Q: I’m a 38-year-old female, 5’3” and not overweight. For the past year, my blood pressure readings average about 135-140 over 85-95. Is that bad? Should I see a doctor? I would rather not be on meds—what are some things I could do to lower it?
Well, I will break the news to you gently. Times have changed, and since 2017, new guidelines have come out which explain that high blood pressure is now anything above 120 over 80 (as opposed to the older guidelines of 140 over 90).
So, that means that I want to get your blood pressure lower to reduce your chances of future heart attacks and strokes. You should definitely see a doctor to review your entire medical history and check you out thoroughly.
If you have additional risk factors for heart disease such as diabetes, smoking history or high cholesterol, medication may need to be started earlier to lower your risk.
The good news is that you can make some changes in your lifestyle to see if they help before starting medications. You say that you are not overweight, but maybe you can afford to lose a few pounds. Even a modest amount of weight loss will help reduce your blood pressure. This translates to about a one-point drop in blood pressure for every two pounds of weight lost.
Regular exercise and a healthy diet are both cornerstones of an excellent plan to reduce blood pressure without medications. The exercise program has to be regular and consistent, meaning at least 30 minutes of walking, jogging, cycling or other moderate intensity activity at least five times per week. It also helps to throw in some strength training.
The diet plan that has evidence behind it for lowering blood pressure is called the DASH diet (Dietary Approach to Stop Hypertension). Eating a diet rich in whole grains, fruits and vegetables, and low in saturated fats and cholesterol is key. If you are very strict and consistent with this way of eating, you can lower your blood pressure by up to 11 points.
Lowering sodium intake can also reduce your blood pressure readings, so watch the canned and frozen foods, restaurant food, deli meats and canned soups. Read labels, and try to keep your sodium intake below 1,500 milligrams per day. Although salt does add flavor to foods, try adding pepper or other spices or even lemon to add some zing to your food, and you may not miss the salt.
You didn’t mention if you are a smoker, but quitting is an excellent way to not only reduce your blood pressure but also improve your overall health. In addition, alcohol is a double-edged sword. If you drink in moderation (defined by one drink per day for women and two drinks per day for men), this can reduce blood pressure by about four points. But more than that can have the opposite effect and can even reduce the effectiveness of many blood pressure medications.
Finally, it’s all about stress reduction. In these heady times, think about what causes you stress and try to make some positive changes to reduce it. Mindful meditation, yoga, or just staring at the sunset or ocean can all have positive effects.
So get out there and make some changes, and check your blood pressure at home regularly. If it’s not coming down, talk to your doctor about the next step.
If you do need medications, there are many options that may provide life-prolonging benefits without the side effects that you may fear.
This page is available to subscribers. Click here to sign in or get access.