There are a number of simple ways which may be enough on their own to lower high blood pressure: eating a sensible diet, not smoking, exercise to achieve physical fitness and some form of regular relaxation.
High blood pressure may sometimes be managed successfully through dietary modifications, chiefly by cutting calories and/or sodium chloride (salt).
Overweight is often associated with a rise in blood pressure because of the added load on the heart. Blood volume increases with body weight. Extra tissues must be supplied with blood and it has been estimated that each extra kilogram (2 lb) of fat requires two kilometers of smaller blood vessels to nourish it. So in overweight people the heart is forced to pump more blood through an extensive system of blood vessels.
Most adults and children use much more salt than they need, often only because of habit. This has been estimated to be up to a tenfold excess.
By simply not adding any salt in cooking or at the table, a good salt reduction can be achieved. If very salty foods (bacon, potato chips, salted nuts) are avoided as well, a level is reached which is very effective for lowering blood pressure without the need to buy special foods.
By using salt-free bread, margarine and other recommended salt-free foods, an even lower dietary sodium level can be achieved. This reduces blood pressure even further. Because restricting salt in the diet can lessen or avoid the need for drug therapy, many people find it a highly acceptable form of treatment.
As cigarette-smoking greatly aggravates the effects of high blood pressure on the arteries and increases the risk of sudden death from a heart attack, (death from heart attack is twice as common in cigarette smokers as non-smokers) people with high blood pressure – and people who do not know whether their blood pressure is high – should not take the risk.
Other long-term ills attributed to cigarette smoking are coronary artery disease, cancer of the lung and bladder, chronic lung disease (emphysema and chronic bronchitis), peripheral vascular disease (blockages in arteries to the legs) and peptic ulcers. Surveys indicate that cigarette smoking kills more than four times as many people as road accidents do each year.
Regular walking, jogging, running, cycling and swimming have a small but important beneficial effect on high blood pressure. Exercise also has positive psychological benefits and generally promotes a feeling of well-being.
It is important to consult a doctor before embarking on an exercise program, as very strenuous exercise may be a hazard to people with uncontrolled high blood pressure or other risk factors. A commonsense rule is moderation, starting with mild exercise and slowly working up.
This should be controlled and avoided as far as possible in a person with high blood pressure. Changes have to be made to adjust working and living habits to a sensible pace. It is often possible to avoid arguments. Make a habit of positive thinking. Worrying will never solve a problem. There are many useful books and tapes available which teach muscle and other forms of relaxation. Regular relaxation training (20 minutes twice daily) lowers blood pressure by a small but significant extent.
Rest is something we all enjoy. For people with high blood pressure, it is the best possible medicine. This is because blood pressure usually goes down during sleep and much of the strain is taken off the arteries and heart. If possible eight hours of sleep a night and a daytime “quiet period” is recommended.
Avoid proprietary cold and flu remedies. They often contain chemicals which cause small arteries (arterioles) to constrict with sometimes alarming and dangerous rises in blood pressure, particularly when some medicines for high blood pressure are being taken.
Today, doctors are armed with a wide variety of drugs to control high blood pressure of all degrees of severity. No single one is effective in all people or in every phase of the condition, but where one fails, another or a combination of drugs is likely to succeed.
Some act to reduce fluids in the circulation by increasing the amount of salt and fluid lost through the kidneys. Others relax the part of the nervous system which controls the muscles in arterioles, or act directly on the arterioles to relax them.
The newer drugs produce few and relatively mild side effects. It is possible to keep blood pressure under control, without affecting performance of work or interfering with other activities. The great value of drugs in severe and even mild high blood pressure is now well documented.
Death rates have been dramatically reduced. When blood pressure is brought under control, signs and symptoms of heart failure often recede or disappear, deterioration of the kidneys is arrested, and the threat of strokes greatly diminished.
The dramatic decline in death rates from high blood pressure during the past few decades can confidently be expected to continue in the future.