Nonpharmacologic Therapy For High Blood Presure (Hypertension)

Many people with high blood pressure often wonder if there is anything they can do to reduce their blood pressure other than by taking medications. In fact, there are several changes a person can make which can reduce blood pressure. In a few people these lifestyle changes can substitute for medications and in many people, can result in a reduction in the amount of a drug or number of drugs required to control their high blood pressure. Several of the lifestyle modifications will also prevent increases in blood pressure over time which could lead to high blood pressure. Most of the changes will reduce the risk of your having a heart attack or a stroke. It is important that these changes be made in consultation with your health care provider so that medications can be appropriately adjusted and that the changes can be individualized to suit you.

1. Overweight
Being overweight is one of the most frequent causes of having high blood pressure and reducing weight is one of the best methods of reducing blood pressure without drug therapy. Weight loss should only be attempted by those who are overweight. To notice a reduction in blood pressure it is necessary to lose approximately 4.5 kg. Some people are more sensitive to weight loss than others. It is usually best to accomplish weight loss both by an increase in physical activity (see Physical Activity section) and by a reduction in caloric intake. It is important to maintain a healthy diet. A diet rich in fruit and vegetables and low in saturated fats is generally recommended. Reducing weight is difficult for many persons to accomplish. A change in dietary habits to healthier foods and a slow reduction in weight through an increase in physical activity and a modest reduction in caloric intake is likely to be more successful than a rapid and radical change which would be difficult to maintain over the long run.

2. Alcohol
Excessive intake of alcohol both increases blood pressure and causes hypertension. The increases in blood pressure are usually seen above 2 drinks per day (a drink is the equivalent of 12 oz of 5% beer, 5 oz of 12% wine or 1 oz of 40% spirits). Women appear to be more sensitive to the adverse effects of alcohol than men. It is recommended that drinking be less than 2 drinks per day and less than 14 drinks per week in men and 9 drinks per week in women. Those who drink more than these limits would benefit from a reduction in alcohol consumption. A reduction in alcohol consumption can also assist with weight reduction. Those who are unable to reduce their drinking on their own should consult a health care professional.

3. Exercise
Inactive individuals can lower their blood pressure by increasing their physical activity. Physical activity is especially important for those who are overweight as an aid to weight loss. Vigorous physical activity is not necessary to lower blood pressure. Optimum reductions in blood pressure are achieved by as little as 1 hour of low intensity activity (e.g. walking) performed three or four times a week. It is important that the activity that you choose be one that is enjoyable to you. Even if you are not able to accomplish 1 hour of physical activity 3 or 4 times a week you should attempt to increase your physical activity during your daily routine. Simple measures such as walking rather than driving to close locations, using stairs instead of elevators and avoiding the use of electronic conveniences can be effective. If you have heart disease or other significant medical conditions consult your health care professional before changing your physical activity.

4. Salt (Sodium)
Reducing sodium intake will usually reduce blood pressure in persons who have hypertension. This can be achieved. However, it is difficult to sustain a reduced salt diet because much of the salt is added in the processing of foods. It is recommended to avoid salty foods and not to add salt to food at the table. Also reduce or do not add salt in cooking. Eating a healthy diet high in fresh fruits and vegetables will help. If you are in a position where you can influence government or the food industry, apply pressure to have the addition of salt to food reduced.

5. Stress
Persons with high blood pressure who are under significant stress may be able to reduce their blood pressure by specialized stress counselling. Specialized stress counselling with "individualized cognitive behaviour modification" is an effective means of reducing blood pressure but not usually available. If you are seeking stress counseling to lower blood pressure a referral to a qualified psychologist is required.

6. Smoking
Smoking does not cause high blood pressure but markedly increases the risk of heart disease in persons with high blood pressure and can reduce the effectiveness of blood pressure lowering medication. Stopping smoking is an important step for persons with high blood pressure. Because the nicotine in tobacco is addictive, stopping smoking is difficult. The use of nicotine supplements makes it twice as likely to stop smoking. Identifying and avoiding activities that are associated with your smoking may also help. Most persons require several attempts at stopping before finally succeeding. Encourage your workplace and home to be smoke free. This will assist your ability to quit.

Failures?
Most life style changes are difficult. If you try and do not succeed, do not be overly discouraged. Most persons require several attempts before achieving long lasting success. In fact, your chance of success increases with each attempt you make.

Quick Fixes:
A number of persons with high blood pressure believe there are quick fixes, crash diets, special herbs or remedies, that can lower their blood pressure. Some of these quick fixes can be dangerous, many are expensive and most are poorly tested both for ability to lower blood pressure and safety.

Following the above lifestyle changes can have a significant impact in preventing hypertension in those whose blood pressure is at the upper range of normal and can replace drug treatment in some people with milder levels of hypertension. Drug requirements can be reduced and overall health can be improved in those who continue to require drug treatment. Changes or alterations in drug therapy should always be performed in consultation with a health care professional.
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