Part oft he problem with clinical trials of nutrition is that they do not stratify for genetics. Take Riboflavin for example. For a long time there were studies saying it worked and then studies saying it did not. But when they looked at MTHFR variants in people the result became more consistent that for these people with the minor allele Riboflavin worked.
https://www.sciencedirect.com/science/article/abs/pii/S01675...
https://jmhg.springeropen.com/articles/10.1186/s43042-022-00...
https://www.sciencedirect.com/science/article/abs/pii/S03009...
So in this case, if someone was deficient in Riboflavin, supplementing Riboflavin is much more preferable since the deficiency is the root cause of the hypertension and correcting the deficiency might resolve a variety of issues, not just the hypertension.
Yes there is:
1) Treatment just treats the issue, unlike a healthy lifestyle which helps people avoid them in the first place.
2) Good health has various benefits beyond just fixing one particular health problem.
But the role of medicine is to treat the diseased and maybe offer some guidance along the way. Being healthy is up to the individual and maybe public health campaigns.
1. Supplements/"Natural compounds"
2. Diet/lifestyle changes
We should absolutely not replace pharmaceuticals with supplements/"Natural compounds" without clinical data showing it works.
And for diet/lifestyle changes, that's really hard to implement. People just aren't good at changing their lifestyles. So while overall we should be promoting more healthy lifestyles, it should not replace pharmaceuticals when trying to treat a specific issue.
I've been on ADD medication (time-released amphetamines) for more of my life than not and I'm pretty chemically dependent on it at this point, which I resent and wish I could change about myself, but as of right now it is simply not feasible to do so, because withdrawal is horrible, and I have a job to do, bills to pay, and a family on the way. every three months I check in with my psychiatrist to get three more months of prescriptions, and to have a quick chat about my mental health and how I'm doing. this past month I told her I was experiencing some anxiety at work around completing projects, which is something I've had issues with for years, but I told her that I noticed I was getting significantly better at dealing with it, to the point of surprising myself somewhat. she told me that was great... but that if I ever wanted to try any anxiety medications, keep in mind I could ask her, because, for example, drug $X and $Y would probably work well for me. I told her thanks but no thanks I feel like I'm doing great without that, and it made me realize, once again, how crazy the pill-pushing nature of modern medicine is, especially psychiatry. it would have been very easy for me to say "sure why not" and add another medication whose effects can't be 100% predicted to my daily intake, affecting my mind and body in ways that may or may not be desirable, possibly in the short term, possibly in the long term.
with previous psychiatrists, especially as a youth, I was put on a variety of different anti-depression medications, because nobody could understand my depression, but in hindsight it wasn't any sort of "clinical depression" (maybe not the right term?) where I was depressed inexplicably and randomly, my depression was pretty obviously caused by my environment at home and school. a gym coach would have been infinitely more useful than any of the medications I took for depression during this time. but no, the Scientifically-Reached Medical Conclusion was, take more pills, try different ones until you find one that works for you, this is the Only Possible Solution To Your Problems.
shit's fucked
There's certainly no money for pharmaceuticals!
Patent-free availability and lower cost can be reasons. (assuming they work)
If you discover that, say, eating cocktail onions cures cancer, you're allowed to patent that. Cocktail onions as such wouldn't be patentable, but using them to cure cancer would be.
In the sense that a person with cancer could be sued for eating unlicensed cocktail onions?
This can also be viewed from the opposite end:
> The fact that certain "drugs" mimic the pharmacodynamics of existing natural substances is nothing new.
Actually I find it more appropriate to say that the man-made substance mimics nature.
People have been using natural remedies for thousands of years.
Oetzi the Iceman carried a piece of Fomes Fomentarius 5,000 years ago, a fungus that apparently was used as a diuretic in Indic folk medicine:
https://botit.botany.wisc.edu/toms_fungi/dec2001.html
I have no reason to believe that it did not work.
Why not address a potential root cause?
Because it's hard and people are unreliable when it comes to diet/lifestyle changes.
No reason not to address it, and I'd be surprised if most doctors don't bring up their desire for the patient to have a healthier lifestyle. But it's not realistic to have it replace pharmaceuticals as a general stance.
Especially not the natural approaches which are merely anecdotally "proven" for thousands of years.
Certainly all modern drug companies have come so much further in only the last few decades when they have never been so modern. And benevolent too, in a way only they can do. The human brain is so much different now. I love it every time they come up with a miracle pill where you take one and you are cured for life. My first job out of university was at a pharmaceutical manufacturer. It couldn't have been more eye-opening after you see the amazing things going on back there!
Instead of natural approaches, sometimes all you really need are the much more potent and rapidly effective pharmaceuticals which are completely non-toxic and have no possible side effects whatsoever.
Oh wait . . .
"Dr. Houston also cautioned that the role of supplements in hypertension has not yet been tested in clinical outcomes trials in the manner that conventional drugs have been assessed. So while there is an apparent role for supplements in treating hypertension, their ability to improve cardiovascular outcomes remains to be proven."
"Many natural compounds in food, as well as certain nutraceutical supplements, vitamins, antioxidants, or minerals, can mimic drugs, functioning in a similar fashion to a specific class of antihypertensive medications. However, they may be less potent and take longer to work than the antihypertensive drug."
And beyond supplements, diet/fitness changes are massively more difficult to implement than taking a medication.
There's no inherent reason to prefer more "natural" solutions to medical issues. It just sounds good. Put up clinical trials to give your hypothesis real standing.