CHOOSING TO BEAT HIGH BLOOD PRESSURE WITH DIET AND EXERCISE IS A BETTER AND LONGER-LASTING FIX.
Close to a third of the adult U.S. population has high blood pressure (also referred to as hypertension, or HBP). All people with HBP are at risk for stroke, heart failure, myocardial infarction (heart attack), arterial aneurysm and chronic kidney failure. Overall, HBP reduces life expectancy. The specific causes are unknown, but there is an unmistakable and significant correlation between HBP and sedentary lifestyles, smoking, stress, obesity, alcohol intake, sodium (salt) intake, insulin resistance (diabetes), use of certain human immunodeficiency virus (HIV) pharmaceuticals and vitamin D deficiency.
In other words, it’s not good to have high blood pressure. And some leading causes are a matter of behavioral choice. The pharmaceutical industry has responded in kind with roughly 20 different drugs to treat the condition, which fall into the following four categories — and each has its own set of side effects:
- Ace inhibitors. These reduce blood pressure through a complicated chain reaction involving kidneys, the adrenal gland and pulmonary circulation. The drugs Zestril, Coversyl, Renitec and Lispril fall into this category. Common side effects are a dry cough, headache, dizziness, fatigue, nausea and renal impairment.
- Angiotensin receptor blockers. Diovan, Approval, Advent, Lostress, and Easiday fall into this category. They prevent body-produced hormone angiotensin from performing its natural function on blood vessels. Common side effects include headaches, nausea and gastrointestinal distress.
- Beta blockers. Examples are Tenormin, Atenolol, Concor and Probase. These drugs prevent nervous system signals sent to blood vessels. Side effects include dizziness, lightheadedness, drowsiness and blurred vision — and possibly cold hands and feet as well as confusion, depression, rash, swelling and breathing problems.
- Calcium channel blockers. Examples are Isoptin, Calan, Herbessor, Norvasc and Sofvasc. In the process of keeping calcium out of the heart and blood vessel cells, these drugs can cause palpitations, constipation and edema (swelling of the ankles and feet).
Hair loss is associated with some hypertension medications. According to Joe and Terry Graedon, authors and teachers on health and pharmaceutical products who provide information on medications through their Web site, PeoplesPharmacy.com: “Beta blockers such as Metoprolol (Lopressor, Toprol XL) and Atenolol (Tenormin, Tenoretic) may cause hair loss,” they say, adding “a surprising number of medications can cause hair loss as a side effect.” Most often, this type of hair loss is reversible, after the patient goes off the medication that is found to be responsible.
I worked in a clinical setting with people on some of these medications. For three years I was a research assistant on a study of peripheral arterial disease (aka PAD), a condition that makes it painful to walk more than short distances. The study looked at the effects of treadmill and strength training for individuals with this condition, to see if exercise could improve their leg function. Almost all patients were 65 years and older, and almost all were on some medication for HBP. But a funny thing happened with many patients in the study. As they adopted a thrice-weekly, one-hour exercise regimen, their blood pressure dropped naturally. Under their doctors’ supervision, many reduced or eliminated use of those medications altogether.
This suggests something remarkable. For many people, even the elderly, adoption of a regular, moderate exercise program can eliminate the need for medication (diet is known to affect blood pressure as well, but dietary improvement was not part of the protocol in the study I worked on). Just three sessions a week on a treadmill — about 45 minutes total, with frequent rests — did it.
Diet and exercise – and cut the salt
But you would never know that exercise works, given the pharmaceutical advertising. And doctors often assume that patients just aren’t going to bother to exercise or improve their diets.
The National Heart, Lung and Blood Institute (NHLBI), a part of the National Institutes of Health, developed the Dietary Approaches to Stop Hypertension (DASH) eating plan a few years ago. Based on an accumulation of research, DASH emphasizes consumption of fruits, vegetables, whole grains, poultry, fish and nuts. It advocates for foods lower in saturated fats, total fats and cholesterol.
A second part of the NHLBI regimen, DASH-sodium, studied dietary sodium reduction. The study looked at individuals on the DASH diet as well as those with more typical, unhealthy diets, then reduced salt intake in both groups. Individuals with both types of diets benefited, but those on the DASH diet achieved the bigger result.
In other words, if you do nothing else, reduce the amount of salt you use in your food. (For ideas on reducing salt intake with herbs, spices and juices, see The Smart Way to Salt Reduction.)
How they did it — stories on reducing hypertension without pharmaceuticals
The DASH diet is a good program, and there are several books published on it that include recipes. But sometimes it helps to know about specific directives or programs that people follow to overcome hypertension. Here a few such cases that we were able to uncover.
- Woody McMahon, with degrees in human biology, chiropractic medicine and a certification in personal training, works with clients with all kinds of health problems, including those typical of middle age. Through his company, Sequoia Health and Fitness (Herndon, Va.), he helped a 50-year-old female client reduce her blood pressure reading from 145/90 to 107/70. The program consisted of an integrated cardio- and weight-training exercise program, a diet that managed portion sizes and was composed of at least 50 percent fruits and vegetables, and stress reduction through meditation. He also encourages all trainees to get adequate hydration, because dehydration can trigger HBP.
- Personal fitness trainer Josef Brandenburg (The Body You Want, in Washington, D.C.) worked with three clients in 2010 who were able to go off their HBP medications as a result of lifestyle changes. “The clients’ ages range from 30 to mid-50s,” he says. “It took about three months for one of the clients and about six months for the other two. They achieved this by drastically reducing their intake of refined carbohydrates in addition to consistent exercise. By reducing their refined carb intake and consistently doing resistance training and interval training, they got rid of stubborn stomach fat and reduced their high blood pressure.”
- Fitness planning consultant Adam E. Kessler (based in Dublin, Ohio) worked with a client who lost 50 pounds through diet. His doctor told him that if he could lose 50 pounds and things looked OK, he would take him off hypertension medication. Says Kessler, “My client was only 34 at the time and embarrassed by this fact. He dropped the 50 pounds essentially by changing his diet. He ate a much cleaner diet, avoiding sodium, saturated fats and processed foods. Stopped smoking and his physique looks completely different. His doctor did take him off the meds.”
So clearly, it can be done. And it’s no accident that the lifestyle changes each person adopted are beneficial in many other ways.
Perhaps for every patient who opts for the non-Rx route, addressing his or her condition through diet, lifestyle and maybe stress-management techniques, the key question boils down to quality of life. Do you want to deal with the side effects of medication — possibly even hair loss — all the while knowing that a healthy diet and physical fitness could accomplish the same thing?