Editors Choice

How I Dropped My Blood Pressure (and You May Too)

EVEN AFTER I came off testosterone supplementation (I needed it after I had a benign brain tumor removed), my blood pressure remained somewhat elevated. I turned to a healthy lifestyle to manage my blood pressure. I want to share with you some cornerstones of my approach to lowering blood pressure.

I had a cut in my visual field in 2015. A magnetic resonance imaging (MRI) study revealed a large tumor in my pituitary gland region. Fortunately, surgery showed it to be benign, but I still needed three surgeries to reduce the tumor’s total gross removal.

The pituitary gland greatly influences our blood levels of the hormone testosterone. As the tumor had compromised my pituitary function, I no longer made much testosterone. My care team recommended testosterone supplementation. While it fixed the blood levels of this so-called male hormone, my blood pressure rose from a baseline of 90/60 mm Hg to 140/95.

I cannot overemphasize the role lifestyle played in getting my blood pressure down. For many (but not all) of us, turning to more healthy habits may be sufficient to bring blood pressure down to a safer level. Even if you need medications to help control your blood pressure, you should still optimize your healthy habits.

First, I continue to avoid tobacco-containing products. You probably already know that there is no safe level of the substance. Nicotine raises blood pressure and pulse. It also narrows your arteries and hardens their walls, making it more likely for you to have a clot. Smoking stresses your heart, raising your risk of a stroke or heart attack.

Drinking too much alcohol can lift blood pressure to unhealthy levels. Having more than three drinks in one sitting raises your blood pressure temporarily, but repeated binge drinking can lead to long-term increases.

For my patients, I ask them to consume no more than one drink daily if they are female and two if they are male. Still, there does not appear to be any safe level when it comes to cancer risk.

Second, I improved my diet. For me, the DASH diet formed the foundation for my approach to eating. DASH stands for Dietary Approaches to Stop Hypertension and aims to lower blood pressure. This method includes lots of fruits and vegetables, whole grains, and several servings daily of low-fat dairy products, some fish, poultry, nuts, dried beans, nuts, and seeds. There should be minimal consumption of sweets, red meat, and sugary beverages.

Do DASH diets work? Absolutely. One study showed that following the DASH diet for eight weeks allowed participants with high blood pressure to drop their blood pressure by 11.4 mm Hg in systolic (the top number) blood pressure and 5.5 mm Hg in diastolic (the bottom number) blood pressure.

I used a particular DASH diet, one with a high level of proteins. This approach appears to be better than a high-carbohydrate DASH-like diet. The high-protein diet dropped systolic blood pressure 3.5 points more than the high-carb diet in people with hypertension, for a total 16.5 point reduction.

A bonus? The high-protein approach also dropped LDL (“bad”) cholesterol three points more than the high-carb diet. Both approaches lowered HDL “good” cholesterol slightly. I had to turn to healthier snacks than my preferred pretzels. You may wish to substitute carrot sticks for potato chips or crackers. Air-popped popcorn (without butter) is sometimes a go-to snack for me. Finally, I upped my unsalted nut intake.

These DASH diet results are comparable to the effects of some drugs. Because those with borderline high blood pressure had improvements, the DASH diet may prevent hypertension from developing.

Honestly, I have not always been good about added salt to my diet. I worked to cut my sodium intake to no more than 1,000 milligrams per day. I had read that the American Heart Association suggests no more than 1,500 milligrams per day for most adults), especially if you are at higher risk.

Salt sensitivity appears to be most prevalent among those of us who are middle-aged or elderly, overweight, or African-American. Salt sensitivity also tends to become more prevalent as we age. I also raised my dietary intake of potassium, striving for 3,500 to 5,000 milligrams daily.

I dropped my weight from 165 pounds to 143 pounds. Weight loss may lower blood pressure by 5 to 20 mm Hg per 10 kg of weight loss in a patient with more than 10 percent of ideal body weight. Not surprisingly, the amount of blood pressure-lowering varies significantly among individuals.

I aimed to get a minimum of thirty minutes of moderate aerobic exercise on virtually all days of the week. Regular physical activity can reduce blood pressure by 5 to 7 mm Hg for those who already have high blood pressure. This drop can translate to a reduction of cardiovascular risk by 20 to 30 percent or nearly one-third.

Besides blood pressure improvement, modest amounts of exercise can also improve cholesterol, reduce plaque buildup in your arteries, and lower the chances of unwanted clots. You may strengthen your muscles and bones and see benefits in mood and mental functioning. Of course, if you have heart disease or other health problems, please check in with your doctor before initiating an exercise program.

Finally, I reduced my stress levels. I began walking for 45 minutes daily. I also started box breathing and, for a while, did Vinyasa flow yoga. Alas, the last no longer appeals to me. While the association between stress and high blood pressure remains unclear, stress is known to contribute to risk factors such as a poor diet and excessive alcohol consumption.

So, you may wonder how well I did with my aggressive and multifaceted approach to health improvement. Remember that 140/95 mmHg blood pressure that served as a wake-up call for me? I give you today:

A healthy lifestyle — including avoiding tobacco, minimizing my alcohol intake, eating nutritious foods, watching my salt intake, exercising almost every day, and lowering my stress levels — led to a remarkable improvement in my blood pressure and cholesterol levels.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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