Often called a silent disease, hypertension has no symptoms beyond the readings that come from a blood pressure cuff. And yet, high blood pressure is a risk factor for a slew of other conditions, including heart attack, congestive heart failure, stroke, kidney disease and vision loss. So treating hypertension is all about lowering your risk for these diseases.
More than a quarter of U.S. adults have hypertension, and three out of four of them are on medication to keep their blood pressure in check. Those drugs come with side effects, such as needing to urinate more often (diuretics), insomnia (beta blockers) and constipation (calcium channel blockers).
You can see why people might want to avoid such medications.
Here’s the latest on the possibilities for controlling hypertension without drugs.
The biggest winner
Diet is the method that doctors say has the biggest benefit and for which there is the best evidence, much of it garnered in the late 1990s and early 2000s through a series of studies called DASH (Dietary Approaches to Stop Hypertension).
Research since then has only bolstered the claim that eating a diet low in salt and fat and high in fruits and vegetables can reduce high blood pressure. For someone with blood pressure at or above the hypertension threshold of 140/90 mm Hg mercury, following the DASH diet can lower systolic blood pressure (the top number) by 11.6 mm and diastolic pressure by 5.3 mm. By comparison, medications can achieve larger decreases: Drops of 20 and 10 mm, respectively, are considered a good response.
However, Brook says, patients often want options beyond diet, because they doubt they can or will change their eating habits enough to make a difference. “They want some evidence-based methods, short of taking medication,” he says.
Brook recently co-authored a scientific statement for the American Heart Association that reviewed evidence-based studies of a wide variety of non-drug approaches for reducing high blood pressure, including Transcendental Meditation, yoga, acupuncture, slow-breathing techniques, biofeedback and various types of exercise
They found a mixed picture.
What worked best? Aerobic exercise.
“The typical recommendation is 30 minutes on most days, or five times per week, at a moderate intensity, such as 4 miles per hour walking or light jogging,” Brook says. Although the studies varied in their exercise methods, overall the reductions in blood pressure approached that of diet intervention.
Resistance exercise and weight training
There are fewer studies on the effects of resistance exercise or weight training, and the reductions in blood pressure that result are generally much smaller: less than 3 and 2 mm for systolic and diastolic blood pressure, respectively. Still, the evidence was sufficient for the authors of the AHA statement to conclude that “dynamic resistance exercise is reasonable to perform in clinical practice in order to reduce blood pressure.”