Heart Health / By Scott Ewing, DO / May 12, 2022
Did you know that nearly half of all adults in the US have high blood pressure? As a practicing interventional cardiologist, I see patients with high blood pressure, or hypertension, every day and can verify this statistic. The good news I give to those who do have high blood pressure is this—they have the ability to improve their blood pressure with certain lifestyle choices. And so do you. Here’s how.
What is high blood pressure?
First, let’s define what we’re talking about. Blood pressure is the measurement of the force placed against the blood vessel walls by the blood flowing through the artery. High blood pressure is diagnosed when the pressure against the walls is persistently above normal. High blood pressure is also called hypertension.
It is measured in two numbers, the systolic over the diastolic blood pressures. The systolic blood pressure, or the upper number, is determined while your heart is contracting and squeezing out the volume of blood from within. The diastolic blood pressure, or the lower number, is determined between heartbeats when the heart is resting, and the pressure is at its lowest.
The current blood pressure guidelines are below. Be sure and check the American Heart Association or the American College of Cardiology for the most up to date guidelines, as they do change occasionally.
- Normal – less than 120 over less than 80
- Elevated – 120-129 over less than 80
- High blood pressure (hypertension) stage 1 – 130-139 over 80 to 89
- High blood pressure (hypertension) stage 2 – 140 or higher over 90 or higher
- Hypertensive crisis – higher than 180 over higher than 120.
Lifestyle habits to lower your blood pressure
So, how does lifestyle affect blood pressure? Let’s talk about several key ways that your lifestyle can impact your blood pressure, for better or for worse.
DIET
A diet low in fat and high in fiber such as fresh fruits and vegetables will help you maintain a healthy blood pressure. I recommend the DASH (Dietary Approaches to Stop Hypertension) diet. It was developed by the National Heart, Lung and Blood Institute.
The DASH diet is rich in these healthy foods:
- Fruits
- Vegetables
- Whole grains
- Low-fat dairy
- Meat, fish and poultry
- Nuts
- Beans
I also recommend the Mediterranean diet which is very similar but includes more dairy and cheese.
SODIUM INTAKE
American Heart Association guidelines specify 2300 mg of sodium daily—that’s equal to one tablespoon of salt. There are some easy ways to monitor your sodium intake.
Read food labels. Examine the ingredients list, as it usually includes the amount of sodium. In general, try to avoid or limit these foods that are notorious for being high in sodium:
- Fast food
- Canned foods
- Cured meats and cold cuts
- Canned soups
- Salty snacks like chips and popcorn
- Snack mixes
- Cheese and cottage cheese
- Vegetable juices
- Pickles
- Prepacked frozen dinners
- Breads and sandwiches
- Condiments
- Frozen shrimp
- Tomato sauce
- Burritos and tacos
ALCOHOL
Too much can cause hypertension. Current guidelines recommend two drinks per day for men and one drink per day for women. Of course, no alcohol consumption is also acceptable. While the myth of drinking one glass of red wine per day is widespread, there is no good data to back up the theory.
WEIGHT
People who are overweight are more likely to have hypertension. Talk to your doctor about what a healthy weight looks like for you, and how to maintain it.
If you want to lose weight, set a reasonable goal. I tell my patients to try to lose one pound a week. Get a bathroom scale and weigh yourself. Know your starting point and use the scales to keep track of your progress. Be sure to celebrate and be proud of what you’ve accomplished.
PHYSICAL ACTIVITY
Get up and move! The Centers for Disease Control and Prevention recommends 150 minutes per week. Think of it as 30 minutes, five days a week, or whatever breakdown works best for your schedule.
Start a regular daily exercise program. Here are a few tips for getting started:
- Begin slowly, say 15 minutes three times a week. Gradually increase your exercise until you reach the recommended 150 minutes per week.
- Set incremental goals you can achieve and celebrate as you progress.
- If you don’t want to count minutes, count steps instead. Carry your smartphone or wear a smartwatch. Each has an app that will allow you to count your steps. A recent study suggested 7,000 steps per day is a great starting point, although my wife and I do 10,000 steps a day which includes our seven-day-a-week 45 minute-walks in the evening.
- Get your spouse, significant other, coworker or friend involved so you can keep each other motivated.
My advice to you is the more exercise, the better. Don’t stop. If walking is not right for you, there are many other choices for cardiovascular exercise that you will benefit from. Besides walking, other exercises include running, treadmill, elliptical, stair stepper, rowing, bicycling, stationary bicycling, swimming laps, water aerobics and even yoga.
SMOKING
Smoking increases your chances of having hypertension, so please stop. Talk to your doctor if you need help.
STRESS
Living with constant stress can lead to or worsen hypertension. We all experience stressful times, but try incorporating exercise, listening to music, meditation or going for a walk. All these techniques and habits have been shown to reduce stress.
Factors you can’t change
The above components are related to lifestyle choices you can make to improve your blood pressure. There are, however, other factors that affect hypertension that are not a matter of choice:
- Family history. Your genetics play a big role.
- Age. The older you are, the more likely you are to have hypertension.
- Race. African Americans are sometimes more likely to have hypertension.
- Gender. Men are more likely to have hypertension than women.
The dangers of uncontrolled hypertension
Patients often ask me about the consequences to their health if they don’t improve and manage their blood pressure. Here are the sobering facts:
- If you have hypertension, you are three times more likely to die of a heart attack and heart disease.
- Hypertension causes hardening of the arteries and hardening of the arteries causes hypertension. A vicious cycle.
- High blood pressure increases your chances of having a stroke.
- Hypertension is the leading cause of kidney disease and going on dialysis.
- Hypertension is the number one cause of morbidity and mortality when it comes to heart disease.
- Hypertension is a leading cause of eye disease and blindness.
- Uncontrolled hypertension can lead to the diagnosis of hypertensive heart disease with or without congestive heart failure. Hypertensive heart disease usually includes thickening of the walls of the heart along with stiffening of the heart muscle making it harder for the heart to fill with blood and pump effectively.
Managing your blood pressure is an investment in your future. It will save you money and help you live well for longer.
Maintaining a heart-healthy lifestyle
Making healthy lifestyle choices and maintaining a healthy lifestyle is hard. Start with baby steps. Check your blood pressure at home regularly, too. There are many good, reasonably priced blood pressure cuffs available online and at your local drug stores.
Three years ago, I decided I wanted to make a change. By following many of the suggestions above, especially eating less and increasing my physical activity, I’ve lost 40 pounds and I’ve improved my blood pressure. If I can do it, so can you. Your heart will thank you for it.
Worried about your heart health? Find a heart specialist near you.
About the author
Scott Ewing, DO
Dr. Scott Ewing, DO, is an interventional cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Fort Worth.
