The Doctor is In

Q: My 23-year-old son’s doctor told him he has prehypertension. High blood pressure runs in the family so we want to get this under control. What are some things he can do to lower blood pressure?

Ronald Reagan once quipped: “My doctors told me this morning my blood pressure is down so low that I can start reading the newspapers.” Although this quote may be still relevant in today’s frenetic world, blood pressure is no laughing matter!

You are very right to be concerned about your son’s blood pressure, as elevated blood pressure, or hypertension, can be a major risk factor for scary scenarios like heart attacks, strokes and end stage kidney disease. The good news is that your son has many behavioral things he can do to bring down his pressure before he would need to start medications.

New guidelines for the definition of high blood pressure came out as recently as 2017, with the current goal of blood pressure to be less than 120 over 80. The new recommendations of the American Heart Association are to intervene earlier with lifestyle changes and possibly even medications when your blood pressure is above 130 over 80, rather than the old numbers of 140 over 90.

Lifestyle plays a very important role in treating high blood pressure, so let’s get to work.

First, weight loss is one of the most effective lifestyle changes for controlling blood pressure. Blood pressure often increases as weight increases, and being overweight can lead to disrupted breathing while you sleep (sleep apnea), which further raises blood pressure. Even modest weight loss will help.

For every two pounds lost, you can decrease your blood pressure by one millimeter of mercury. Regular physical activity, which translates to 30 minutes most days of the week, can lower your blood pressure by five to eight points. But, it’s important to be consistent.

Diet can also play an important role in blood pressure control. The DASH diet (Dietary Approaches to Stop Hypertension) encourages lower sodium and higher amounts of potassium containing foods. This diet emphasizes vegetables, fruits, and moderate amounts of whole grains, fish, poultry and nuts.

Lowering sodium can be tricky, so I recommend reading food labels, avoiding as much processed food as possible and not adding salt to food. Cooking at home is also a much better option than eating out as restaurants use salt as a mainstay of adding flavor to menu items.

If your son smokes cigarettes, encourage him to get help to quit. Smoking and excessive alcohol intake are both vital to better blood pressure control. Alcohol in moderation (one drink per day for women and two per day for men) can actually lower blood pressure by up to four millimeters of mercury, but that protective effect is lost if you drink more than that.

Stress reduction, although easier said than done these days, is another thing your son can do to reduce his blood pressure. Chronic stress may contribute to high blood pressure and may also increase the risk of turning to bad habits, like eating the wrong foods or smoking or drinking excessively. Your son can work on stress reduction techniques, which could include mindful meditation, breathing exercises, yoga or engaging in relaxing activities.

Get a reliable home blood pressure monitor if you have concerns and see your primary care physician regularly to get checked. These interventions could make your son have a happy and healthy life … whatever is in the newspapers.