Lifestyle Modification and Hypertension

I am going to write about lifestyle modification and hypertension.

Lifestyle changes and high blood pressure

You should embrace lifestyle modification if you are being treated for high blood pressure because not everyone with high blood pressure requires pharmacologic therapy. Treatment of high blood pressure should include lifestyle modification alone or jointly with antihypertensive medication(s) ordered by your doctor.

Research shows that moderate dietary salt restriction produces a decrease in blood pressure in people with high and normal blood pressure 4.8/2.5 and 1.9/1.1mmHg, respectively. Approximately 90% of our sodium consumption comes from dietary salt. As far as safety is concerned, humans possess the magnitude to continue living at extremes of sodium ingestion from less than 200mg per day of sodium in the Yanomami Indians of Brazil to over 10,300 mg per day in Northern Japan. This ability of humans to survive at excessively low levels of sodium consumption is consistent with the capacity of the normal human body to preserve sodium by significantly decreasing losses of sodium in the urine and sweat.

The best accessible proof strongly shows a direct relationship between sodium ingestion and high blood pressure. On average, as sodium consumption is reduced, blood pressure is also decreased.

Weight loss, independent of physical activity, can produce a remarkable decrease in blood pressure in overweight and obese individuals. The weight loss induced reduction in blood pressure mainly ranges from 0.5 to 2mmHg for every 1 kilogram of weight loss, or approximately 1mmHg for every 1 pound lost.

Potassium supplementation does have an effect on blood pressure. Low potassium consumption increases the blood pressure and high potassium consumption decreases the blood pressure. Low dietary potassium consumption below 40 milliequivalents per day or 1.5 grams per day has been linked with an augmentation in blood pressure and an increased risk of stroke and an increment in risk of chronic kidney disease. A higher ratio of dietary sodium to potassium ingestion is linked with an increment in all-inclusive cardiovascular mortality.

In comparison to the increase in blood pressure associated with low dietary potassium consumption, potassium supplementation decreases the blood pressure markedly in hypertensive individuals and insignificantly in normotensive individuals. Research shows that in hypertensive individuals increased potassium ingestion markedly decreased blood pressure by a mean of 5.3/3.1 mmHg. Research also demonstrates that the result of potassium supplementation on blood pressure was greater in the black population than in the white population. In one subgroup analysis individuals with an increase in potassium intake to 90 to 120 milliequivalents per day had the greatest decrease in blood pressure 7.2/4.1mmHg. Some experts recommend that individuals with high blood pressure should ingest at least 120 milliequivalents or 4.7 grams of dietary potassium per day with the caveat that they do not have a predilection to hyperkalemia (high potassium level).

The Dietary Approaches to Stop Hypertension (DASH diet) is high in fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, nuts, and low in sweets, sugar-sweetened drinks and red meats. The Dash diet is rich in potassium, calcium, magnesium, protein, and fiber but low in total fat, saturated fat and cholesterol. Research shows that the DASH diet, where all food was provided to normotensive or mildly hypertensive adults, was found to decrease the blood pressure by 6/4 mmHg compared with a usual American style diet that included the same amount of sodium and the same number of calories.

Aerobic and resistance exercise can reduce systolic and diastolic blood pressure by approximately 4 to 6 mmHg and 3 mmHg respectively, independent of weight loss. Most studies showing a decrease in blood pressure have enrolled 3 to 4 periods per week of moderate severity aerobic exercise lasting about 40 minutes for a duration of 3 months.

Most studies demonstrate that moderate alcohol consumption appears to have a cardioprotective effect even in individuals with high blood pressure. Adult men and women with high blood pressure should consume no more than two and one alcoholic drinks, respectively, daily. Women who have 2 or more alcoholic drinks per day and men who have 3 or more alcoholic drinks per day have a markedly augmented incidence of hypertension compared with those who don’t drink.

Fish oil and high blood pressure

Research demonstrates that fish oil supplementation decreased systolic blood pressure by 1.52 mmHg and diastolic blood pressure by 0.99 mmHg. Blood pressure was decreased in both hypertensive and normotensive individuals. The biggest effects were noted in those individuals with untreated high blood pressure, with systolic and diastolic blood pressure fall of 4.51 and 3.05 mmHg, respectively.

Coffee and hypertension

Caffeine is the most commonly used pharmacologically active substance in the world. Coffee and tea average 100 mg of caffeine per serving, colas 50 mg per serving and energy soft drinks as much as 250 mg per serving. Caffeine can acutely elevate the blood pressure by 10 mmHg in people who are seldom exposed. The acute rise in blood pressure precipitated by caffeine is more notable in hypertensive individuals compared with those with normal blood pressure; those with high blood pressure had a greater than 1.5 fold greater elevation in blood pressure. The hypertensive result may be more notable in older adults with hypertension.

Studies found little effect of chronic coffee ingestion on blood pressure and the risk of occurrence of hypertension.

Tea and hypertension

In the United States, 87% of total tea consumption is black tea, 12.5% is green tea and the remainder is oolong and herbal teas. Sour tea (Hibiscus sabdariffa) appears to lower systolic and diastolic blood pressure in individuals with moderate essential hypertension. Studies demonstrate that consumption of black tea notably reduces blood pressure in normotensive and mildly hypertensive individuals.

Chocolate and hypertension

One Study demonstrates that high polyphenol chocolate is efficacious in lowering triglycerides in hypertensive individuals with diabetes and lowering blood pressure and fasting blood sugar without having an effect on weight, inflammation, insulin resistance or glucose control.


Lifestyle modifications to treat hypertension include:

  • Dietary salt restriction
  • Potassium supplementation
  • Weight loss
  • DASH diet
  • Exercise
  • Limited alcohol intake
  • Black tea
  • Fish oil
  • Cocoa

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