Lifestyle measures can help lower blood pressure and keep it at a healthy level. Research shows that the effects of lifestyle changes are additive: The more lifestyle changes you adopt, the greater the benefits. In a Johns Hopkins University study, people with prehypertension or mild hypertension who lost weight, followed the DASH diet, reduced salt and alcohol intake, and exercised regularly lowered their systolic blood pressure by an extra 4 mm Hg over a six-month period, compared with people who only received advice on these lifestyle changes.
By making lifestyle adjustments like the ones listed here, you will also improve the effectiveness of your blood pressure medication and lower your risk of hypertension complications, such as heart attack and stroke.
1. Maintain a healthy weight. Research shows that overweight people can reduce blood pressure with weight loss and improved exercise habits, and it does not need to be dramatic. For every 2 pounds of weight loss, blood pressure declines by about 1/1 mm Hg.
Your doctor will determine whether or not you’re overweight by calculating your body mass index (BMI), which takes into account your weight in relation to height. If your BMI falls between 18.5 and 24.9, you are in the healthy range. But if your BMI is between 25 and 29.9 you are overweight, and if it is 30 or more you are obese. You can calculate your BMI online.
The best way to lose weight is to reduce the number of calories you eat and increase physical activity. While fad diets and over-the-counter dietary supplements may result in quick weight loss, the key to keeping off those pounds is making permanent changes in your eating and exercise habits. A safe rate of weight loss is 0.5 to 2 pounds a week, which translates to eating 250 to 1,000 fewer calories a day. If you add exercise, this calorie cutback does not need to be as drastic.
2. Follow a DASH-style diet. A healthy diet has the potential to dramatically lower blood pressure and control hypertension. Clinical trials show that the DASH (Dietary Approaches to Stop Hypertension) eating plan can have a beneficial effect on blood pressure. The diet is rich in fruits, vegetables, and low-fat dairy products and low in saturated fat and cholesterol. It also includes whole grains, fish, poultry, and nuts. Red meat, sweets, and sugary beverages are kept to a minimum.
In one study, individuals with hypertension who followed the DASH diet for eight weeks lowered their systolic blood pressure by 11 mm Hg, compared with people who ate a typical American diet (low in fruits and vegetables and high in fat). This result is similar to the amount that a single blood pressure drug can lower blood pressure.
3. Cut down on sodium. Blood pressure levels increase with higher intakes of dietary sodium. By limiting sodium intake, you may be able to lower systolic blood pressure by 2 to 8 mm Hg and in turn reduce your risk of heart attack and stroke. The effects of sodium on blood pressure tend to be greater in blacks, people over age 50, and those with hypertension, diabetes, or kidney disease.
The average American consumes 4,000 mg of sodium each day, much more than the U.S. Department of Agriculture’s recommended maximum amount of 2,300 mg daily if your blood pressure is normal, and 1,500 mg if you have hypertension, are age 51 or older, or are black. The American Heart Association goes even further, recommending a maximum of 1,500 mg daily for all adults and children.
Almost all of the sodium we consume comes not from the salt shaker but from processed and pre-prepared foods like bread; cold cuts; canned vegetables, meats and soups; frozen dinners; cheeses; salad dressings; snack foods; and fast food. Thus, reducing salt intake means not only avoiding the salt shaker while cooking and at meals but reading food labels and choosing foods that are low in sodium (less than 200 mg of sodium per serving).
4. Increase potassium. Potassium is a mineral found in fruits, vegetables, dairy products, and beans. An increased intake lowers blood pressure and dampens the rise in blood pressure that occurs with excessive salt consumption. You should consume at least 4700 mg of potassium a day, which can be achieved without dietary supplements by following the DASH diet.
Milk, black beans, lima beans, bananas, cantaloupe, citrus fruits, Brussels sprouts, mushrooms, and spinach are all good sources of potassium.
5. Increase physical activity. Exercise plays a role in controlling blood pressure. Aim to engage in physical activity (such as walking, bicycling or swimming) for at least 30 minutes five to seven days a week. You do not need to push yourself to the point of discomfort to get benefits. Regular, moderate physical activity reduces blood pressure by 4/3 mm Hg.
If you’re too busy to set aside 30 or more minutes a day, you should still try to get some extra brisk physical activity. In one study, people who exercised a total of 30 to 90 minutes a week decreased their blood pressure almost as much as those who exercised more. So exercise when you can, even if it falls short of the goal. Also, you do not have to do all 30 minutes at once; doing three 10-minute sessions is just as beneficial.
6. Restrict alcohol consumption. Moderate alcohol consumption—no more than two drinks per day for men and one drink per day for women—lowers systolic blood pressure on average by 2 to 4 mm Hg. One drink is equivalent to 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof spirits. Nondrinkers shouldn’t begin drinking to reduce blood pressure. Exceeding these limits can raise blood pressure, particularly in women.
7. Quit smoking. The harmful chemicals in cigarettes can damage blood vessels and raise blood pressure while you smoke. In addition, smoking is one of the major risk factors for heart disease. If you need help quitting, take advantage of programs sponsored by the American Heart Association and the American Lung Association.
8. Manage stress. In stressful situations, your body releases hormones like epinephrine that cause blood pressure to rise and your heart rate to accelerate. Whether chronic stress contributes to hypertension is less clear. Still, reducing stress may help you follow other lifestyle recommendations and maintain other healthy habits. Stress reduction techniques include exercising regularly; practicing relaxation techniques such as deep breathing, guided imagery or meditation; lightening your work or personal schedule; and having a strong network of friends and family.