According to the CDC, as many as 47% of American adults have high blood pressure. Are you one of them? Hypertension increases your risk for heart disease and its many complications. It’s important to understand the risks and take control of your blood pressure.

A Lifestyle Approach to Decrease High Blood Pressure

The best medicine may be fruits and vegetables.

Diagnosis Life summary:
Doctors can prescribe more than drugs. A movement has them writing prescriptions for fruits and vegetables! A study in Circulation: Cardiovascular Quality and Outcomes (https://doi.org/10.1161/CIRCOUTCOMES.122.009520) looked to see how food vouchers impacted patients and families in low-income neighborhoods, including 2061 adults and 1917 children. Over 6 months, the odds of food insecurity decreased by one-third! Children and adults ate more fruits and vegetables. Adults with high blood sugar saw their HbA1C decrease by 0.29%. Those who had hypertension saw their systolic blood pressure decrease by 8.38 mm Hg, their diastolic blood pressure by 4.94 mm Hg. Adults who were overweight or obese saw a decrease in BMI by 0.36. That’s a lot of impact for a simple intervention. We need to see more of this.

Blood pressure control in middle age may help to prevent dementia.

Diagnosis Life summary:
In 2020, as many as 6 million Americans were living with Alzheimer’s disease. In 2050, that number is expected to jump to 13.8 million. We need ways to decrease the risk of developing dementia as we get older. A meta-analysis in Lancet Neurology (https:doi.org/10.1016/S1474-4422(19)30393-X) looked at 6 large studies that included more than 31,000 people 55 years and older. None of the participants had dementia at the start. Depending on the study, the participants were followed for 7 to 22 years. People with high blood pressure (> 140 systolic, > 90 diastolic) lowered their risk for Alzheimer’s disease by 16% when treated with anti-hypertensive medication. Check your blood pressure and do not hesitate to get treatment.

Both systolic and diastolic blood pressure readings affect your heart health.

Diagnosis Life summary:
People tend to think of the top number, the systolic blood pressure, as the bad guy. It looks like the bottom number, the diastolic blood pressure, could be just as troublesome. A study in the New England Journal of Medicine (https://doi.org/10.1056/NEJMoa1803180) looked at the blood pressure readings of 1.3 million adults. The researchers noted an increased risk for heart attack or stroke over 8 years for systolic blood pressure readings 130 mm Hg and above and diastolic readings 80 mm Hg and above. Systolic blood pressure had a greater effect. Keep an eye out on both measurements though. Your heart depends on it.

An evening workout may be more effective for men to get blood pressure control. 

Diagnosis Life summary:
Blood pressure can be hard to control. A simple change in routine could help men take charge of their hypertension. A study in Medicine & Science in Sports & Exercise (https://doi.org/10.1249/MSS.0000000000001852) divided 50 men into one of three exercise groups: cycling for 45 minutes between 7 am and 9 am (morning exercise), cycling for 45 minutes between 6 pm and 8 pm (evening exercise), or stretching in the morning or evening for 30 minutes (control). They performed exercise three times a week. After 10 weeks, aerobic workouts in the evening hours had more meaningful reductions in blood pressure than the other groups. This small study suggests that for the same amount of effort, the best time of day for a man to workout may be at night.

Lead exposure could explain hard-to-control hypertension.

Diagnosis Life summary:
Many people have a hard time controlling their blood pressure, even if they are on multiple medications (3 or more). Lead may be to blame. Even if you were exposed as a child and have normal blood levels as an adult, lead can be stored in the bones for decades. The problem is that few people are screened for this as adults. A study of nearly 500 veterans in the Journal of the American Heart Association (https://doi.org/10.1161/JAHA.118.010014) found a man’s risk of drug-resistant high blood pressure went up 19% for each 15 μg/g increase in lead levels in the shin bone. Not only could bone lead screening help identify the cause of uncontrolled hypertension, but it shows we need to be more proactive in preventing lead exposure in the first place.

A low salt diet can help decrease your blood pressure over time.

Diagnosis Life summary:
I know more than enough people who swear that a low salt diet doesn’t do much for their blood pressure. Research, however, suggests that most people will respond to cutting salt from their diet. A meta-analysis of 133 studies that included nearly 12,200 study participants was published in BMJ (https://doi.org/10.1136/bmj.m315). People who decreased their salt intake showed an average improvement in systolic blood pressure by 4.26 mmHg and diastolic blood pressure by 2.07 mmHg. More specifically, for every decrease in urinary sodium by 50 mmol, there was a 1.10 mmHg systolic drop and a 0.33 mmHg diastolic drop in blood pressure. The results were most pronounced for older, non-white people and for low salt diets that were longer in duration, > 2 weeks. Eating low salt for a week isn’t likely to make a big dent in your blood pressure but getting into the habit long-term may help you get it in control.

Mobile phone use may affect your blood pressure measurements!

Diagnosis Life summary:
It’s time to pull away from your devices. A study in European Heart Journal (https://doi.org/10.1093/ehjdh/ztad024) included more than 212,000 people in the UK who did not have hypertension. After 12 years of follow-up, 7% of them developed hypertension. The more time they spent on their mobile phones, regardless of other risk factors they had, the more likely their blood pressures went up. The risk was 7% higher on average for people using mobile phones when compared to those that did not use them at all. The risk also increased the more time spent on the phone, increasing to 8% for people on the phone for 30 to 59 minutes per week, to 13% for 1 to 3 hours per week, to 16% for 4 to 6 hours per week, and 25% for people using their phone 6 hours per week.

Tightening blood pressure control could extend your life by as much as 3 years.

Diagnosis Life summary:
High blood pressure increases your risk for heart attack and stroke. However, it remains unclear how low we should go. The SPRINT study in JAMA Cardiology (https://doi.org/10.1001/jamacardio.2019.6192) looked at approximately 9,400 adults with high blood pressure but no diabetes. The researchers randomized study participants into two categories, one treated with a goal systolic blood pressure < 120 and the other to a goal < 140. People who received the more intensive therapy had fewer cardiac events and lived longer by as much as 6 months to 3 years than those in the less intensive treatment group. Extension of life expectancy was greatest for those in their 50s and least for those in their 80s.