You may not need to take drugs to bring blood pressure down.
Currently, normal blood pressure is defined as less than 120/80 mmHg (millimeters of mercury, a measurement of pressure), according to the American College of Cardiology and American Heart Association.
The first or top number, systolic blood pressure refers to the pressure in the blood vessels as the heart beats. The bottom number, diastolic blood pressure is the resting pressure between heart beats. If your blood pressure, is consistently elevated (systolic of 120 to 129 and diastolic of less than 80) or you have stage 1 hypertension (systolic of 130 to 139 over diastolic of 80 to 89), treatment typically doesn't begin with medication. Instead, you'll probably start with non-drug, lifestyle-based approaches, and the more of these healthy changes you make, the more you can optimize your numbers.
Waist size in itself is an independent driver of high blood pressure, says Dr. Miles Hassell, medical director of the Comprehensive Risk Reduction Clinic at Providence St. Vincent Medical Center in Portland, Oregon. He describes a patient, about 60 years old, who has a systolic blood pressure of 160 but really doesn't want to take drugs to treat it. Losing weight can help patients like this shed pounds, whittle their waistlines and therefore decrease their blood pressure, he says.
"For example, if you lose 20 pounds, that can actually lower your blood pressure somewhere between 5 and even up to 20 mm/Hg," says Dr. Jacqueline Latina, a clinical and research cardiovascular disease fellow at Johns Hopkins Hospital in Baltimore. Of course, as with any method, the effects vary from person to person.
An inactive lifestyle is an invitation for hypertension. Becoming more physically active can help lower your blood pressure.
In some cases though, lifestyle changes alone might not be enough to control high blood pressure, particularly if you already have a medical condition like heart disease. In the cardiology clinic where Latina practices, most patients are already on antihypertensive medication.
However, she says, she tries to additionally recommend healthy lifestyle changes to lower blood pressure. Exercise is one. "We typically recommend 30 minutes, five times a week -- so 150 minutes of moderate-intensity exercise." That can lower your systolic number by 5 to 9 mmHg, she says. Moderate-intensity exercise might include brisk walking, swimming or biking.
Ease up on alcohol.
Raising your glass can also raise your blood pressure. If you're having more than a couple of alcoholic beverages a day, cutting down can improve your health. "Limiting alcohol can reduce your blood pressure by about 2 to 4 mmHg, so limit yourself to one or two drinks a day," Latina says. "(Cutting back) to one drink if you're a woman, two if you're a man -- or less -- tends to lower the blood pressure a little."
With caffeine, Latina says, the jury is still out. She generally recommends limiting caffeine or tea to one or two cups a days. "We do know that energy drinks definitely can cause hypertension. Coffee and tea are better than energy drinks, or than having a caffeine pill."
Eat more vegetables.
There is excellent evidence from DASH and Mediterranean diet studies that diets high in vegetables lower blood pressure, says Hassell, who is the co-author of "Good Food, Great Medicine: Recipes and Ruminations From a Medical Practice."
That's not surprising since DASH -- which stands for dietary approaches to stop hypertension -- was created with that goal in mind. The Mediterranean diet is a balanced eating plan that emphasizes plant foods such as veggies, fruits, whole grains, beans, nuts, legumes and olive oil.
A specific nutrient, like nitrate, may have independent antihypertensive action. Participants in one 2015 study published in the journal Hypertension who drank about 8 ounces of nitrate-rich beet juice daily for up to six weeks experienced a roughly 7 to 8 mmHg decrease in blood pressure, compared to no decrease for participants who had placebo drinks.
Avoiding salt can help keep high blood pressure at bay -- particularly if you're salt-sensitive, which means your blood pressure rises when you increase your salt consumption. Reducing salt includes setting aside your salt shaker and avoiding hidden sources of dietary salt, or sodium. Processed foods such as soups, frozen foods and canned goods tend to be higher in salt than home-cooked versions. Sprinkle on herbs and spices to season your food instead.
Adapting the way you cook, eat, drink and exercise may seem like a lot to ask. But staving off high blood pressure is truly that important, as it can lower a person's risk for everything from heat attack to stroke.
Insufficient sleep can elevate your blood pressure. "If you get less than six hours of sleep at night, that's been (associated) with hypertension," Latina says. Untreated sleep apnea can contribute to a host of health problems including heart disease and stroke, as well. There is "overwhelming" evidence to support the relationship between hypertension and obstructive sleep apnea, according to a review published September 2017 in the International Journal of Hypertension.
Even a single bad night's sleep can cause blood pressure to spike the next day, according to a study of 300 healthy people published earlier this year in the July/August issue of the journal Psychosomatic Medicine.
Not just your lungs suffer from smoking. With each cigarette, your risk for stroke and heart disease rises along with your blood pressure. "Long-term smokers can certainly have hypertension, and unfortunately the effects can be permanent," Latina says. "So they might have high blood pressure, even still after quitting smoking. Their vasculature -- their blood vessel walls -- are permanently damaged." That said, she adds that if someone quits, she'd expect their blood pressure to lower by 5 mmHg.
Of course, quitting can be difficult. Talk to your doctor about methods such as smoking cessation aids and counseling.
If your potassium levels are low, consuming more potassium can battle high blood pressure. Eating more potassium-rich foods, such as bananas, tomatoes and vegetables overall, can help lower your blood pressure by about 4 to 5 mmHg, Latina says.
One caveat, she notes: People who have abnormal kidney function shouldn't increase their potassium -- in fact, they may need to follow a low-potassium diet. In such cases, they'd likely already be on medication to control their blood pressure, if indicated.
Certain prescription and over-the-counter medications can increase your blood pressure. "The first thing we look at is: Is there something that's actually raising your blood pressure artificially?" Hassell says. Non-steroidal anti-inflammatory drugs (or NSAIDs) like ibuprofen (Advil and Motrin) and naproxen (Aleve and Naprosyn) can have this effect.
Decongestants containing pseudoephedrine (Sudafed) may increase blood pressure, as well. Some migraine and weight-loss medications can also raise blood pressure, as can ADHD medications such as methamphetamine (Desoxyn) and methylphenidate (Ritalin and Concerta).
For some patients, stopping a specific drug can help drop blood pressure back down, Hassell says. If you're concerned that any medication you're taking may be raising your blood pressure as a side effect, talk to your doctor or pharmacist.
Get a dog.
Having a pet offers many health benefits for owners, such as improved mood, increased socializing, reduced stress, motivation to walk more and better well-being. Dog ownership, in particular, has been linked to reduced blood pressure and longer life in studies. By simply petting a dog, you can temporarily lower your blood pressure in about 15 to 30 minutes after doing so, according to a 2004 study.
Natural Ways to Lower Blood Pressure
These non-drug methods can help reduce and control your blood pressure, either alone or in combination with prescribed medications:
-- Lose weight.
-- Ease up on alcohol.
-- Eat more vegetables.
-- Limit salt.
-- Sleep more.
-- Quit smoking.
-- Increase potassium.
-- Evaluate medications.
-- Get a dog.