By Natasha Persaud
Making smart lifestyle changes can help you better manage blood pressure, suggests David L. Katz, M.D., director of the Integrative Medicine Center at Griffin Hospital in Derby, CT, and of Yale University's Prevention Research Center. Here, we caught up with Dr. Katz for answers to popular questions:
Q: What are some natural blood pressure reducers?
A: "Physical activity, a wholesome, low-sodium diet and relaxation techniques all help to lower blood pressure," explains Dr. Katz. "Do all of these things regularly, and the effects can be truly enormous."
Q: How can physical activity reduce blood pressure?
A: "Moderate physical activity reduces blood pressure both directly and indirectly," Dr. Katz says. "It does so directly by strengthening the heart, so that it pumps more efficiently. Over the long term, it also indirectly promotes weight loss; Losing as few as five pounds can improve blood pressure levels."
Q: What if you're too busy to exercise?
A: "You're too busy not to exercise. It’s that important to your physical and mental health."
Q: What kind of diet lowers blood pressure?
A: "The evidence is ironclad that a diet restricted in sodium and full of wholesome foods—including fruits, vegetables, whole grains, lean protein sources, and nonfat and low-fat dairy—can lower blood pressure as much as medication can," says Dr. Katz. In fact, the eating plan known as DASH ("Dietary Approaches to Stop Hypertension") is based on landmark studies on blood pressure from the National Institutes of Health, he says. "It's rich in potassium, magnesium and calcium as well as in protein and fiber—nutrients that help lower blood pressure."
Q: What role does stress play?
A: "When you’re in danger—say, you see a tiger racing towards you—your 'fight or flight' mechanism kicks in," Dr. Katz explains. "Stress hormones such as cortisol and adrenaline rise, spiking blood pressure so more blood flows to your muscles—all in an effort to help you fight or flee.
"The response should be temporary, but when stress becomes chronic—it's not about running away, but about a boss you can't tolerate or bills you can’t pay—the result may be chronic elevation of blood pressure," Dr. Katz says. "There's a constant wear and tear on your blood vessels that puts you at risk for heart attack and stroke."
If you have high blood pressure, advises Dr. Katz, take stock: Are you also suffering from insomnia, stress, anxiety? "Sometimes people are not very good at judging their stress levels. They're so used to it, it becomes background noise. The goal isn't to live a stress-free life, but to learn to process stress in a way that's not harmful to you."
Q: Can relaxation techniques help?
A: "Any relaxation technique that is practiced well has the effect of lowering blood pressure. The trick is to find a relaxation therapy that’s comfortable for you, so you truly do relax. It’s not a one-size-fits-all situation."
The four main mind-body therapies are meditation, yoga, visualization and biofeedback. For a lasting effect, find one that works for you and engage in it frequently. "Your relaxation should be as chronic as your stress. The magnitude of the effect on blood pressure may vary, but the range of effects overlaps with the range seen with medications." Dr. Katz also recommends massage, as well as regular vacations.
Q: How can I learn more about these approaches?
A: While your primary-care doctor oversees your care, you may want to consult a naturopathic doctor, who can coach you on nonconventional therapies, says Dr. Katz. But to rule out any safety risks and track the benefits, it's important to keep your primary-care doctor informed about new treatments.
Q: Won't many people with high blood pressure still need prescription medication?
A: Yes. "Even in my clinic, where we’re very devoted to natural techniques," says Dr. Katz, "I’ll often wind up telling a patient, 'Your blood pressure is too high.' My preference is to get it under control with medication sooner rather than later. When you take a pill, your blood pressure will go down in a half hour. If you have side effects or don't like the medication in any way, I'll select a different one.
"Then I tell the patient, 'I'd also like you to work on diet, physical activity and relaxation—and I'll coach you. Lifestyle change can enhance the effectiveness of medication. But you’re not going to snap your fingers and have that in place today. If over the next few months, the lifestyle changes have a full effect, we'll wean you off the medication.'
"I don’t want people to be afraid to take medication," sums up Dr. Katz. "The most important thing is to get the blood pressure under control. Concerns about potential risks and side effects shouldn't distract you from what is likely the far graver danger: failing to control a risk factor for heart attack and stroke!"