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Blood Pressure Reduction with Lifestyle Change

 

 

Blood Pressure Facts

25% of the US adult population have high blood pressure, 50 million people.

Half of all people aged 60 or above have high blood pressure.

90% of people in the US will develop high blood pressure sometime in their life.

Almost 1/3 of BP-related deaths occur in people who don't have "high blood pressure" but whose pressure is above 120/80.

Everyone should aim for a pressure less than 120/80 for optimum health.

Lifestyle modifications that lower blood pressure include:

  • weight loss

  • low sodium intake

  • physical activity

  • no or low alcohol intake

  • high fruit and vegetable intake

  • low saturated fat intake

  • nonfat dairy

JAMA Apr 23/30, 2003

 

 

 

 

   A landmark study, called PREMIER1, on blood pressure reduction shows remarkable success using a lifestyle approach. According to the National Heart Lung and Blood Institute director Dr. Claude Lenfant in a recent news release, blood pressure reduction with lifestyle change was better than would be expected even if using medication.

The study included 810 people either with high blood pressure or at high risk for high blood pressure. Most were overweight and sedentary. The trial lasted 6 months. The participants were divided into three groups. The first group, called "advice only" received a one time 30 minute personal counseling session on lifestyle approaches to reducing high blood pressure.

A second group received multiple group education and counseling sessions relating to "established" practices for reducing blood pressure, namely:

  • Limited calorie intake to lose weight (goal 15 pounds in 6 months)
  • Regular exercise (goal 180 minutes per week)
  • Limited sodium intake (goal no more than 2400 mg of sodium/day)
  • Limited alcohol intake

The third group had the same treatment as group two above plus instructions on following the "DASH Diet" which included:

  • Increased intake of fruits and vegetables (goal 9-12 servings daily)
  • Low fat dairy such as milk or yogurt (goal 2-3 servings daily)
  • Low saturated fat diet (goal less than 7% of calories)
  • Moderate total fat intake (goal about 25% of calories)
  • Whole grain breads and cereal and nuts

The study lasted for 6 months, the recommended amount of time for persons with high blood pressure to try lifestyle approaches before resorting to medication to treat high blood pressure.

Here are the results:

  • All three groups dropped their blood pressures. The third group using the DASH diet and high intake of fruits and vegetables dropped the most, an average of 11.1 points in systolic pressure and 6.8 points diastolic pressure. This amount of change would result in about a 30% decreased risk of stroke, a 20% decreased risk of coronary heart disease, and a 15% decrease in mortality from all causes!
     
  • In the lifestyle change group plus the DASH diet, 77% of those who had high blood pressure at the start of the study were able to return to a normal blood pressure (less than 140/90). The researchers point out that this is even a better outcome than would be expected if these persons started taking blood pressure medications.
     
  • In the lifestyle change group plus the DASH diet, 48% of those in the "above optimal" blood pressure range dropped their blood pressures to the "ideal" level, less than 120/80. About one-third of the general population have blood pressures "above optimal".
     
  • Those on the DASH diet also lost the most weight, about 13 pounds during the 6 months. This was in spite of the large amount of fruits and vegetables they were encouraged to eat, 9 or more servings daily!

These are remarkable outcomes achieved just by adopting a healthy lifestyle and in only 6 months! Think of the potential health benefits to the 50 million Americans who have high blood pressure, and the other more than 50 million who have pressure above optimal levels. These same healthy lifestyle principles can also help prevent high blood pressure from occurring.

 
 

References
1. PREMIER research group, Effects of comprehensive lifestyle modification on blood pressure control, JAMA april 23/30, 2003
2. Whelton PK et al. Primary Prevention of High Blood Pressure, JAMA Oct. 16, 2002

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Making Healthy Choices articles are written by Don Hall, DrPH, CHES president of LifeLong Health with contributions from associated health professionals. Content is general health information from evidence based research. It's purpose is not to treat disease or take the place of advice by your doctor but to promote healthy lifestyles. Persons with health problems should contact their physician for specific guidance.

Copyrighted 2003 by PrevMedix LLC. All rights reserved. Do not make unauthorized copies.

Updated: 7-14-03 DRH