Blood Pressure Strategies Get Short Shrift from Media

A close read of a new Canadian study shows it doesn’t say what everybody says it says.

March 3, 2009

Cutting salt from your diet can lower your blood pressure--if you actually do it.

RODALE NEWS, EMMAUS, PA—The way some media outlets are reporting a new Canadian study, you’d think we should all just give up on living a healthy lifestyle and line up for hypertension medication right away. In the study, researchers found that more hypertension patients were able to maintain a healthy blood pressure with medication only than with a combination of medication and healthy lifestyle changes. It may seem like that means exercise and a healthy diet are a waste of time if you want to beat high blood pressure. But what this actually points to is the fact that making lasting and significant changes can be more challenging than people realize.


THE DETAILS: The researchers surveyed 2,551 men and women, aged 20 to 79. Twenty-one percent had hypertension (high blood pressure); of those, 41 percent were taking drugs for the condition, and 42 percent were taking drugs and making lifestyle changes (like eating differently or exercising) to control it. The scientists found that 85 percent of participants who used drugs alone had their blood pressure under control, while 78 percent of participants who used drugs and made lifestyle changes had their blood pressure under control.

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WHAT IT MEANS: So why wasn’t a healthy lifestyle more effective at lowering blood pressure? The researchers suggest that the study subjects weren’t living up to the healthy guidelines they claimed to be following—perhaps without realizing it. “It’s not that lifestyle changes can’t work,” says study co-author Frans Leenen, MD, PhD, director of the Hypertension Unit at the University of Ottawa Heart Institute in Canada. “We know that they do. It’s just that, if you get a low-sodium diet at the hospital that’s sufficient to lower blood pressure, for instance, it’s often harder than you think to carry it over to your real life.” As a result, the study authors caution against making half-hearted lifestyle changes to lower your blood pressure in lieu of drug therapy. You’ll simply be delaying treatment of a potentially serious condition, they say, if you’re not absolutely committed to restricting calories and salt, and boosting exercise.

Here’s how you can get serious about lowering your blood pressure:

• Measure your progress. Just because changing your lifestyle is difficult doesn’t means it isn’t worth trying—you just have to make sure you’re trying hard enough. Dr. Leenan suggests asking your doctor to give you a 24-hour urine analysis. If you’re significantly reducing your salt intake, the test will show it; if you’re not, it will show that, too. “You need to know objectively if you’re doing what you think you’re doing,” he says. “Only then can you evaluate your chosen therapy.” Keep a food diary so you can assess what you’re eating. And consider regular phone sessions with a nutrition specialist—new research suggests it’s an effective strategy for losing weight.

• Stop supersizing it. The one dietary change you can make that would have the biggest positive impact on your blood pressure? Forgoing fast food. “Fast food greatly increases your calorie and salt intake, both of which impact blood pressure,” says Dr. Leenan. “The high salt content in fast food will also compel you to drink more, and what’s available at those places? High-calorie, sugary sodas. It’s exponential.”

• Move it. Exercise leads to weight loss, and weight loss improves blood pressure. The equation is simple; the trick is to do it, not just say you’re doing it. A new report suggests you should aim for at least 50 minutes of exercise, five days a week, for weight loss.

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