Recently, I kicked around this idea of explaining the importance of non-medical treatments such as diet and exercise for hypertension, though it is applicable to other problems like diabetes. You can see my prior post about the proper diet to address high blood pressure here.
4 tiers of medical severity or hypertension
Tier 4: These patients have permanent end organ damage-permanent uncontrolled hypertension (elevated blood pressure), severe chronic kidney disease on hemodialysis, strokes, and congestive heart failure.
Tier 3: Uncontrolled hypertension or high blood pressure (or other medical problem such as diabetes) are present requiring steady escalation of medications with no end in sight.
Tier 2: These patients have stable controlled hypertension or medical problem requiring stable medication dosing without decrease.
Tier 1: Stable controlled hypertension or medical problem without any use of medical therapy
Fine points about this diagram
Every patient with any chronic medical problem from high blood pressure and diabetes to rheumatoid arthritis fits into this continuum. No one wants to be in tier 4, the worst level. Long-term complications at this are permanent. The best we can do is hope to contain it, and the original problem still remains unstable.
Those in tier 3 are frequently unaware of when and how they entered into tier 4 until it is much too late. These patients are unstable and really not much better than tier 4.
Tier 2 is a good place and is all you can expect from a doctor’s effort, but medications are required.
No one, and I do mean no one, achieves tier 1 without sacrifice and significant change, and many are happy at tier 2. But if non-medical control of hypertension and diabetes is a goal, then profound changes are necessary. Yes, the appropriate medicine combination delivers you into tier 2. Non-medical treatments of hypertension through exercise and diet (clean fuel or whole food plant based diet) are necessary to reduce any tier, but especially for achieving tier 1.
In conclusion, taking medications only gets you to tier 2 if the correct medicine is found. Tier one is only achieved through extensive lifestyle changes. I discussed diet and hypertension in prior posts, but I still emphasize a marriage of a DASH diet (8-9 servings of fruits and vegetables daily), clean fuel and aerobic exercise to achieve with a tier 1 results. More to come later.
And lastly I want to apologize. I have had internal medicine board duties and extracurricular work-related activities keeping me away from addressing this blog. My goal is to at least do a monthly entry and weekly if I can get it. Feel free to contact me by email if you have questions or concerns. You can also comment. Do not forget to like or comment on facebook as well.