I know you were told that if your blood pressure is below 140/90, it is normal. Unfortunately, this is not true, either. It is average - not normal. This number is used because it is the midpoint of adult Americans older than sixty. The risk for strokes and heart attacks starts climbing at 115/70.
In societies where we do not see high rates of heart disease and strokes, we don't see blood pressure increase with age. In rural China the healthy elderly had the same low blood pressure readings as they did when they were kids. Almost all Americans have blood pressure that is unhealthfully high. At a minimum, we should consider blood pressure higher than 125/80 abnormal.
Numerous scientific investigations have shown that the following interventions have some degree of effectiveness in lowering blood pressure.1
- Weight loss
- Sodium restriction
- Increased potassium intake
- Increased calcium and magnesium intake
- Alcohol restriction
- Caffeine restriction
- Increased fiber intake
- Increased consumption of fruits and vegetables
- Increased physical activity or exercise
Studies have shown controlling sodium intake and weight loss to be effective in reducing blood pressure, even in the elderly.2 How can you implement these interventions into your lifestyle? It's simple. Eat many more fruits, vegetables, and legumes; eat less of everything else; and engage in a moderate amount of exercise. High blood pressure is relatively simple to control.
I encourage my patients to do what it takes to normalize their blood pressure so they do not require medication. Prescribing medications for high blood pressure has the effect of a permission slip. Medication has a minimal effect in reducing heart attack occurrence in patients with high blood pressure because it does not remove the underlying problem (atherosclerosis), it just treats the symptom. Patients given medication now falsely believe they are protected, and they continue to follow the same disease-causing lifestyle that caused the problem to begin with, until the inevitable occurs -- their first heart attack or stroke. Maybe, if high blood pressure medications were never invented, doctors would have been forced to teach healthful living and nutritional disease causation to their patients. It is possible that many more lives could have been saved.
1. Miller, E. R., T. P. Erlinger, D. R. Young, G.P. Prokopowicz, and L.J. Appel. 1999. Lifestyle changes that reduce blood pressure: implementation in clinical practice. J. Clin. Hypertens. 1: 191-90; J., R. Fagard, P. Lijnen, et al. 1989. Body weight, sodium intake and blood pressure. J Hypertens. 7: S19-S23; Appel, L.J., T.J. Moore, E. Obarzanek, et al., for the Dash Collaborative Research Group. 1997. A clinical trial of effects of dietary patterns on blood pressure. N. Eng. J. Med. 336: 1117-24.
2. Whelton, P.K., L. I. Appel, M.A. Espeland, et al. 1998. Sodium reduction and weight los in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly. JAMA 279:839-46.