BY DR. PANCHAJANYA PAUL, MD*
High Blood Pressure or Hypertension is a condition when the blood pressure in the arteries remains elevated over time. Hypertension is a serious medical condition. Persistent blood pressure above 140/90 mm Hg is defined as hypertension. It is recommended that people should take action even before that and keep the blood pressure below 120/80 mm Hg. Chronic hypertension is a direct risk factor for stroke and heart Attack, kidney disease, vision loss and many others. The exact cause is unknown in majority of cases. There is a rise in the number of cases of hypertension across the world. It is probably due to a combination of multiple factors including the genes and the environment. As more people are moving into the cities, the traditional ways of living are being replaced with fast urban ways of living. This has led to a surge in the life-style diseases like hypertension, hypercholesterolemia, diabetes, obesity worldwide and, the number is expected to grow in the coming years.
Although, it is acknowledged, that hypertension is a disease of the life style; it remains a challenge to regulate the blood pressure. Our life has become busier. We are constantly driving from one point to the other, eating fast food while we work to save time, spending less time with family and friends, taking fewer vacations, and sleeping less. All the while we are working more and more. This chronic stress of the urban life impacts our mental and physical health. However, we can always make changes to our lifestyle and use the natural healing mechanisms of the body to restore out health and reduce blood pressure. There are evidence based life style modifications that has shown to reduce the blood pressure naturally. They are easy to start, but requires motivation and discipline to continue. Here are a few major ones which are easy to follow and reduce blood pressure.
Exercise: Switching to an active lifestyle remains the quintessential part of any life style change. Exercise reduces blood pressure. Aerobic exercises like running, jogging, walking, and weight lifting exercises can reduce the blood pressure. The important part is physical movement. It’s not enough to remain sedentary all day, and then exercise for 1 hour and hope to see the changes. No matter of exercise can mitigate the 23 hours of inactivity. Thus the key is to keep on moving all day at regular intervals. Hypertension was virtually unknown in the primitive societies where people are always moving and working. Many of us can recall our grandparents or great grandparents living in the villages working all day and never having to worry about obesity of hypertension.
Stress: The level of stress in the modern American society is high. In the past, one dealt with the acute stress of famine, war, and pestilence. They had a marked beginning and an end for those lucky to survive. But now, in the developed world, there is no acute danger. Life is more safe and secured. Instead we have chronic stress. People are more isolated and lonely than ever. The quest for material success drives us to work more and more. The encroachment of the digital world in our home has meant that there is no boundary between work space and home. The connectivity of cell phone and internet means that we can now work 24×7. We are witnessing a rise of mental health illness like depression and anxiety disorders across the world. Stress kindles the fight or flight response in our brain. It leads to sympathetic system activation which causes constriction of the blood vessels, thus increasing the blood pressure as the heart has to pump harder against the narrow vessels to send the blood across the body. There are many proven ways to remove stress like meditation, yoga, better work life balance which will go a long way to reduce the blood pressure. Although we all feel stress the same way, we relax differently. Every day, try to carve out some time for activities that help you relax.
Diet: There is a saying that we are what we eat. Diet influences every aspect of our life. In earlier times, people used to eat fresh fruits, fresh vegetables and fresh meat. Now most of us buy our food from the big grocery stores like Wal-Mart, Costco, Kroger, and Publix. We enjoy the convenience to get the food when we want and what we want. But this shift from eating fresh and seasonal has consequences. All natural and whole food comes with more potassium and less sodium. But as soon as the food the stored and processed, sodium is a main ingredient to aid in preservation. The increased sodium content of the processed food changes the balance. Most of us now consume more sodium than potassium. Just eliminating salt from the diet will not help. Any food we buy like the simple bread comes with high sodium. All food in nature comes packed with vitamins and anti-oxidants. The nutrient level is at its peak when the fruit or vegetable is plucked from the tree, and for meat at its source. But as the food stays in cold storage, it loses nutrients over time. Thus, the key is to eat local and eat as much unprocessed food as possible. Try to find local farmers in your ears, and if time and money permits, get the fresh produce in season. There is some food which specifically reduces blood pressure. It has been shown that onion and garlic consumption reduces blood pressure. Food rich in omega 3 fatty acids like fish, organic eggs can help to reduce blood pressure. Vegetarians can take flax and chia seeds which are rich sources for omega 3 fatty acids.
Outdoors: We are now staying most of our time indoors. This is a big shift from the past. Time spend in outdoors among nature has multiple health benefits. We have access to fresh air full of oxygen and healthy microbes. We get sun exposure which helps the body to make natural vitamin D. Low vitamin D levels in blood have been correlated with hypertension. Thus sun exposure in moderation will boost the vitamin D levels in the body and help lower the blood pressure. Spending time outdoors also boost the endorphin levels which makes us feel good and decreases the stress hormones. All this helps to reduce the blood pressure. The age old advice of 1 hour of morning walk outside for good health is truer than ever. In India there is a practice called ‘Tahal’ where people will walk every day with friends or alone and relax themselves.
Sleep: Sleep is the healing time for the body. Every night when we go to sleep, the body repairs the wear and tear, removes the germs and toxins, and does routine maintenance tasks essential for survival. As the body prepares for sleep- the pulse rate drops, blood pressure decreases, temperature drops, metabolism slows. The sleep cycle is regulated by circadian rhythm determined by exposure to sunlight and other bright light. Sleeping within 4 hours of sunset is ideal and had been the norm world-wide till the availability of the artificial lights. Hence, sleeping late at night, sleeping less at night, exposure to bright light like computers just before sleep- will interfere with body’s natural repair mechanism. Poor sleep can contribute to hypertension. Ideally one should sleep by 10 pm every night, and the last one hour before sleep should be spend on relaxing activities.
Obesity: Obesity is big risk factor for hypertension and diabetes. As we age we gain weight and become more sedentary. This puts us at risk for hypertension. The more weight we have, the harder the heart has to pump the blood across the body. In addition, obese people are more likely to have sleep apnea, which is a direct cause of hypertension. Losing the weight will reduce one’s blood pressure. However, losing weight is not easy and will require many of the above mentioned life style changes. Thus, all the life style changes go hand in hand. Good diet, good sleep, good exercise will reduce weight and improve sleep, which in turn will keep the blood pressure, blood cholesterol, and blood sugar normal.
Supplements: I am not a big fan of supplements. All the nutrients should ideally be obtained from food. However, it is not always possible. Due to political reasons like farm subsidies, fresh food is more expensive than processed food in US. Thus for many, supplements become an economical and practical approach. Certain natural supplements have shown to reduce blood pressure. Regular consumption of tea reduces blood pressure. Omega 3 acid supplements or fish oil supplements can also help with blood pressure. Vitamin supplements are a good option for people who cannot go outdoors. Other supplements like potassium, magnesium, Coenzyme Q-10 can reduce blood pressure, but should only be taken after consultation with the doctor.
In summary, high blood pressure should be taken seriously. Most hypertension is due to life style problems. Life style change is not easy. However, everyone should try to do more exercise, better nutrition, improve sleep, reduce stress, and decrease weight as a first line approach to reduce blood pressure. Many patients with Hypertension will need additional support of blood pressure medications. Hypertension can also be due to specific diseases of kidney, adrenals, and thyroid, and will not respond to life style changes unless the source is addressed. Therefore, always consult your doctor to explore reasons for chronic high blood pressure and other treatment options.
Dr. Panchajanya Paul, MD, ABIHM, ABPN, is an American Board certified – Child, Adolescent, and Adult psychiatrist. He is a diplomate of the American Board of Integrative and Holistic Medicine. He holds adjunct faculty position at Emory University School of Medicine;University ofGeorgia &GeorgiaRegentsUniversity, and University of Central Florida School of Medicine. He is a freelance writer who lives in Atlanta.