Southeast Texas Medical Associates, LLP James L. Holly, M.D. Southeast Texas Medical Associates, LLP


Your Life Your Health - 10 ways to control high blood pressure without medication
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James L. Holly,M.D.
January 29, 2009
Your Life Your Health - The Examiner
You don't always need prescription medications to lower your blood pressure. By making these 10 lifestyle changes, you can lower your blood pressure and reduce your risk of heart disease without medication. However, do not stop any medication until you discuss that change with your healthcare provider.

If you've been diagnosed with high blood pressure (a systolic pressure of 140 or above or a diastolic pressure of 90 or above) or with prehypertension (a systolic pressure between 120 and 139 or a diastolic pressure between 80 and 89), you might be worried about taking medication to bring your numbers down. Don't assume medications are the key to controlling your high blood pressure (hypertension). Lifestyle plays an important role in treating your high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you may avoid, delay or reduce the need for medication.

Here are 10 lifestyle changes you can make to lower your blood pressure and keep it down.

Lose those extra pounds and watch your waistline

Blood pressure often increases as weight increases. Losing just 10 pounds can help reduce your blood pressure significantly. In general, the more weight you lose, the lower your blood pressure. A 20 pound weight loss will result in a 5-20 mm Hg (read as 5-20 millimeter of mercury) drop in your systolic blood pressure. Losing weight also makes any blood pressure medications you're taking more effective.

Besides shedding pounds, you should also keep an eye on your waistline. Carrying too much weight around your waist can put you at greater risk of high blood pressure. In general, men are considered at risk if their waist measurement is greater than 40 inches (102 centimeters, or cm). And women, in general, are at risk if their waist measurement is greater than 35 inches (88 cm). However, for people of Asian descent, men are considered at risk if their waist measurement is greater than 36 inches (90 cm), and women are at risk if their waist measurement is greater than 32 inches (80 cm).

Increase abdominal fat makes you at risk for the Cardiometabolic Risk Syndrome which raises your risk for hypertension, heart disease and diabetes significantly. (You can read more about this below under "Related Articles") You and your doctor can determine your target weight and the best way to achieve it. Your doctor might recommend that you eat healthier foods, exercise and change self-defeating behaviors, such as late-night snacking or big servings at meals.

Exercise regularly

Regular physical activity - at least 30 to 60 minutes most days of the week - can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). And it doesn't take long to see a difference. If you've been sedentary, increasing your activity can lower your blood pressure within just a few weeks. If you have pre-hypertension, exercise can help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.

Talk to your doctor about developing an exercise program tailored to your needs and medical conditions. Your doctor can help determine whether you need any exercise restrictions. Even moderate activity for 10 minutes at a time, such as walking and light strength training, can help. You should get 150 minutes (30 minutes a day, five days a week) of moderate physical activity a week to improve your health but 300 minutes a week will have greater benefit.

But avoid being a "weekend warrior." Trying to squeeze all your exercise in on the weekends to make up for weekday inactivity isn't a good strategy. If you have uncontrolled hypertension or heart problems, those sudden bursts of activity could actually be risky.

Eat a healthy diet

Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. This eating plan is known as the DASH (Dietary Approaches to Stop Hypertension) diet. (For more about the DASH Diet see below under "Related Articles")

It isn't easy to change your eating habits, but with these tips, you can adopt a healthy diet:
  • Evaluate your eating style. Keep a food diary, even for just a week, to assess your eating patterns and habits. Monitor what you eat, how much, when and why. This can shed surprising light on your true eating habits.
  • Consider boosting potassium. While most Americans get too much sodium, which increases their blood pressure, they often get too little potassium. Potassium can lessen the effects of sodium on blood pressure. The best source of potassium is food, such as fruits and vegetables, rather than supplements. Some packaged food products list potassium on the labels. Talk to your doctor about the potassium level that's best for you.
  • Be a smart consumer. Make a shopping list before heading to the supermarket to avoid picking up junk food. Read food labels when you shop, and stick to your healthy-eating plan when you're dining out, too.
  • Cut yourself some slack. Although the DASH diet is a lifelong eating guide, it doesn't mean you have to cut out all of the foods you love. It's OK to treat yourself occasionally to foods you wouldn't find on a DASH diet menu, like a candy bar or mashed potatoes with gravy.
If you're craving something sweet, reaching for dark chocolate may be a good way to indulge without risk of raising your blood pressure. Research suggests that flavonol, a substance found in cocoa beans and dark chocolate, may improve blood flow and lower your blood pressure. But, even the healthiest chocolate adds calories to your diet, so treat yourself sparingly.

Reduce sodium in your diet

Even a modest reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. And bigger cutbacks mean greater reductions in blood pressure. To decrease sodium in your diet, consider these tips:
  • Calculate your sodium consumption. Keep a food diary to estimate how much sodium you consume each day. You may be surprised at how much you're taking in. Most healthy adults need only between 1,500 and 2,400 milligrams (mg) of sodium a day. But if you have high blood pressure, are older than 50, are black, or have such chronic conditions as heart disease, kidney disease or diabetes, you may be more sensitive to sodium. In that case, aim for less than 1,500 mg of sodium a day.
  • Read food labels. Look at the sodium content before you buy. If possible, choose low-sodium alternatives. Even some foods you think are healthy, such as some vegetable juices, may contain surprisingly high amounts of sodium.
  • Eat fewer processed foods. Potato chips, frozen dinners and cured meats, such as bacon and processed lunch meats, are high in sodium.
  • Don't add salt. Just 1 level teaspoon of salt has 2,300 mg of sodium. Use herbs or spices, rather than salt, to add more flavor to your foods.
  • Ease into it. If you don't feel like you can drastically reduce your sodium consumption suddenly, cut back gradually. Your palate will adjust over time.
  • Eat more fresh foods. Fruits, vegetables and unprocessed grains contain little sodium.
  • Check your water softener. Water softeners are sometimes a hidden source of sodium in your water at home - although cold water to the kitchen often isn't softened. If your water softener adds a lot of sodium to the water you drink, you might want to consider switching to a different water-purification system or buying demineralized water for drinking and cooking.
  • If you enjoy Chinese food, ask that your food be prepared without MSG and/or soy sauce.
Limit alcohol consumption

Alcohol can be both good and bad for your health. In small amounts, it can help prevent heart attacks and coronary artery disease and potentially lower your blood pressure by 2.5 to 4 mm Hg. But that protective effect is lost if you drink too much alcohol - generally more than one drink a day for women and more than two a day for men.

If you drink more than moderate amounts of it, alcohol can actually raise blood pressure by several points. It can also reduce the effectiveness of high blood pressure medications.
  • Track your drinking patterns. Along with your food diary, keep an alcohol diary to track your true drinking patterns. One drink equals one 12-ounce (355 milliliters or mL) beer, one 5-ounce glass of wine (148 mL) or one 1.5-ounce of 80-proof distilled spirits (30 mL). If you're drinking more than the suggested amounts, cut back.
  • Consider tapering off. If you're a heavy drinker, suddenly eliminating all alcohol can actually trigger severe hypertension for several days. So when you stop drinking, do it with the supervision of your doctor or taper off slowly, over one to two weeks.
  • Don't binge. Binge drinking - having four or more drinks in a row - can cause large and sudden increases in blood pressure, in addition to other health problems. Don't abstain during the week and make up for it on the weekend.
Avoid tobacco products and secondhand smoke

On top of all the other dangers of smoking, the nicotine in tobacco products can raise your blood pressure by 10 mm Hg or more for up to an hour after you smoke. Smoking throughout the day means your blood pressure may remain constantly high. In addition, chemicals in tobacco can damage your arteries and cause fluid retention, both of which can raise your blood pressure. And like alcohol, tobacco products can interfere with the effectiveness of your blood pressure medications.

Also, avoid secondhand smoke. Inhaling smoke from others also puts you at risk of health problems, including high blood pressure and heart disease.

Cut back on caffeine

The role caffeine plays in blood pressure is still debatable. Drinking caffeinated beverages can temporarily cause a spike in your blood pressure. And some studies show that people who drink caffeine regularly have a higher average blood pressure, suggesting that caffeine might have a long-term impact. But other studies show you can develop a tolerance to caffeine so that it doesn't affect your blood pressure.

To see if caffeine raises your blood pressure, check your pressure within 30 minutes of drinking a cup of coffee or another caffeinated beverage you regularly drink. If your blood pressure increases by five to 10 points, you may be sensitive to the blood pressure raising effects of caffeine.

Regardless of your sensitivity to caffeine's effects, doctors recommend you drink no more than 200 milligrams a day - about the amount in two cups of coffee.

Reduce your stress

As with caffeine, the influence of stress on blood pressure isn't settled. Stress or anxiety can temporarily increase blood pressure. You need to know what stresses you before you can try to reduce your stress. Take some time to think about what causes you to feel stressed, such as work, family, finances or illness. Once you know what's causing your stress, consider how you can eliminate or reduce stress.

If you can't eliminate all of your stressors, you can at least cope with them in a healthier way. Take breaks for deep-breathing exercises. Get a massage or take up yoga. If self-help doesn't work, seek out a professional for counseling. Try meditation or ask your doctor about purchasing a machine that helps teach slow deep breathing.

Get regular health care

If you have high blood pressure, you may need to monitor your blood pressure at home. Learning to self-monitor your blood pressure with an upper arm monitor can help motivate you. Talk to your doctor about home monitoring. Make sure you ask about what size arm cuff you should use and what time of day you should measure your blood pressure. Also, a record of your blood pressure readings helps your doctor know if your medications are working or if they need to be adjusted. Regular visits to your doctor are also likely to become a part of your normal routine. These visits will help keep tabs on your blood pressure - and ensure that you don't neglect other health issues. If you don't have hypertension, you can avoid it; If you do have it, you can control it without multiple medications. If you want to avoid a stroke, keep your blood pressure low. Remember it is your life and it is your health.
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