PFAS chemicals
- Microplastics
These toxins may damage blood vessels and increase inflammatory burden.
Chronic Inflammation
Inflammation contributes to vascular dysfunction.
Potential sources include:
- Periodontal disease
- Chronic infections
- Autoimmune disease
- Gut dysfunction
- Obesity
This is one reason inflammatory markers such as CRP are often evaluated.
What We Are Going To Do Next
If your blood pressure is elevated, we are not going to ignore it.
We are also not going to rush blindly into treatment.
Instead, we will gather information.
Step 1: Confirm the Diagnosis
Blood pressure fluctuates.
One reading does not define your health. We typically recommend home monitoring.
Take readings:
- Morning and evening
- After resting quietly
- Using a validated upper-arm cuff
Additionally, we recommend Ambulatory Blood Pressure Monitoring (ABPM) which is the gold-standard on how we evaluate blood pressure. We have this device available in the clinic.Â
Step 2: Evaluate Root Causes
This may include:
- Comprehensive laboratory testing
- Renin and aldosterone
- Kidney function
- Metabolic markers
- Sleep evaluation
- Inflammatory markers
- Toxin testing
Step 3: Develop a Personalized Plan
No two patients have identical causes of hypertension.
Your treatment plan should reflect your physiology.
Nutrition and Lifestyle Changes
Most patients benefit from:
- Reducing ultra-processed foods
- Increasing vegetables
- Improving protein intake
- Reducing excess sugar
- Maintaining healthy body composition
Even modest changes can produce meaningful improvements.
Supplements We Commonly Consider
Depending on your individual situation, options may include:
- Omega 1300
- Mag Citrate
- CoQ10 Omega
- ActiveMulti
- Multi-Mineral
Supplement recommendations should always be individualized.
Will I Need Medication?
Some patients do. Some patients don't.
The answer depends on:
- Blood pressure severity
- Cardiovascular risk
- Underlying causes
- Response to intervention
Medication is neither a failure nor a success. It is simply one tool among many.
Our Goal
Our goal is not merely lowering your blood pressure.
Our goal is helping you:
- Reduce cardiovascular risk
- Protect your brain
- Protect your kidneys
- Protect your heart
- Improve longevity
Most importantly, our goal is addressing the factors that caused the problem in the first place.
Final Thoughts
If we have recently identified elevated blood pressure, I want you to understand something:
This is an opportunity.
An elevated blood pressure reading is often one of the earliest warning signs that something in the body needs attention.
Too many patients spend years being told to simply "watch it."
By the time treatment begins, significant vascular damage may already have occurred.
That is a missed opportunity.
Instead, we are going to take this seriously, investigate why it is happening, develop a plan, and work together to improve it.
The earlier we intervene, the better the outcome is likely to be.
Scientific References
- Whelton PK, et al. 2017 ACC/AHA Guideline for High Blood Pressure in Adults. Hypertension.
- Lewington S, et al. Age-specific relevance of usual blood pressure to vascular mortality. Lancet.
- SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med.
- Carey RM, et al. Resistant hypertension and secondary causes. Hypertension.
- Hall JE, et al. Obesity-induced hypertension. Circ Res.
- Parati G, et al. Sleep apnea and hypertension. Eur Respir J.
- Williams B, et al. ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J.