One in three adults worldwide has high blood pressure according to the World Health Organization. Left untreated, the condition – also known as hypertension – could lead to strokes, heart attacks, heart failure, kidney damage and many other health problems. The good news is that simple lifestyle changes can help to significantly reduce blood pressure, says an expert from global health system Cleveland Clinic ahead of World Hypertension Day on May 17.
“Blood pressure management is often 70% lifestyle and 30% medications,” says preventive cardiologist Luke Laffin, MD, Co-Director, Center for Blood Pressure Disorders. “While some people can lower blood pressure with lifestyle changes alone, the two approaches are complementary. If you take blood pressure medication but don’t make lifestyle changes, your medications won’t work effectively.”
Here, Dr. Laffin evaluates five effective lifestyle modifications and their estimated impact on reducing systolic blood pressure. Systolic blood pressure is the top number in a blood pressure reading and should ideally measure 120 mmHg or less.
1. Eat less salt
“Cutting your salt intake is probably the most important way to lower high blood pressure,” Dr. Laffin says. “In fact, studies show that a low-sodium diet has the same effect as one-and-a-half to two blood pressure medications.”
The American Heart Association (AHA) recommends no more than 1,500 mg (or about one teaspoon) of salt per day. However, because this amount is so strictly limited, Cleveland Clinic providers set the limit at 2,300 mg. “The AHA recommendation is an aspirational goal,” Dr. Laffin says. “If you can get there without changing your diet a radical amount and being miserable, that’s great — but getting to 2,300 milligrams or less can go a long way.”
Dr. Laffin points out that it takes about 10 to 14 days to adjust to a low-sodium diet, and then some foods will begin to taste too salty. He adds that choosing smart salt substitutes such as potassium chloride can help. It is also important to check food labels as sodium is hidden in many foods.
Impact: Lowering sodium intake from 3,500 mg – the American average daily intake – to 2,300 mg could drop a person’s blood pressure by 2 to 3 mmHg. Limiting sodium intake to the AHA’s limit of 1,500 mg a day, should drop it by 5 or 6 mmHg.
2. Consume more potassium
Potassium can help lower blood pressure because it gives the kidneys an assist in getting rid of excess sodium. “Potassium is the inverse of sodium,” Dr. Laffin explains. “Too much sodium increases blood pressure, and too little potassium increases blood pressure.”
A diet that’s high in fast food, processed food, carbohydrates, potatoes and meat is a diet that is likely to be low in potassium, Dr. Laffin says. “Instead, try to take in 3,000 to 3,500 mg of potassium per day by eating foods like bananas, tomatoes, avocados, cantaloupe, carrots, grapefruit, kiwi, lima beans, nectarines, and spinach.”
Importantly, Dr. Laffin points out this advice does not apply to patients with kidney disease, who should avoid consuming too much potassium, as the kidneys may not be able to get rid of it.
Impact: For individuals with hypertension and healthy kidneys, increasing potassium intake to recommended levels should drop blood pressure by 4 to 5 mmHg.
3. Adopt the DASH diet
The DASH diet — which stands for Dietary Approaches to Stop Hypertension — was created specifically to lower blood pressure. Dr. Laffin says research into this diet is so positive that it is now considered one of the most important non-pharmaceutical measures for controlling hypertension.
“The DASH diet is a really balanced diet rich in fruits, vegetables and whole grains and can be done in combination with a low-sodium diet,” Dr. Laffin says. “It can be really helpful in lowering your blood pressure, and people who adopt the DASH diet usually meet low-sodium and high-potassium guidelines, and may lose weight, too.”
Impact: Following the DASH diet can drop systolic pressure up to 11 mmHg in just a few weeks.
4. Get physical
“Being sedentary can increase blood pressure,” Dr. Laffin says. “Moreover, exercise, especially aerobic activity, is incredibly effective in reducing blood pressure. It forces your blood vessels to expand and contract, which keeps them flexible. It also increases blood flow and encourages the creation of new blood vessels, among other benefits.”
Other options recommended by Dr. Laffin include dynamic resistance exercises (for example, bicep curls with weights) and isometric resistance exercises (for example, wall push-ups).
Impact: Doing 150 minutes of aerobic activity a week can lower blood pressure by 5 to 8 mmHg. Dynamic resistance exercises have the potential to lower blood pressure by 4 to 5 mmHg, depending on factors such as frequency, number of repetitions and heaviness of weights used.
5. Achieve a healthy weight
As an individual’s weight increases, so does his or her blood pressure, and losing even a few kilograms can have a significant impact on lowering systolic blood pressure, says Dr. Laffin. “The fat cells that we get around our mid-section are metabolically active cells. They secrete all kinds of hormones, which ultimately raise blood pressure,” he explains.
Impact: Every loss of 1kg (2.2-pound) loss should result in a drop of 1 mmHg in blood pressure.
Dr. Laffin adds that smoking, stress, lack of sleep and drinking alcohol can also contribute to high blood pressure directly and indirectly, so should be avoided.