“You have elevated blood pressure,” your doctor announced. “You need to lower it, but I can’t give you a prescription.”
Say what now?
Unfortunately, this story is not unique.
Almost 900 million people worldwide are living with hypertension today and 3.5 billion people have an elevated blood pressure that doesn’t fall within the classic definition of hypertension. There is strong evidence that the risks associated with high blood pressure start way below the classic threshold of 140 over 90. In fact, the problems start between 110 and 115 mm Hg, which are considered to be normal, and 68% of strokes and heart attacks happen to people with normal blood pressure.
It’s easy to see why blood pressures below 140 should also be treated, but the reality is most doctors don’t believe that it justifies the significant side effects of blood pressure medications. As a result, doctors have become reluctant to prescribe blood pressure drugs in these instances.
Fortunately, there are several drug-free options that are relatively risk-free and sometimes more effective than blood pressure drugs.
How do you manage your blood pressure without medication?
First of all: reduce your salt intake.
As one of the body’s main electrolytes, sodium helps nerves and muscles function normally and regulates water levels in the body; making it critical in controlling blood volume and blood pressure. While sodium is an essential nutrient for normal body functions, the balance is delicate. Consuming too little can cause dehydration, muscle cramps, weakness and low blood pressure. However, consuming too much can can cause fluid overload and high blood pressure.
Most people have no trouble getting enough sodium. In fact, sodium intake around the world is well above physiological needs at more than 3,400 mg per day.
So, what happens when you factor out sodium?
Reducing salt intake to just 3,800 mg per day decreased blood pressure by almost 6 points. When combined with the Diet Approaches for Stopping Hypertension (DASH diet), blood pressure decreased by a whopping 10 points.
For best results, limit your salt intake to 2,300 mg per day.
Excess weight didn’t become public health enemy #1 for no reason; it causes a lot of problems to the body with no real benefits. First, fat, especially abdominal fat, is extremely inflammatory. Inflammation is both directly and indirectly damaging to blood vessels of the heart and peripheral blood vessels by causing insulin resistance and type 2 diabetes. Second, excess weight increases systemic vascular resistance, which causes the heart to pump harder and blood pressure to rise.
You unfortunately only need to gain 5 pounds for these problems to start happening. However, losing as little as 5 to 10 pounds can make a difference in your blood pressure. Some studies have shown that for every 2 pounds (or 1 kg) you lose corresponds to a decrease of 1.05 points in your blood pressure. In one study, a weight loss of 17 pounds (8 kg) resulted in a reduction of at least 8.5 points in blood pressure. Even better, combining weight management with an exercise program reduced blood pressure by 12.5 points.
Although losing weight is far from easy, the rules are simple: move more, take in less calories and make every calorie count by making smarter food choices.
Moderate to intense exercise- whether jogging, brisk walking, swimming, playing sports, or cycling- has been shown to improve insulin resistance, skeletal and joint health, muscular strength and decrease instances of depression. It has been associated with decreased risk for cancer and increased cancer survival.
Aerobic exercise is generally successful at reducing blood pressure by around 5 to 8 points. The effects are also extremely dose dependent, which means that the more frequent and the longer you exercise, the better the outcome. One of the ways that exercise lowers blood pressure is by increasing the production of nitric oxide, an endogenous substance responsible for relaxing and widening the blood vessels (which also makes it great for men with erectile dysfunction).
Of course, you don’t need to be a triathlete or an olympian to reap these benefits. Doing low to moderate intensity aerobic exercises for 20 to 60 minutes, 3 to 5 times per week (preferably 5) is a recommended.
Eat more potassium
Potassium is probably one of the most under-appreciated and under-utilized minerals when it comes to reducing blood pressure. Like sodium, potassium is one of the major electrolytes in the body. Unlike sodium, potassium decreases blood pressure by actually counteracting the water-retention effects of sodium. Potassium also relaxes the muscles and blood vessel walls.
Research during the last four decades has linked potassium with significant reductions in blood pressure, in both hypertensive and non-hypertensive people and those with high salt intake. In hypertensives, eating 4.7 grams of potassium from food sources can decrease blood pressure by an average of 8 points, reduce heart attacks by 11% and strokes by 25%.
Although potassium is available in dietary supplements and prescription pills, it is best to get your potassium from fruits and vegetables, unless otherwise instructed by your physician.
Figuring out what to eat when you have high blood pressure can seem like a battle in itself. This is especially true as the do-not-eat list can be miles longer than the actual acceptable foods list. In recent years, the DASH diet has made things much simpler.
The DASH diet plan emphasizes whole grains, fruits, vegetables, beans, legumes, nuts and lean meats while limiting red meat, processed food, baked goods, and full-fat dairy. DASH is filled with nutrients like magnesium, calcium, potassium, protein and fiber.
Here’s what a typical day on DASH looks like:
- 6-8 servings of whole grains
- 4-5 servings of vegetables
- 4-5 servings of fruits
- 4-5 servings of dairy
- Less than 6 servings of lean meats or fish
- 2 servings of fats and oils
Plant-based nutrition like DASH works in a variety of ways to reduce blood pressure. They relax blood vessel walls, improve insulin sensitivity, decrease blood thickness, reduce the effects of sodium, decrease stress response, reduce inflammation and have great antioxidant benefits.
The DASH diet by itself can reduce blood pressure by 6 points.
There are many other steps you can take to reduce your blood pressure without drugs. These include:
- Garlic supplements- could reduce blood pressure by 12 points
Limiting alcohol consumption to no more than two drinks per day for men and one for women.
Omega-3 fatty acids
- Water fasting- could reduce blood pressure by 60 points