Once you know you have hypertension or you are at risk of developing hypertension, it’s important to follow a comprehensive programme of lifestyle changes. But what exactly does this involve?
Hypertension can seem like some cruel lottery – why me and not them? And yes, many people simply inherit hypertension.
Fortunately there are many risk factors that you can control, mostly by changing your lifestyle. By making and maintaining these adaptions many people are able to control their hypertension without medication.
Lifestyle modification is also important for those with other risk factors who do not have hypertension yet. This can delay or prevent them from developing high blood pressure and heart disease.
1. Bodyweight – lose it
Losing excess weight is the most effective way in which you can lower your blood pressure, besides medication. Some studies find that for every kilogram of weight lost, blood pressure drops with 2,5 mm Hg systolic and 1,5 mm Hg diastolic. A Body Mass Index of more than 25 is considered as overweight.
2. Exercise - move it
A high activity level not only helps to maintain a healthy weight, but also lowers your blood pressure and improves your overall cardiovascular health. It strengthens your heart and lungs, and tones your muscles, increasing your lean body mass. As a bonus, it is also a powerful stress-reducing tool. Exercise should be regular and dynamic, according to your ability and medical advice. As a rapid resting pulse rate is seen as a risk factor for hypertension by some experts, being fitter can only benefit you. Twenty minutes of brisk walking four times a week, is a good start.
3. Eating and drinking – it’s what you put in
The word "diet" signals deprivation to many people. However, adopting a health-giving eating plan can be very rewarding and is quite easy. Opt for low fat, high fibre food including whole grains and legumes. Eat plenty of fresh fruit and vegetables to supply potassium and other crucial nutrients. Choose low-fat dairy products and experiment with lean meat like ostrich. Fatty fish, like salmon and tuna, contains omega-3 oils that protect your heart. See the DASH eating plan for a user-friendly guide.
Many people are highly sensitive to salt (sodium chloride), and that leads to a rise in blood pressure. Try to limit intake to 6 g (one teaspoon) per day. Do this by adding less salt during cooking and adding no salt to food at the table. Most important is to avoid processed foods, which is full of sodium, in many forms. Salt is also bad news for your kidneys, one of the target organs that can be damaged by hypertension and vascular disease.
Potassium seems to replace and eliminate excess sodium from the body, which reduces blood pressure in salt-sensitive people. It protects you and can be found in potatoes, nuts, bananas and other fruit. Increase your intake of this heart-friendly mineral.
Regular drinking, especially heavy drinking, can raise blood pressure. Men with hypertension should limit their intake to no more than two drinks per day, and women to one drink a day.
Although still much debated, coffee produces a temporary increase in heart rate and blood pressure, also in people who do not suffer from hypertension. It would be wise for hypertensive people to avoid the repeated elevations in blood pressure by drinking less coffee.
Blood lipids – bad fats
High cholesterol, especially the “bad fats”, like LDL-cholesterol and triglycerides, cause damage to the lining of arteries. These fatty deposits, called plaques, partially obstruct and reduce flow through the blood vessels. High HDL-cholesterol, however, seems to play a protective role. Diet and lifestyle changes are very important, and sometimes lipid-lowering drugs are necessary.
Smoking – snuff it
Smoking is a major culprit, causing damage to the heart and blood vessels. Adding insult to injury, it also raises the blood pressure by constricting and therefore narrowing the vessels. A disaster triangle of disease is formed when people with hypertension and high cholesterol opt to smoke. It is the most preventable cause of premature death in the Western world.
Smoking is a well-known health hazard affecting many organs, causing cancer and numerous other diseases. If you do smoke, add years to your life by making every effort to stop.
Medication and recreational drugs
Actually a secondary cause, it is important to realise that certain drugs affect blood pressure. The contraceptive pill can raise the blood pressure of some women, especially if they smoke. This is of even greater importance after the age of 35.
Many drugs, whether illicit drugs like Ecstasy or cocaine, or over-the-counter drugs like anti-inflammatories can raise your blood pressure. Remember to inform your health professional about your self-medication.
The good news about all these lifestyle factors is that you can participate in improving your health enormously.
(Dr Kathleen Coetzee, MBChB.)
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