Updated and expanded in 2011, this Second Edition clinically-oriented monograph explores and substantiates the following three positions in the ensuing discussion of hypertension in particular and true health and wellness promotion in general.  The chiropractic profession should play a major role in the clinical management of chronic hypertension. At present, chiropractic care of the hypertensive patient is marginalized to an “alternative and complementary” role. The medical profession has taken a leadership position on the management of hypertension based on a wealth of drug research and the establishment of evidence-based clinical protocols and professional standards of care. In contrast, the chiropractic profession, although it has within its scope of practice the most effective treatments for hypertension, has not—until now—had a cohesive evidence-based guide for the clinical management of the hypertensive patient. This monograph serves to fill that void by providing chiropractic clinicians with 1) an overview of the disease, 2) its differential diagnoses and assessment (including: history, physical examination, laboratory and imaging), and 3) clear evidence-based treatment protocols and interventional options.  Drug management of hypertension is by no means a panacea, leaving significant numbers of patients untreated, undertreated, or mistreated. The expenses and adverse effects of drug management leave many patients untreated and/or harmed by drug side-effects. According to recent peer-reviewed research, shortcomings in the medical management of hypertension place patients at risk of adverse effects, inefficacy, and unnecessary expense. By failing to address the underlying causes of high blood pressure, and by failing to treat the constellation of comorbid conditions (e.g., insulin resistance, obesity, hyperuricemia, and nutritional deficiencies), drug suppression of elevated blood pressure cannot be viewed as optimal therapy. The integrative care options detailed in this book help to alleviate hypertension by addressing the underlying causes.  Because hypertension is a major patient-centered and public health concern, the chiropractic profession must have an evidence-based protocol for its management. Chronic hypertension is a “disease” of epidemic and indeed pandemic proportions in America and increasingly in other nations. The lifetime incidence of high blood pressure among Americans is 90%, while on any given day, approximately one in three (33% of total) Americans has high blood pressure. These patients and potential patients would benefit more from integrative chiropractic care and the nutrition-based protocols in this document than they can hope to benefit from drug-only treatment. The evidence supporting the dietary and nutritional prevention and treatment of hypertension and cardiovascular disease is irrefutable. Adding to this, the recent evidence that chiropractic spinal manipulation is as effective as two-drug treatment for hypertension makes the case for the chiropractic profession’s assumption of a leadership role timely and of paramount importance. This document not only serves to provide individual clinicians with practical protocols, but—more importantly—this document is a call to action for the chiropractic profession. The chiropractic profession must stand and deliver the quality healthcare that our patient population needs and deserves.
Professional & Technical, Medical, Allied Health Professions, Chiropractic,