Hypertension or high blood pressure is one of the most common conditions encountered in primary care. Nonpharmacologic strategies have been shown to help lower blood pressure. Lifestyle modifications are recommended for all patients with hypertension. The American heart association/American College of Cardiology lifestyle management guideline recommends a diet emphasizing vegetables, fruits, whole grains, limiting sodium intake, exercising three or four times per week for an average of 30 minutes per session to control high blood pressure. Here are some advices to your query how to control high blood pressure.
What is High Blood Pressure:
High blood pressure is sometimes called the silent killer because it generally has no warning signs or symptoms so most people do not know they have it. About one in three adults in the United States has hypertension. For over 85% of people, the cause of their high blood pressure is not known; this called primary or essential hypertension. Secondary hypertension is caused by a known condition such as kidney disease, sleep apnea, steroid therapy, thyroid or parathyroid disease and some other medical conditions.
Steps to control high blood pressure:
Currently, despite the availability of several antihypertensive drugs, to control blood pressure is still a challenge and this can attribute several health risk factors. On the other hand nonpharmacological interventions are free of cost and create a feeling of well-being. Nonpharmacological treatment of hypertension may be effective to control early hypertension or high blood pressure without any cardiovascular complications. But nonpharmacological measures should be generally be regarded as useful adjuncts to antihypertensive drugs therapy rather than alternatives to it. The nonpharmacological measures to control high blood pressure include:
- Diet modification
- Salt restriction
- Body weight reduction
- Avoid smoking
- Alcohol restriction
- Stress management and yoga
- Minimize air pollution
- Get good sleep
- Eat garlic or garlic extract
How to Control High Blood Pressure:
1. Diet modification:
Nutritional requirements of hypertensive individuals can be addressed through adopting either DASH diet (DASH stands for Dietary Approaches to Stop Hypertension) or through traditional mediterranean diet. These dietary guidelines promote the consumption of fish, vegetables, whole grains, fiber and food rich in potassium, magnesium, calcium and phosphorus, low-fat products, unsaturated fatty acids and have low consumption of red meat and saturated fatty acids. Regular consumption of sugar-sweetened soft drinks has been associated with overweight, metabolic syndrome, type-2 diabetes and higher CV risk. The consumption of these drinks should be discouraged.
The dietary approach to stop hypertension through DASH diet is expected to reduce BP by 8 to 14 mmHg and may affect equal to that of single drug therapy. It is likely that several aspects of the DASH diet, rather than just one nutrient or food, reduces BP levels significantly. Thus, adopting a healthy and balanced diet may assist to control high blood pressure and reduce the CV risk.
2. Salt Restriction:
Excess of salt is associated with increased cardiovascular events and mortality. The recommendation for daily consumption of salt is less than 5 g/day and this is expected to reduce blood pressure by 2 to 8 mmHg. salt is directly related to the development of hypertension and reduction of salt lowers BP. Reduce sodium intake by avoiding processed foods and not using salt in cooking. Potassium chloride salt can be used instead of regular salt.
3. Body Weight Reduction:
Increased body weight is associated with hypertension. The weight reduction can be achieved by lifestyle modification by dietary advice and regular exercise. Weight loss decreases cardiovascular risk factors and may contribute to lowering of dose of antihypertensive drugs. A weight loss of 5 kg is associated with a fall in systolic blood pressure of 4.4 and diastolic BP of 3.6 mmHg. As weight is lost, blood pressure also tends to fall. The BMI should be under 25.
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4. Giving up Smoking:
All hypertensive patients should be counseled regarding giving up smoking and use of tobacco in any other form. Passive smoking is also harmful for the patients with cardiovascular problem. Smoking is a major modifiable risk factor for cardiovascular disease. Besides counseling, drugs are also used for helping patients to quit smoking.
Nicotine is responsible for causing addiction to tobacco products. Smoker when try to quit smoking they may develop symptoms of nicotine withdrawal like the urge to smoke, depression, irritability etc. NRT helps smoker to withdraw from smoking by providing nicotine in a controlled amount and thus helps to control the blood pressure.
5. Regular Exercise:
Regular aerobic exercise at least of 30 minutes of moderate dynamic exercise for 3-4 days per week is recommended. Exercises help in reducing blood pressure and can lower blood pressure by an average of 4 to 9 mmHg. Regular exercise also helps in maintaining weight which may help also contribute to control of BP. It takes about 1 to 3 months for regular exercise to have an impact on blood pressure. The benefits lasts only as long as the exercise is continued. Any physical activity that increases your heart and breathing rates is considered aerobic activity like household works such as mowing the lawn, gardening or active sports, such as tennis, football, jogging, bicycling, swimming, dancing etc.
6. Alcohol Restriction:
Continued use of alcohol results in a sustained rise in blood pressure and binge drinking is associated with chronic high blood pressure. The use of alcohol also increases body weight and obesity, and this further elevates the risk of hypertension in the long run. Quitting alcohol reduces blood pressure but patients with alcohol addiction should not abruptly withdrawal alcohol.
7. Stress Management and Yoga:
Stress is an important contributory factor for hypertension. Avoiding stressful lifestyle, depression and anxiety .helps in reducing elevated blood pressure. Yoga helps in combating stress and has shown to have a modest effect on lowering blood pressure. Besides this, it also benefits diabetes and atherosclerotic heart disease which are commonly associated with it. Relaxation, exercise, meditation, listening to music, yoga, reading or other activities can reduce stress and in turn blood pressure also.
8. Air Pollution:
This is also a contributory factor for hypertension and a small study has shown that there is a mild rise in blood pressure after two hour exposure to PM2.5 and ozone. Cohesive efforts are needed to minimize air pollution.
9. Get Good Sleep:
Your blood pressure typically dip down when you are sleeping. If you don’t sleep well, it can affect your blood pressure. People who experience sleep deprivation, specially those who are middle-aged, have an increase risk of high blood pressure. These are some of the many ways to help you get good sleep –
- Try setting a regular sleep schedule
- Spend time relaxing before bedtime
- Exercise during the day
- Avoid daytime naps
- Make sure bedroom comfortable
The national Sleep Heart Health Study found that regular sleeping fewer than 7 hours a night and more than 9 hours a night was associated with an increased rate of high blood pressure. Regularly sleeping fewer than 5 hours a night was linked to a significant risk of high blood pressure.
10. Eat Garlic or Garlic Extract:
Fresh garlic or garlic extract are both widely used to lower blood pressure. A meta-analysis found that for people with high blood pressure, garlic supplements reduced their systolic blood pressure by up to about 5 mmHg and reduced their diastolic blood pressure as much as 2.5 mmHg.
Risk Factors for High Blood Pressure:
Both environmental and hereditary factors increase the risk of developing high blood pressure. Some risk factors can be controlled, such as lifestyles changes, while others, such as gender and age, cannot.
The risk of developing hypertensin increases in those over 45 years of age. Almost half of all Americans over the age of 60 have hypertension. Of this age group, two out of three will have systolic pressures above 120. This is termed isolated systolic hypertension. Due to an increases rate of obesity among youth, an increased trend in hypertensin has been observed.
In some individuals, heavy or even moderate alcohol consumption can cause hypertension.
Ethnicity or race:
A higher rate of hypertension is found among individuals with Africans or Native Americans ancestry compared to those with European or East Asian ancestry.. Those with Hispanic ancestry have a higher incidence of diabetes and obesity compared to non-Hispanic Americans. These higher incidences of hypertension among Africans and Hispanic Americans may be due to poor diet, stress or hereditary factors.
Individuals who have close family members with high blood pressure are more likely to be at risk for the condition. This increased risk is likely to be genetic, although environmental factors such as constant stress, poor diet and smoking are contributing factors for those with a genetic predisposition for hypertension.
Both men and women age 45 to 54 are at equal risk for hypertension. After age 55, women are more likely to have high blood pressure compared to men.
High Fat Diet:
A diet high in saturated fat such as red meats, butter, lard and cheese can contribute to obesity and high cholesterol. High cholesterol, in turn, can cause the formation of plaque and arthrosclerosis, which causes a narrowing of the arteries and thus an increase in blood pressure.
High Sodium Intake:
A diet high in salt (sodium chloride) can predispose some individuals to hypertension.
Obesity and Overweight:
Being overweight or obese is a risk factor for many health problems, including hypertension. A measure of overweight or obesity is the body mass index (BMI), a measure of body fat based on height and weight. An individual with a BMI of 25 to 29.9 is overweight and BMI of 30 or greater is obese. Both of these conditions increase the risk of hypertension and other diseases, including diabetes, heart disease and some cancers.
Individuals with constant environmental stress, heightened anxiety, anger and suppressed expression of anger are often at risk for developing high blood pressure.
Nicotine is a stimulant that increase blood pressure. Smoking and chewing tobacco can lead to hypertension and other heath issues such as cancer.
Impact on your body organs in hypertension:
The surge in blood pressure damages the inner lining of arteries (blood vessels), limits the ability of the heart to pump blood.
Heart: Most crucial organ to involve and results in left ventricular hypertrophy (enlargement of heart chamber), congestive heart failure, arrhythmias (irregular rhythm of heartbeat), coronary artery disease, ischemic heart disease, myocardial infraction (damage to the heart due to interruption of blood supply to the heart) and sudden death.
Brain: Stroke (cerebrovascular accident, CVA – damage to the brain due to disruption of blood supply) is the second most frequent cause of death in hypertension patients after a heart attack. This debilitating and often fatal condition happens when a blood vessel in the brain suddenly bursts (cerebral hemorrhage) or is blocked by a blood clot (cerebral thrombosis). Brain cells in the area of the broken blood vessel die due to a lack of oxygen.
Kidney: Chronic hypertensin can lead to renal failure or the slow deterioration of kidney function. In addition to diabetes, hypertension is the primary risk factor for this condition.
Peripheral arterial disease – hypertension is a major risk factor for the heart disease, the leading cause of death in the United States among both men and women. The most common type of heart disease is coronary artery disease, where the arteries are thickened through the process of atherosclerosis.
Aneurysm – high blood pressure can weaken the vessels which can bulge and form an aneurysm. If it gets ruptured, it may result in cataclysmic bleeding and death.
Dementia (memory loss)
Diagnosis of High Blood Pressure:
- Macro/micro- albuminuria (excretion of albumin > 300 mg per day/ 30-300 mg per day in urine specimen) suggests vascular damage in kidneys and heart.
- Fundoscopic examination – retina should be evaluated.
- Echocardiography, ECG – to diagnose cardiomegaly (enlarged heart size) and other cardiac problems.
- Laboratory screening for serum sodium, potassium, calcium, TSH (thyroid stimulating hormone), fasting blood glucose, total cholesterol.
- Weight loss (BMI <25 kg/m2)
The answer of the widely search question how to control high blood pressure depends on the simple mantra – eat less, eat right, walk and exercise regularly, sleep well, avoid anxiety and avoid smoke and alcohol. These nonpharmacological measures are very much useful to know how to control high blood pressure and lowering your blood pressure.