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  • 7/13/2010

High blood pressure? 5 key ways to bring it down

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By January W. Payne

Yes, many people will need medication. But remember that lifestyle changes can often do the job.

Hypertension affects about 74.5 million people ages 20 and older—or about 1 in 3 adults. Older people especially are at high risk; more than half of those ages 60 to 69 and about three quarters of those ages 70 and older have high blood pressure, according to a report published in the journal Hypertension. Normal blood pressure is considered to be less than 120 systolic (the top number) over 80 diastolic. Prehypertension is defined as 120 to 139 systolic over 80 to 89 diastolic, and hypertension includes blood pressure readings of 140 and above systolic and 90 and above diastolic.

But high blood pressure doesn"t have to be an inevitable part of aging. Making some changes to your lifestyle can help lower blood pressure—and offer other health benefits, too. Here are some of the most important steps you can take:

----Change your diet—and be consistent.

The DASH—Dietary Approaches to Stop Hypertension—diet, with lots of fruits and vegetables and low-fat foods and nonfat dairy items, is a widely recommended approach for lowering blood pressure. Studies show that the DASH diet can lower blood pressure in as little as 14 days, especially in people with moderately high blood pressure or prehypertension. For those with severe high blood pressure who need medication, the DASH diet can help improve the response to medication and help lower cholesterol, too. The DASH diet is recommended by the National Heart, Lung, and Blood Institute, the American Heart Association, and the 2005 Dietary Guidelines for Americans.

The key to lowering blood pressure using this approach is that you ""have to be consistent on a day-in, day-out basis,"" says Clyde Yancy, president of the AHA and medical director at the Baylor Heart and Vascular Institute at Baylor University Medical Center in Dallas. There"s one potential obstacle, if cost is a concern: ""It"s actually a more expensive diet to consume"" because of the need for fresh fruits and vegetables, he says.

---Lose some weight, then keep it off.

Research shows that losing weight helps to lower blood pressure—but you must maintain a lower weight in order to reap the benefits, experts say. ""People who are heavier tend to develop high blood pressure,"" says Ralph Sacco, president-elect of AHA and chairman of neurology at University of Miami School of Medicine. He notes that even modest weight loss makes a difference. Still, a body mass index of lower than 25 should be your goal in order to attain ideal cardiovascular health, according to the American Heart Association.

---Exercise regularly.

""Physical activity is critical to maintenance of weight loss and maintenance of weight,"" Sacco says. ""By exercising as little as 30 minutes each day, you can reduce your risk of heart disease and stroke."" But aim for at least 150 minutes of moderate-intensity exercise per week—including brisk walking, ballroom dancing, or gardening—or 75 minutes per week of vigorous activity, such as jogging, aerobic dancing, or jumping rope.

---Stop smoking.

Smoking temporarily raises blood pressure, though blood pressure will return to normal level 15 minutes after the person stops smoking, according to the 2003 Hypertension report. That makes it tough to assess blood pressure during doctor"s office visits if a smoker has just had a cigarette.

Beyond blood pressure, smoking is a ""critical risk factor for cardiovascular disease and stroke,"" says Sacco. ""We emphasize smoking because it"s such a controllable, modifiable behavior that has a big impact.""

----Be prepared to try medication.

Even people who make the necessary lifestyle changes sometimes still need medication to get their blood pressure into a safe range, Sacco says. And it"s important to know your blood pressure level so you can work with your doctor if it starts running higher than normal. If you do end up needing medication, diuretics (also known as water pills) are often a first-line treatment, and beta blockers, calcium channel blockers, ACE inhibitors, and ARBs (angiotensin II receptor blockers) may be used alone or in combination to lower blood pressure. ""Many people cannot get adequate blood pressure control with one medication, so your doctor may put you on more than one,"" Sacco says, and he may switch you from one to another to get the best results.

Source: U.S.News.com

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