Gan Pou Wee
M.Pharm, MBBS, BCPS, R.Ph
According to the National Health and Morbidity Survey (NHMS) in 2011, about one third of Malaysians older than 18 years of age have high blood pressure. This is a staggering figure! Even more confusing is that we often hear advices from various sources claiming to help reduce blood pressure. But what are the scientifically proven lifestyle changes that lower blood pressure?
Lifestyle and blood pressure. The missing link?
Many people wonder, how is lifestyle linked to blood pressure? Well, food and activities have a huge impact on blood pressure and general health. With good lifestyle practices, it is possible to:
- reduce blood pressure and/or prevent the development of high blood pressure in the first place.
- reduce the risk of developing complications of high blood pressure such as heart attacks and strokes.
- synergize with blood pressure control medications to achieve better blood pressure control.
- reduce the dependence or dosage requirement on blood pressure medications.
What to change?
There are many things that one can change in his/her lifestyle that have huge impacts on blood pressure. Please do not be intimidated by the list of changes that follows. It is not necessary to change everything at once. Try to make lifestyle changes, one at a time , by keeping at it until it becomes a habit. If it’s too difficult, do not fret, change something else instead. Remember, there is no one single solution that is right for everyone. You would have to try the changes out and see what’s best and most suited for yourself.
- Weight Loss
If one is overweight, this is a good place to start. For those who are not, go ahead and skip this. Weight loss is essentially based on diet and exercise. There is no two ways about it. Start with diet or exercise first, if you can do both right off the bat, even better. Make sure you set a goal and have a plan that is realistic. A plan is only good if it is executed. So, make sure you plan something you can stick with. Losing weight not only helps in controlling blood pressure, it also reduces risk for heart attacks and strokes.
- Dietary changes
Because of cultural differences, dietary recommendations may not work for everyone. However, it is generally recommended to have a balanced diet which includes:
- Generous amounts of vegetables, fruits and wholegrains
- Low-fat dairy products
- Less meat, fish is encouraged as a source of meat
- Beans and nuts in small amounts
Furthermore, sugar and refined carbohydrates such as white bread, white rice, pastas and junk food should be reduced.
- Exercise recommendations
To control blood pressure, extreme exercises are not necessary. Just by increasing daily activity level would be helpful such as taking stairs, park further and walking to the office. Or you can take an evening walk or do some gardening. The goal is to carry out these activities for at least 30 minutes a day for most days of the week, but you don’t have to hit the goal immediately. Take your time to achieve it by increasing the level of activity slowly but steadily. If you don’t like a certain activity, just change it. For those who are overweight, a greater increase in the level of physical activity is recommended. Brisk walking, jogging or swimming is a good activity to start with.
- Reduce salt intake
Reducing salt intake means reducing sodium intake. The recommended daily sodium intake is 2.4 grams or less. Contrary to common belief, the bulk of sodium consumed by most people is not through home cooked food. Reducing the amount of salt in cooking does help, but not significantly. Most of the sodium that we consume comes from processed food and food from restaurants. Hence home cooked food with fresh ingredients are highly recommended. If processed food such as canned food, instant noodles cannot be avoided, then read the nutrition label and choose wisely.
Do not try to cut salt out from all food immediately. It will probably make your meals taste like “hospital food”. Instead, try cutting salt back from a couple of dishes or meals and work your way from there until you are used to the taste. Keep going until most of your food is low in sodium.
- Reduce alcohol consumption
For those who consume alcohol, it is recommended that women should not have more than 1 “standard drink” and men not more than 2 “standard drinks” a day. A “standard drink” is defined as
- One can of beer (330ml, 4% alcohol)
- A glass of wine (150ml, 12% alcohol)
- A shot of whiskey/vodka/hard liquor (45ml, 40% alcohol)
- Smoking cessation
By quitting the habit of smoking tobacco, it not only reduces blood pressure, it also reduces the risk of complications of high blood pressure such as heart attacks and strokes. However smoking cessation is a large topic that would not be dealt with in detail here. If you need help, feel free to approach pharmacists who are certified smoking cessation service providers to better aid you in this journey.
Which to start first
To improve and change a persons’ lifestyle is never easy, but with so many choices, you can choose the one that you find easiest. For example, if you used to work out, but stopped for certain reasons, or became lazy, then maybe it would be easier to pick up where you left off. Get out there and start exercising again. If you enjoy cooking, then perhaps cooking yourself healthy meals is a good place to take off. Don’t be over-ambitious. Choose realistic goals and start working from there.
So, what are you waiting for?
- Maitin I, Cruz E. Current diagnosis & treatment. 1st ed. Lange;.
- Asthana S, Halter J, High K, Ouslander J, Ritchie C, Studenski S et al. Hazzard’s Geriatric Medicine and Gerontology, 7e. New York, N.Y.: McGraw-Hill Education LLC.; 2017.
- Abel N, Contino K, Jain N, Grewal N, Grand E, Hagans I et al. Eighth joint national committee (JNC-8) guidelines and the outpatient management of hypertension in the African-American population. North American Journal of Medical Sciences. 2015;7(10):438.
- Patient education: Controlling your blood pressure through lifestyle (The Basics) [Internet]. Uptodate.com. [cited 4 September 2017]. Available from: https://www.uptodate.com/contents/controlling-your-blood-pressure-through-lifestyle-the-basics