ASK DR. BAUGHAN                                                         April 24, 1997

LOWER BLOOD PRESSURE WITHOUT DRUGS

The medical profession has been criticized for emphasizing drugs more than a healthy lifestyle.  Therefore, I am pleased to highlight the lead article in the April 17, 1997 issue of the New England Journal of Medicine (which I note did not get a big play-up elsewhere in the media).  Researchers from Johns Hopkins University reported the results of the DASH study (Dietary Approaches to Stop Hypertension) - no relation to Mrs. Dash seasonings.  This study, conducted over two years, reached the following startling conclusion:  “A diet rich in fruits, vegetables, and low-fat dairy foods and with reduced saturated and total fat can substantially lower blood pressure.”  In other words, Grandma was right, “Eat your fruits and vegetables.”  Unfortunately, Grandma often cooked with lard, too.  So much for nostalgia.

This study showed that in people with normal blood pressures, the diet would modestly lower their blood pressures, but in people with high blood pressure (hypertension), the diet would lower the systolic (first number) and diastolic (second number) blood pressures an average of 11.4 and 5.5 mm Hg respectively.  This is about the average reduction one would expect from taking a single blood pressure medicine.  This diet contained 8 to 10 servings per day of fruits and vegetables and 2.7 servings of dairy products, almost twice the national average.  The blood pressure reduction occurred within two weeks of starting the diet.

Other dietary measures shown to help reduce blood pressure include limiting sodium (usually in salt) to 6 gm/day or less.  Note however, that only about half of people respond to salt restriction.  Diets high in potassium (citrus, tomatoes, bananas, etc.) help lower  blood pressure.  If your diet is low in calcium or magnesium, that may contribute to high pressures; it is less clear that supplements above average will reduce hypertension.

If someone is overweight, modest weight reductions of 10-15 pounds can lower blood pressure as much as some medicines.  Another important dietary consideration is alcohol.  More than 1 ounce of ethanol (24 oz beer, 8 oz wine, 2 oz liquor) per day can raise your blood pressure.

Other approaches to lowering blood pressure include exercise and stress management.  Regular exercise for 20 to 30 minutes at least 3 times a week helps.  More vigorous exercise helps more.  Walking, bicycling, swimming are ideal.  More than 25 years ago, Herbert Benson, M.D., demonstrated that sitting quietly for 30 minutes a day works as well as many pills.  His book, The Relaxation Response, remains a classic and is an easy and enjoyable read that I recommend regularly.  Finally, eliminating chronic stress, such as an abusive relationship or an oppressive job, has made the difference in many a person’s blood pressure.

One important caveat:  If you have a good diet, exercise, meditate and still have hypertension, don’t beat yourself up about it.  Don’t assume you are “doing something wrong.”  Lifestyle changes will not always avoid the need for medications, and there are no known special places in Heaven for those who successfully avoided the need for medicine.

Lifestyle changes can be difficult.  But consider this:  If you have hypertension, you may well be paying $50 per month or more for medicines.  Treating your blood pressure for 20-30 years would cost you $12 - $18,000 in medicines alone.  (Let’s not discuss seeing your doctor less often)  That’s a nice car you could have had, or a down payment on a house.  Wouldn’t it be worth a concerted effort to see if you can bring your pressure down with these approaches?  Another perspective:  43 million Americans have hypertension.  Suppose one-fourth of them could control their blood pressures by lifestyle change.  Over 20 years the country could save around $150 billion, a nice chunk out of the national debt.  Fruits and vegetables, anyone?