Hypertension (or high blood pressure), like any other cardiovascular disease, is managed partly through medication and partly through lifestyle changes. Globally, certain hypertension-related guidelines (e.g., those by the British Hypertension Society, the Korean Society of Hypertension, and the American Heart Association [AHA]) strongly recommend lifestyle modification in people with hypertension, (1-3) which includes weight loss, eating a healthy diet (quality as well as quantity), physical exercise (aerobic and weight training), reduced salt intake, and reduced alcohol consumption.
Making lifestyle changes can be challenging. It is easy to take a pill in the morning, but hard to start jogging or meditating for 20 minutes daily. In fact, only half of those with hypertension make changes to their diet and physical activity. (4) However, pills only do so much.
Here, you will learn why it is important to make healthy changes in your life and how these changes will go a long way in not only improving your test results but also the quality of your life.
1. Pills vs. Lifestyle
Antihypertensive medications form a crucial part of your blood pressure treatment. However, without lifestyle modifications, you might need higher doses and/or additional pills to keep your blood pressure under control. Plus, medication alone won’t prevent the risk of other complications associated with hypertension. Diet and exercise will improve your cardiometabolic profile, which may cause you to take, even in the long run, only one tiny pill a day.
2. Focus on ‘best’
Recently, the AHA guidelines (2017) have revised their definition of hypertension to >130/80 mm Hg, and have classified blood pressure between 120 and 130 mmHg as ‘prehypertension’. (2) These revisions reflect the need to get one’s blood pressure down to the best range, and not just to ‘acceptable’ levels. Therefore, at the moment, there is extra pressure to meet the target blood pressure as prescribed in the guidelines, and if lifestyle changes are not made, the doctor will have to prescribe extra pills.
All the guidelines are specific on cutting back on smoking because it is associated with a very strong risk of cardiovascular disease: it can cause a heart attack or stroke even if the person’s blood pressure is under control! (1)
A healthy diet helps in weight loss and lowers blood pressure. The Dietary Approaches to Stop Hypertension (DASH) or Mediterranean diet (or some version of it) can improve blood pressure by an average of 11/6 mmHg. (1) But, such a diet does a lot more: it lowers the risk of type 2 diabetes, heart failure, and stroke; it reduces the heart rate, and it improves the general condition of your heart and metabolism. (3)
Halving your salt consumption (to <5 gm of salt per day) alone can reduce your blood pressure by 4-6 mmHg. (1) Although there is some variation with this figure, the salt restriction remains a simple and effective means of reducing blood pressure.
For hypertension, it is recommended to do at least 150 minutes of moderate to heavy intensity aerobic exercise per week, in addition to weight training at least once or twice a week. Physical activity, in addition to diet changes, can reduce blood pressure by an additional 15/7 mmHg. (3)
Do these changes add up when combined? Yes! Combining diet and exercise reduces the risk of complications associated with hypertension by 75%! (5) Moreover, it also improves almost all metabolic parameters (e.g., cholesterol, waist circumference, etc.) higher than the control conditions.
8. Sexual health
High blood pressure is also linked to sexual dysfunction in many ways; also, nearly all of the lifestyle factors can independently cause sexual dysfunction. Additionally, a few antihypertensive medicines themselves cause erectile dysfunction. (6) This is another reason why non-pharmacological approaches to hypertensive treatment are crucial.
9. Physical appearance
Last but not least, a healthy lifestyle makes you look and feel healthy, improves your focus and productivity, makes you feel less tired during the day, and enhances your skin condition.
It can be difficult to see the long-term effects of lifestyle modifications. These changes can be hard to make, but there is ample evidence to show that they benefit patients in many ways, much beyond blood pressure reduction. Join a gym or partake in any physical activity and use apps like Wellthy to help you lead a holistically healthy lifestyle.
- Shin J, Park JB, Kim KI, Kim JH, Yang DH, Pyun WB, et al. 2013 Korean Society of Hypertension guidelines for the management of hypertension. Part II—treatments of hypertension. Clinical hypertension. 2015;21(1):2.
- Ioannidis JP. Diagnosis and treatment of hypertension in the 2017 ACC/AHA guidelines and in the real world. Jama. 2018;319(2):115-6.
- Nicoll R, Henein MY. Hypertension and lifestyle modification: how useful are the guidelines? 2010; 879-880.
- Abu HO, Aboumatar H, Carson K, Goldberg R, Cooper L. Hypertension knowledge, heart healthy lifestyle practices and medication adherence among adults with hypertension. European Journal for Person Centered Healthcare. 2018;6(1):108-14.
- Malakou E, Linardakis M, Armstrong M, Zannidi D, Foster C, Johnson L, Papadaki A. The combined effect of promoting the Mediterranean diet and physical activity on metabolic risk factors in adults: a systematic review and meta-analysis of randomised controlled trials. Nutrients. 2018;10(11):1577.
- DeLay KJ, Haney N, Hellstrom WJ. Modifying risk factors in the management of erectile dysfunction: a review. The world journal of men’s health. 2016;34(2):89-100.