DEAR MAYO CLINIC: I’ve been on blood pressure medication for nine months. It has lowered my blood pressure, but I’m having trouble with side effects like dizziness. I eat a healthy diet and walk every day, but want to know if there are other ways to lower my blood pressure so that hopefully I can stop taking this medicine. I am only 57.
ANSWER: You’re on the right track. Eating well and staying active are two good ways to help control blood pressure. But there are more steps you can take that can make a difference and could eliminate your need for blood pressure medication.
Blood pressure is a measure of how much resistance there is to blood flow through your arteries. It’s recorded as two numbers: a top number and a bottom number. The top is called systolic pressure — the pressure in your arteries when your heart beats. The bottom number is diastolic pressure — the pressure in your arteries when your heart is at rest between beats.
Blood pressure generally is considered too high when the top number is more than 140 or the bottom number is more than 85. High blood pressure can lead to serious medical problems, including kidney disorders, heart attack, stroke and heart failure, among others.
Medication often is used to help keep blood pressure under control. But it may not be necessary for everyone who has high blood pressure. Estimates are that at least 25 percent of people in the U.S. currently taking blood pressure medicine might not need it if they made certain lifestyle changes.
One of the best things you can do for your blood pressure is to get to and stay at a healthy weight. Weight makes a significant difference in blood pressure because every pound you put on equals about five additional miles of blood vessels through which your heart has to pump blood. To meet the extra demand, your heart works harder. As it does, blood pressure goes up. Losing even a small amount of weight can lower blood pressure.
A healthy diet is key to healthy weight, and it benefits blood pressure, too. In particular, eat at least five servings of fruits and vegetables a day, and lower the amount of salt in your diet. Salt makes your body retain fluid, and the more fluid in your body, the higher your blood pressure. Processed, packaged and fast foods contain high amounts of salt. As much as possible, eat foods prepared from fresh ingredients, without added salt.
Weight loss can also combat another contributing factor to high blood pressure: sleep apnea. About half of all people with high blood pressure have this sleep disorder. When sleep apnea is left untreated, it can be difficult to get blood pressure under control. If you snore loudly, briefly stop breathing during sleep, wake feeling unrested, or have significant bouts of daytime sleepiness, consider being evaluated for sleep apnea.
Daily physical activity can also help lower blood pressure. As you move, your blood vessels open to allow for more blood flow, and they remain open for a time after you are done. As part of your activity, consider engaging in interval training — alternating bursts of intense activity with lighter activity. This type of exercise has been shown to be more effective in opening arteries than steady, continuous activity alone.
Limit the amount of caffeine and alcohol you have each day, and don’t smoke. Over time, caffeine, alcohol and tobacco can narrow and stiffen blood vessels, raising your blood pressure.
Finally, keep track of your blood pressure at home. A number of devices are available you can use to measure blood pressure. When you see those numbers on a regular basis, you become more familiar with what has an impact on your blood pressure and you gain a better understanding of how you can control it. — Stephen Kopecky, M.D., Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.