Hypertension (High Blood Pressure)

About This Condition

Hypertension affects nearly half of all American adults and is the leading modifiable risk factor for stroke, heart attack, heart failure, and chronic kidney disease. It is called the "silent killer" because it produces no symptoms until end-organ damage is already occurring. Standard medical care defaults rapidly to antihypertensive medications — often several — without a structured investigation of why blood pressure is elevated. Root causes include insulin resistance, sleep apnea, chronic psychological stress with HPA axis dysregulation, sodium-potassium imbalance, magnesium deficiency, excess alcohol, obesity, and, in a subset, secondary causes like primary aldosteronism or renal artery stenosis.

Our Approach

We treat hypertension as a symptom of an underlying physiologic state, not as the disease itself. Our initial evaluation includes a fasting metabolic panel (glucose, insulin, lipids), urine aldosterone-to-renin ratio to rule out primary aldosteronism, 24-hour urine sodium and potassium, red blood cell magnesium, and a structured sleep history with referral for polysomnography when indicated. We prescribe home blood pressure monitoring with validated cuff devices and track ambulatory patterns. Our non-pharmacologic protocol is aggressive and structured: therapeutic dietary sodium targets, resistance training prescriptions, stress physiology management (HRV tracking, cortisol assessment), and targeted supplementation (magnesium glycinate, potassium, taurine, CoQ10). When medication is warranted, we select agents that align with metabolic profile rather than defaulting to the most-prescribed first-line drug.