By Teresa Liccardi, M.D.
“You pray for good health and a body that will be strong in old age. Good — but your rich foods block the gods’ answer and tie Jupiter’s hands.” Persius (34 AD -62 AD) – a Roman poet
So here we are in 2012 A.D. in the middle of a national health crisis from obesity, poor eating habits and lack of exercise, trying desperately to work backwards with drugs and procedures to regain our health at an astronomical expense.
It appears that we have not learned the basic lesson even after 2,000 years. But learning comes from repetition, trial and error, no matter how long it takes. So let’s go through the basics of a healthy lifestyle.
Obesity and sedentary lifestyle are risk factors for high blood pressure, cardiovascular disease, stroke, and kidney disease. About 68 million Americans have high blood pressure and 30 percent have pre-hypertension. Five percent of American children may have high blood pressure and even more may have pre-hypertension. Sixty-five percent of adults and 16 percent of children are obese. These statistics show that learning healthy living habits are as important for youths as adults.
Lifestyle changes in daily routines can improve long-term health outcomes which may otherwise lead to heart disease, stroke, kidney disease, and have immediate and long-term beneficial effects in reducing high blood pressure. Changes include weight reduction, physical activity, a low salt diet, DASH diet, and moderate alcohol consumption.
Let’s review these modifications, beyond salt restriction, and their impact on reducing high blood pressure.
Obesity, defined as a body mass index (a measurement calculated from both weight and height) greater than 30 in adults, is a major cause of hypertension. Increased body fat stimulates the sympathetic nervous system, which raises blood pressure. Weight reduction of even 9 pounds can reduce blood pressure by 4 to 6 mmHg. As a point of reference, single drug therapy reduces blood pressure by about the same amount. Interestingly, weight loss through diet and exercise reduces blood pressure more than weight loss through drug intervention.
Physical fitness is a state of health that is produced by consistent long-term daily physical activity, and leads to reductions in blood pressure. Only 3 out of 10 Americans achieve the recommended amount of daily activity. Aerobic exercise independent of diet can reduce blood pressure by as much as 5 mmHg. More information on physical fitness is available at The Presidents Council on Physical Fitness and Sports: http://www.fitness.gov/resources_factsheet.htm.
The landmark DASH Diet (Dietary Approaches to Stop Hypertension) is a diet high in fresh fruits, vegetables and low in fats. Changes in blood pressure similar to that of a single drug therapy can be seen after just two weeks on this diet. Because it lowered blood pressure in normotensive individuals, the DASH Diet is a primary preventative measure to reduce the incidence of hypertension in all Americans.
Now alcohol has some controversy surrounding its role in hypertension. It is a double-edged sword. Binging – more than two drinks per day for men and one drink per day for women – leads to increased blood pressure, stroke and heart disease. One drink daily with food improves blood pressure and reduces the risk of stroke and heart disease.
A high potassium diet reduces blood pressure and the incidence of stroke. Using a diet such as the DASH diet is a good source of potassium. I will give a word of caution with regard to potassium: potassium supplements should only be taken if recommended and under the guidance of a medical doctor. Diabetics and patients with kidney disease should consult their doctor and a qualified dietitian to manage potassium intake.
Flavonoids are a group of compounds found in fruits, vegetables, nuts, dark chocolate and wine that may help reduce blood pressure.
Lastly, breathing techniques, meditation, yoga, and learning coping skills reduce blood pressure and, very importantly, the ability to laugh may be cardioprotective.
So here is the bottom line: through multiple methods that act individually and synergistically, we can improve our blood pressure and long-term health outcomes. Even small efforts in several areas will help prevent and reduce high blood pressure. We owe it to ourselves, and families to make a difference in our health through good lifestyle choices.
Dr. Teresa Liccardi, who is board certified in internal medicine and nephrology, maintains a clinic for hypertension and chronic kidney disease at the Parker Family Health Center in Red Bank.