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Coping with High Blood Pressure By Vincent E. Friedewald, Jr. If you have been diagnosed with hypertension, your goal is simple: Bring your blood pressure down to a healthy level, and keep it there. Very few people should settle for less. In fact, many people with hypertension could do fine without medication. Take these simple steps, and watch your blood pressure fall. Know what’s going on in your arteries Don’t wait for your next trip to the doctor’s office. With proper instruction, measuring your blood pressure at home is easy and accurate. Regular self-monitoring also gets you intimately involved in your own care. Keep a blood pressure diary. Record your blood pressure measurements, including the time of day and notations about events that might have affected the readings, such as changes in medication, diet, or physical activity. Take your blood pressure diary with you every time you visit the doctor. A word of caution: Don’t use your blood pressure readings to self-medicate or to change doses of prescribed medications. That’s your doctor’s responsibility. Shed those extra pounds and move a little Lose the weight. Nothing is more critical than dropping those extra pounds. For some people, excess weight means the difference between normal and elevated blood pressure. Weight loss may also allow you to take lower doses of hypertension medications. Move a little! Sedentary folks have a significantly greater chance of developing hypertension. Regular exercise lowers blood pressure—and you don’t have to run a marathon to reap benefits. Brisk walking for 30 to 45 minutes three times each week will do just fine. Swimming and biking also help control hypertension, and they’re fun. But whatever exercise you choose, make it a regular part of your life, just like sleeping and eating. Another word of caution: If you have been inactive for some time, consult your doctor before starting any exercise program. Avoid table salt The sodium found in ordinary table salt can elevate blood pressure, especially in African Americans and the elderly. That’s one reason why diuretics—pills that rid the body of sodium—are so effective in treating hypertension in some people. To reduce salt intake, remove the saltshaker from the table. Cut back on snacks such as potato chips and pretzels, fast foods, processed foods, and frozen foods. Read the label on every type of food you buy—you may be shocked at how much sodium is in that little package! Potassium is a form of salt, too. But unlike sodium, potassium has positive effects on blood pressure. Folks who ingest a lot of potassium tend to have lower blood pressure. Most fruits and vegetables are high in potassium, and as an added bonus, they are low in calories and high in fiber. Other salts include calcium and magnesium. Despite some evidence that these salts may help lower blood pressure, their role is uncertain right now. For the time being, focus on lowering your sodium intake and adding more potassium to your diet. Cut back on fat You’ve surely heard this one before: restrict your intake of fatty foods. One of the main reasons for controlling blood pressure is to reduce the risk of developing atherosclerosis, which leads to heart disease and stroke. Diets high in saturated fats accelerate atherosclerosis. Confused? Follow DASH, an ideal diet for persons with hypertension. DASH stands for Dietary Approaches to Stop Hypertension. This diet is rich in low-fat dairy products, calcium, potassium, magnesium, fiber, and vitamins. And don’t keep the fun all to yourself; following DASH is good for everyone. Put your whole family on DASH. After all, if you have hypertension, it’s likely someone else in your family is at risk as well. Cut back on the hooch, and quit smoking already Drink less alcohol. Excess alcohol intake contributes to hypertension, reduces the effectiveness of blood pressure medications, and increases the risk for stroke. Need guidelines? Adult men should limit their daily intake to 24 ounces of beer, 10 ounces of wine, or 2 ounces of 100-proof whiskey. Women and lightweight males should consume only half these amounts. A note of caution: A heavy drinker who suddenly stops consuming all alcohol may develop higher blood pressure for a few days. Stop smoking. Now. The nicotine in cigarettes raises blood pressure with every puff. Need help? Consider nicotine replacement products. These stop-smoking aids don’t contain enough nicotine to raise blood pressure. Need more help? The Centers for Disease Control maintains a list of resources to help you quit smoking. Don’t believe the hype As with any disease, hypertension has its share of stories about miracle cures and remedies. Make sure you’re not putting your money and energy into a treatment that won’t work. Myth: Garlic and onion reduce blood pressure You may have heard that diets high in garlic and onion will lower your blood pressure. Scientific studies have failed to show that these foods have any consistent effect on blood pressure. Don’t endure garlic or onion breath to lower your blood pressure—they don’t work. Myth: To bring down blood pressure, just relax While it is true that emotions like stress and anxiety can temporarily raise blood pressure, relaxation-training therapies including biofeedback and meditation have not been scientifically proven to reduce hypertension. And learning these techniques can be pricey. You might do better investing your time and money in a good pair of walking shoes, a bicycle helmet, or a swimsuit. Myth: People with high blood pressure shouldn’t drink coffee Go ahead, enjoy that cup of joe. The caffeine in a cup of coffee may temporarily increase blood pressure, but the long-term effects are not harmful. Stay informed There is a lot we don’t know about hypertension. The huge amount of research underway is bound to expand our knowledge and the arsenal of tools we use to fight hypertension in the coming months and years. Stay informed of developments when they occur. Read, surf credible Web sites, and watch the news. When you learn of something new that might relate to you, first ask your doctor about it. On the Web, the American Heart Association offers extensive information about the diagnosis and treatment of hypertension. The National Institutes of Health publishes “Your Guide to Lowering High Blood Pressure,” a comprehensive site with quizzes and a community group to help you learn more tips for reducing hypertension.