Manage High Blood Pressure With Healthy Lifestyle Choices

Avoid hypertension

Reduce your risk of premature death

High blood pressure (hypertension) predicts increased risk of cardiovascular disease, the leading cause of death globally and in Western countries. Italian medical researchers recently published a brief review of evidence linking lifestyle choices to hypertension. The authors found clear evidence that minimal to modest alcohol intake, not smoking, modest sodium (salt) intake, greater physical activity, and a healthy diet individually and collectively predicted lower risk of hypertension. Their specific findings: 1) limit alcohol intake to one drink per day for women and two for men, 2) limit salt intake to 3,000-4,000 mg (a little over ½ teaspoon) per day for hypertensive persons, 3) meet the widely recommended minimum 150 minutes of moderate-intensity or strenuous physical activity per week, 4) emphasize a Mediterranean-type diet that’s rich in fruits, vegetables, legumes, whole grains, fish, and olive oil, while reducing intake of unprocessed and processed meat.

A recent, lengthy review identified lifestyle choices that appeared to reduce the risk of hypertension. Key healthy choices included Keep Moving, Eat Better, Sleep More & Better, and Defuse Chronic Stress. Given the ubiquity of hypertension in developed countries and its close connection to cardiovascular disease, reducing the risk of hypertension would likely decrease the risk of cardiovascular disease and improve other aspects of health and well-being.

The combination of improved lifestyle choices and medication may lower blood pressure more than either alone would accomplish. Chinese medical researchers recruited 12,892 participants with an average age of 58 years in six rural communities in China as part of the Haian Hypertension Patients Intervention Study. Members of the control group received blood pressure lowering medication plus frequent follow-up by doctors and nurses to achieve high adherence to the medication regimes. Members of the experimental group received blood pressure lowering medication as well as biweekly lifestyle training sessions designed to improve diet and physical activity and to discontinue smoking and drinking alcohol.

From baseline to one year, the changes for the medication alone and the medication plus lifestyle intervention groups, respectively, were as follows: systolic blood pressure (-14.0 vs. -8.0 mm Hg) and diastolic blood pressure (-9.7 vs. 8.5 mm Hg). (Lower blood pressure is healthier.) In addition, compared to the medication only group, the medication plus lifestyle intervention group showed significantly better physiological and biochemical factors at one year, including body-mass index, waist circumference, and blood sugar control. The dramatic improvements in blood pressure and physiological and biochemical factors in the medication plus lifestyle intervention group may reflect, at least in part, the frequent follow-up (every three days) by doctors and nurses with participants in the medication plus lifestyle intervention group. Previous research identifies social support and tracking progress as key ways to develop and maintain healthy lifestyle choices.

A newer study by Chinese researchers extended the findings of the previous study to hypertensive persons. The new study found that the combination of healthy lifestyle choices and drug treatment predicted lower risks of cardiovascular disease and death. This group of researchers used data for 14,392 hypertensive retirees with a mean age of 66 years of the Dongfeng Motor Corporation. Healthy  lifestyle factors included not smoking, body-mass index (18.5-24.9), physical activity (at least 150 minutes of moderate or strenuous physical activity per week), diet (at least two daily servings of vegetables, one serving of fruits, and one or fewer servings of meat), and sleep duration (6-8 hours per night). Adherence to these healthy choices was scores from 0 to 10, with 10 showing the highest adherence.

Over a median follow-up of 7.3 years and compared to participants with scores of 0-4 and who did not take anti-hypertensive medication, participants with scores of 8-10 and who took anti-hypertensive medication had significant 68, 67, and 70 percent lower risks of all-cause mortality, cardiovascular-related mortality, and cancer-related mortality, respectively. More good news: Participants whose healthy lifestyle scores were below 5 at baseline but increased to 5 or more after hypertension diagnosis had significant 48 and 47 percent lower risks of all-cause or cardiovascular mortality, respectively. If you have hypertension, do yourself and your family a favor by taking your prescribed medication regularly and by embracing healthy lifestyle choices.

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