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Top 10 Ways to Keep High Blood Pressure at Bay

Alcohol, sleep and even pain reliever choices can play a role in reining in hypertension

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by Debra Melani | December 4, 2023
Black and gold graphic of a blood pressure cuff and machine
What you need to know:

High blood pressure affects almost half of the U.S. population today, its numbers doubling among 30- to 79-year-olds within the past 20 years. A cardiologist shares ways to reduce the risk of joining that group for people without complicated causes.

Like your home’s plumbing system, if a “pipe” clogs or corrodes and bursts within your vascular system, it can create a destructive mess, even leading to an all-systems failure if not addressed. Constant, high-pressure flow weakens arteries, and can knock corrosive plaque loose, creating a dangerous barrier. The best way to prevent a blowout? Take care of your house.

Blood Pressure Basics

  • Blood pressure is measured in millimeters (mm) of mercury (Hg).
  • 120 mmHg (systolic) over 80 mmHg (diastolic) or less is normal.
  • Systolic (the top number) indicates the pressure of the blood pushing against the artery walls when the heart contracts to pump the blood out.
  • Diastolic (the bottom number) is how much pressure blood exerts against artery walls between contractions, when the heart muscle rests as it is refilled with blood.
  • With chronic high blood pressure, the blood constantly exerts too much pressure on the artery walls, causing damage and threatening oxygen-providing blood flow throughout the body.

High blood pressure affects nearly half of U.S. adults (48.1%, 119.9 million, Centers for Disease Control and Prevention) and is a primary cause of the nation’s top killer: cardiovascular disease. In addition to stroke and heart attacks, hypertension can cause vision problems and sexual dysfunction, among other things. Risk rises the longer the disorder goes unchecked.

“It’s a big problem,” said Steven Simon, MD, an assistant professor in the Division of Cardiology at the University of Colorado School of Medicine, who focuses on blood pressure and prevention. The numbers of at-risk and affected patients have risen with the nation’s weight and processed diets, doubling among 30- to 79-year-olds from 1990 to 2019 (National Institutes of Health). Simon teaches his patients life-changing habits that can prevent or lower high blood pressure.

“For many people, lifestyle interventions can certainly make a difference,” said Simon, also co-director of the Cardiometabolic & Advanced Lipid Clinic with David Saxon, MD, at the CU Anschutz Medical Campus. But it’s important to note that for some people, hypertension stems from genetic or other secondary causes that may not respond to lifestyle interventions alone, and they will need medical evaluation, Simon said.

Here are Simon’s top 10 tips for keeping blood pressure in check:

  1. Drop excess pounds

    Weight loss can offer a huge return on investment for those who are overweight or obese, with every 1 kilogram (2.2 pounds) lost lowering systolic blood pressure by about 1 mmHg, Simon said.

    “Weight loss of up to 10% of body weight is linearly associated with reduction of blood pressure, meaning the more you lose, the more the blood pressure improves,” Simon said. “If somebody is overweight, that’s probably one of the most effective ways to lower your blood pressure.”

  2. Add a ‘DASH’ of health to diet

    “The proven diet to decrease your blood pressure is the DASH diet,” Simon said of the program high in vegetables, fruits, low-fat dairy, whole grains, poultry, fish and nuts while discouraging the bad actors: bad fats, sugars and sodium. Adhering to the diet is associated with about a 5 mmHg drop in systolic blood pressure.

  3. Sidestep the sodium

    A key to blood pressure maintenance is reducing high-sodium foods (think packaged, processed foods) and eating foods rich in potassium (such as spinach, sweet potatoes, avocados, pumpkin and white beans). Fine-tuning the balance of those electrolytes can also decrease systolic readings by 5 mmHg, Simon said.

  4. Move your body – for life

    Studies show that regular aerobic exercise results in 5 to 7 mmHg reductions in blood pressure among individuals with hypertension, which translates to a 20% to 30% reduced risk of cardiovascular disease.

    “We really strive for patients to get 150 minutes of moderate intensity exercise per week,” Simon said. While any form of exercise is effective, Simon encourages an aerobic focus with his patients. “Personally, I think aerobic exercise is where I tend to see more benefit for blood pressure reduction.” With a regular regimen, patients will begin to see effects within the first four weeks, he said.

  5. Enjoy your java, in moderation

    While caffeine can acutely increase blood pressure, coffee lovers can keep their morning ritual. Simon says it’s fine in moderation, even for hypertensive patients.

    “While you are drinking caffeine and shortly thereafter you may notice a slight rise in your blood pressure, but it actually attenuates pretty quickly. And people who are chronic caffeine users do not have chronic elevation of their blood pressure. So while there may be limits on how much to drink, I do not tell people to avoid caffeine who have high blood pressure.”

  6. Put down the bottle

    Alcohol, however, can take a toll on blood pressure, Simon said. A meta-analysis by the American Heart Association and published in its journal Hypertension in July found that blood pressure continues to rise over the years with continued alcohol use even in those without initial high blood pressure.

    Drinkers’ data were reviewed for more than five years and compared with non-drinkers’ data. Systolic numbers rose 1.25 mmHg in people who drank an average of 12 grams per day and 4.9 mmHg in those who consumed about 48 grams a day (a 12-ounce beer contains about 14 grams of alcohol).

    “Decreasing alcohol can make pretty profound changes in your blood pressure,” Simon said. “We advise no more than one to two drinks a day maximum.” Binge drinking, in particular, can affect blood pressure, igniting a mini-withdrawal, he said. “People’s blood pressure spikes considerably the following day.”

  7. Nix the nicotine

    Similarly, eliminating nicotine can lower blood pressure, as the addictive component in tobacco and some vape products is a stimulant, Simon said. Studies have found smoking triggers an immediate increase in blood pressure of up to 10 mmHg, which can take up to 20 minutes to decrease. Smoking also increases the risk for atherosclerosis (plaque buildup in the arteries).

  8. Remember to breathe

    Stress and the cascade of hormones that come with it can affect blood pressure, so Simon encourages including stress-reduction techniques in wellness routines, such as deep breathing, yoga, nature walks, journaling or furry-friend time. “Practices including transcendental meditation have been shown to decrease blood pressure. But any kind of stress-reduction techniques can help,” he said.

  9. Snooze: You won’t lose

    Getting at least six hours of sleep is also important for blood pressure maintenance, Simon said. “Studies restricting sleep for just one night have demonstrated increases in systolic blood pressure by more than 10 millimeters of mercury the following day.”

    Tied closely to that is obstructive sleep apnea, known to increase risk of heart disease and stroke, Simon said. “Treating obstructive sleep apnea will reduce your blood pressure. With sleep apnea, you think you are getting eight hours of sleep, but you may be briefly waking up throughout the night, so you are actually not getting adequate sleep. That will raise your blood pressure both acutely and chronically.”

  10. Check the medicine cabinet

    Some medications can also increase blood pressure, and that includes nonsteroidal anti-inflammatories, or NSAIDs, like ibuprofen (Advil) and naproxen (Aleve), Simon said. Other examples include some weight-loss medications and oral contraceptives, he said.

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Staff Mention

Steven Simon, MD