The Cornerstones of Healthy Blood Pressure

The Cornerstones of Healthy Blood Pressure

By Joseph McCaffrey, MD, FACS

High blood pressure is called the silent killer for a good reason. It both strains the heart and damages delicate organs such as the kidneys, eyes, and the brain. Yet very often, it causes no symptoms at all until the damage is done.

Diagnosing high blood pressure is pretty straightforward. We're all used to having our blood pressure checked as part of a routine exam, and now you can find screening booths in places such as pharmacies and health fairs, or even buy a machine that lets you check at home yourself.

Once diagnosed, the standard medical response is, as usual, drug therapy.

Yes, the drugs work, but at a price. They have side effects such as dizziness, electrolyte imbalance, impotence, fatigue, and more. We all would just as soon avoid any of them.

The fact is, if a person is willing to adjust their lifestyle, most people can lower their blood pressure without resorting to drugs. The only side affect of this approach is increased overall health.

Studies show that weight maintenance, diet, and exercise are the cornerstones of lowering high blood pressure.1

Weight
You don't have to be overweight to have high blood pressure, but obesity is a risk factor for high blood pressure. Maintaining a normal blood pressure is just another reason to keep your weight in a healthy range.

Diet
Most people are familiar with the association between excessive sodium and high blood pressure, but that's not the whole story. The best-studied dietary recommendation is the DASH diet (Dietary Approaches to Stop Hypertension), which is promoted by the NIH. This diet emphasizes fruits, vegetables, and lean sources of protein. In short, it's a healthy diet for everyone, not just people with hypertension.

About 25% of the calories on the DASH diet are from fat. It emphasizes healthy fats, such as those found in nuts. The total sodium intake on the standard DASH diet is 2400 mg per day. Blood pressure lowers even more if you restrict the sodium to 1500 mg per day. If you want to look into the DASH plan more, it is explained in detail on the NIH website.

As I mentioned before, sodium isn't the whole story. Many people with hypertension are deficient in potassium. The ratio of sodium to potassium in the diet is important. I've read recommendations suggesting that we should have five times more potassium than sodium in our diet. Someone eating a diet of processed and prepared foods easily reverses that ratio. They commonly take in two times more sodium than potassium.

Clearly, most people need much less salt and more potassium. Nutritionists often recommend bananas as a way to increase dietary potassium. Bananas aren't my favorite because they raise the blood sugar too much. I prefer low-sodium or no-sodium tomato juice. A cup contains about 820 mg of potassium.

If you add some potassium chloride salt substitute for taste (NoSalt and NuSalt are two brands) you'll increase your potassium intake even more. Each ¼ teaspoon adds another 650 mg of potassium.

People with kidney disease need to be careful when changing any electrolyte in their diet, especially potassium. Having said that, eating high potassium foods is safe for most others.

Exercise
You know you should exercise regularly for a lot of reasons. Reducing your blood pressure is one of them. Reviewers looked at 105 studies on the effect of an aerobic exercise program (walking is enough) on blood pressure. On average, it lowered both diastolic and systolic blood pressure by 5 mmHg.

A healthy diet and an exercise program should be the foundation of your healthy blood pressure program. Next, here are some supplements to consider.

Beneficial Supplements

Fish Oil. Fish oil is one of my favorite supplements to recommend. Most people don't get enough omega-3 fats in their diet and there are multiple health benefits to increasing your intake including lowering your blood pressure. The effect of fish oil isn't profound, but it appears consistently and there are enough other benefits, such as modulating inflammation in the body, to recommend it.2

Coenzyme Q10. Coenzyme Q10 occurs naturally in the body and is involved in many metabolic processes, especially those related to energy production. It has been helpful in the treatment of congestive heart failure, and now studies show it helps control blood pressure.3

Coenzyme Q10 levels decline with age, so supplementation is advisable. A reasonable dose to help lower blood pressure is 50-100 mg twice a day.

Calcium and Magnesium. I like to recommend supplements that have multiple benefits. Calcium and magnesium fall into that category. Both, especially when taken with adequate vitamin D, improve bone strength. Magnesium also supports a smooth cardiac rhythm and muscle function -- and both help reduce blood pressure.

If you take a supplement, I suggest 1000 mg calcium and 500 mg magnesium per day.

Relaxation Response and Meditation

Dr. Herbert Benson coined the term “the relaxation response” to describe the physiologic changes he observed in people meditating. Among these changes was decreased blood pressure.

He was the first person to measure and report on the actual physiology of meditation. His initial studies were in the early 1970s. Since then, the results he observed have been confirmed and expanded hundreds of times.

Very recent research on the effects of meditation on the actual structure of the brain is nothing short of astounding, but that's a subject for another day. There's no doubt we live in a fast-paced, high-stress world. If we don't do something to counteract that, there's no way we can avoid the ill effects of chronic stress.

Meditation is an excellent answer and it's easy to find free and simple instructions on the web.

These are my primary recommendations for controlling blood pressure naturally. This list is by no means complete. There are other worthwhile measures including supplements (garlic and hawthorn), relaxation techniques (biofeedback and yoga), and more.

I've covered the most important topics, certainly enough to get you started. I hope you've noticed that all these recommendations really just describe a healthy lifestyle. Again, if you follow them, the only side effect will be feeling great in general -- and not just because your blood pressure is lower.

References

Dickinson HO, J Hypertens. 24.2 (2006): 215-233.
Geleijnse JM, et al. J Hypertens. 20 (2002): 1493-1499.
Hodgson JM, et al. Eur J Clin Nutr. 56.11 (2002): 1137-1142