Tips to Lower Blood Pressure

Risk Factors You Can Control
By making healthy lifestyle changes, including lowering sodium intake, improving diet and exercise, and reducing stress, you can lower blood pressure on your own terms.

One of the most effective ways to lower blood pressure is to reduce your sodium intake. Studies have shown that reducing the amount of sodium in your diet can you're your blood pressure 4-5 mmHg.

Why it works: While it is a complicated process, sodium can increase blood pressure by causing fluid retention and/or constricting blood vessels.

Your daily sodium intake should be:

2,300 milligrams of sodium or less: For adults up to the age of 50

1,500 milligrams of sodium or less: For those older than age 50, African-Americans, and those with high blood pressure

Sources: The National Institutes of Health and the American Heart Association

Goodbye Saltshaker

You might be surprised by the various ways sodium sneaks into your diet. Many high-sodium foods don't even taste salty.

In an average American diet, about 25 percent of sodium intake comes from the saltshaker, while 75 percent comes from processed foods.

Tip: Remove the saltshaker from the table.

Choose Low-Sodium Foods

Maintaining a diet rich in fruits and vegetables can decrease your blood pressure 8-15 mmHg.

Start small. Any high-sodium food you can eliminate counts. Willing to forgo salted peanuts but can't let go of pretzels? Start there.

Choose fresh, frozen, or canned foods without added salt. Or reach for low-sodium versions.

Cook Without Salt

Low-sodium cooking can be flavorful. Here's how to pull it off:

-- Season with herbs, spices, ginger, garlic, wine, lemon, and fruit juices.

-- Avoid salty seasonings such as bouillon, meat tenderizers, prepared sauces, and seasoning packets.

-- Drain and rinse canned vegetables and beans before preparing them.

Dine Out with Less Salt

Learn to recognize menu terms that indicate a preparation might be high in sodium, including:

-- pickled

-- smoked

-- au jus

-- teriyaki

-- soy sauce

-- in broth

Tip: Ask your server to have your food prepared without salt. Request salad dressings and sauces on the side.

Follow the DASH Diet

To help lower your blood pressure, the American Heart Association suggests following the DASH (Dietary Approaches to Stop Hypertension) eating plan.

The DASH diet:

-- Grains and grain products: 7 -- 8 daily servings

Vegetables: 4 -- 5 daily servings

-- Fruit: 4 -- 5 daily servings

-- Low-fat or nonfat dairy: 2 -- 3 daily servings

-- Meat, poultry, and fish: 2 daily servings or less

-- Nuts, seeds, and legumes: 4 -- 5 servings per week

-- Fats and oils: 2 -- 3 daily servings

-- Low-fat sweets: 5 servings per week

Check Your Medicines

Medications can also be a source of sodium. For example, some headache and heartburn medications are high in sodium carbonate or bicarbonate.

Tip: Ask the pharmacist for low-sodium, over-the-counter alternatives.

Consider Aspirin Therapy

Aspirin helps prevent heart attack by thinning the blood and preventing formation of clots that could clog an artery. Aspirin also protects against coronary artery inflammation. Talk with your doctor before starting aspirin therapy.

Dosage: Most patients take one or two low-dose (81 mg) tablets daily. Look for brands with enteric coating to protect against stomach upset.

Recommended for: Anyone with high risk of heart disease, as well as those who have had heart attacks or have been diagnosed with heart disease.

Not recommended for: You shouldn't take aspirin except under a doctor's supervision if you:

-- are pregnant

-- have uncontrolled high blood pressure

-- have a bleeding disorder

-- have asthma

-- have peptic (stomach) ulcers

-- have liver or kidney disease

Side effects: Gastrointestinal problems, including bleeding and/or ulcers. (The risk is less with low-dose formulations.)

Note: Because aspirin thins blood, those who take it daily must tell any doctor or dentist what dose they're taking before even minor surgery or any dental extraction.

Reduce Stress

High levels of stress can increase heart rate, which speeds up blood flow, which increases blood pressure. By taking steps to manage and reduce stress, you can reduce blood pressure. Here's how to do it:

-- Make "me time" a priority.

-- Tame morning mania by staggering wake-up times and keeping quick and healthful foods on hand for breakfast.

-- Say no to extra demands and streamline obligations.

-- Focus on things that you can do and that you can change.

-- Let go of things you have no control over.

-- Have more fun.

-- Handle disputes kindly and with patience.

-- Manage your money by establishing a budget.

Get Plenty of Exercise

Exercising for 30 minutes three to five times a week can lower your blood pressure 5 -- 7 mmHg.

To get started, try yoga. Its many benefits include:

-- blood pressure reduction

-- improved blood glucose in people with diabetes

-- improved mood

-- decreased pain and discomfort associated with chemotherapy for cancer patients

-- reduced back pain

Consider a Prescription

If lifestyle changes haven't been enough to reduce your blood pressure, your doctor may prescribe one of the following medications:

ACE inhibitors help prevent blood vessels from narrowing. (Lotensin, Univasc, Altace)

Alpha blockers block nerve impulses that tighten blood vessels. (Cardura, Minipress, Hytrin)

Alpha-beta blockers help the heart beat slower and less forcefully and block nerve impulses that tighten blood vessels. (Coreg, Normodyne, Trandate)

Angiotensin II receptor blockers help blood vessels widen. (Avapro, Cozaar, Diovan)

Beta blockers help your heart beat slower and with less force. (Lopressor, Toprol-XL, Corgard)

Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. (Norvasc, Cardizem CD, Plendil)

Central-acting agents help relax and widen blood vessels by controlling nerve impulses from the brain. (Aldomet, Catapres, Wytensin)

Diuretics help your kidneys flush extra water and sodium, reducing blood volume. (Hygroton, Lasix, Midamar)

Vasodilators relax blood vessel muscle cells. (Minoxidil, Hydralazine, Apresoline)

Monitor Blood Pressure at Home

Benefits of at-home blood pressure monitors:

-- They can spare you a trip to the doctor's office.

-- They may be covered by health insurance.

-- They help keep tabs on the effects of medication.

-- They can alleviate "white-coat hypertension" caused by the stress of being in a medical office.

-- They can provide a team approach to monitoring blood pressure, says Sharonne Hayes, M.D., cardiologist, and director of Mayo Clinic's Women's Heart Clinic in Rochester, Minnesota.

Before you buy: "You should make the decision to use a blood pressure monitor with your doctor," says Daniel W. Jones, M.D., spokesperson for the American Heart Association. "There are some conditions, such as irregular heartbeat or hardening of the arteries, that may cause inaccurate readings at home."

High Blood Pressure 101

High blood pressure occurs when the pressure of blood being pumped through arteries is above normal. It's also called hypertension.

High blood pressure is a major risk factor for heart disease, stroke, kidney disease, and heart attack. It is the most influential risk factor for stroke.

High blood pressure taxes the heart and cardiovascular system and over time can cause blood vessels to harden, narrow, and even burst.

Normal blood pressure is below 120/80 mmHg.

Prehypertension is above 120/80 mmHg and below 140/90 mmHg.

Hypertension is above 140/90 mmHg.

People at Risk

As with other cardiovascular conditions, high blood pressure has a mixture of controllable and uncontrollable risk factors.

Risk factors you can't control:

Age: The older you are, the greater your risk of having high blood pressure.

Race: African-Americans have a higher incidence of high blood pressure than Caucasians.

Family history: If high blood pressure runs in your family, your risk is higher.

Risk Factors You Can Control

Risk factors for high blood pressure you can control:

Overweight: A larger body requires more blood, which puts more pressure on the blood vessels.

Sedentary lifestyle: Lack of activity causes the heart to work harder to pump blood, increasing blood pressure.

Tobacco use: Smoking causes the arteries to narrow, increasing blood pressure.

Excess sodium intake: A diet with too much sodium can lead to fluid retention, increasing blood volume.

Low potassium intake: Potassium balances sodium; without adequate potassium intake, sodium levels increase.

Excess alcohol use: Too much alcohol over time can damage the heart, making it pump harder to work effectively.

Stress: High levels of stress increase heart rate, which causes blood to be pumped more rapidly through the body.

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