Lifestyle as Medicine - December 2009

Did you know …

Lifestyle changes can lower high blood pressure?

A healthy diet and regular exercise can significantly improve high blood pressure, researchers say in a new review of studies. The greatest impact was found in combining regular exercise, diet changes and weight management. These behaviors also improved other risk factors for heart attack and stroke, such as high cholesterol.

The best exercise routine for reducing high blood pressure is regular, moderate aerobic exercise for 30 to 60 minutes, 3 to 5 times per week. Studies show that blood pressure lowers temporarily up to 24 hours after a single episode of exercise, and the more frequent the exercise, the more sustained the lower blood pressure. Resistance training (like weight lifting or isometrics) is not as effective at lowering blood pressure.

Diet changes that lower blood pressure significantly are: reducing salt intake, increasing potassium intake, moderation of alcohol, and the DASH diet plan. The DASH diet prescribes plenty of fruits, vegetables, and whole grains, moderate amounts of low-fat dairy, and limited saturated fat. This diet has been shown to reduce blood pressure in all populations, especially African Americans by as much as 14 points (mmHg) of the systolic pressure (the higher number of the blood pressure measurement). Vegetarian diets also are associated with lower blood pressure. Weight loss, even in small amounts like 5 to 10 lbs in a person who is overweight, can lower blood pressure dramatically.

Restricting salt is especially beneficial for middle aged and older adults, African Americans, and those with diabetes or chronic kidney disease. Current recommendations are to limit salt (sodium) intake to 1500 mg per day. The studies showed that in general, the lower the salt intake, the better the blood pressure. It is estimated that 75% of salt intake comes from processed foods, so replacing these foods with fresh or low-salt versions is essential. Limiting alcohol intake to two drinks per day for men, and one drink per day for women can lower systolic blood pressure by as much as 4 points (mmHg).

What does CPC recommend?

Lifestyle changes are an effective way to improve your blood pressure, and your overall health. However, exercise training is not recommended for people with blood pressures greater than 220/110 mmHg. If you have high blood pressure, talk with your doctor before starting a new exercise program. To limit sodium intake, read food labels on processed food like store-bought spaghetti sauce, canned vegetables, frozen dinners, packaged rice or macaroni mixes, chips, sodas and cereal. Choose fresh vegetables and fruits more often, and whole grains. High blood pressure is considered the “silent killer” because of the impact it can have whether or not diagnosed, and can be present without symptoms. This holiday season; remember that simple changes, while not easy, can change your future!

This study was published in: American Journal of Lifestyle Medicine. Hypertension; lifestyle modifications for its prevention and management. Vol 3, Nov/Dec 2009.