How to control hypertension without medications? Cardiology Basics

How to control hypertension without medications? Cardiology Basics

Non-pharmacological approaches to control hypertension are essential even in those who do need medications for control of hypertension. In those with newly detected mild degrees of hypertension, non-pharmacological methods will be more acceptable and often all that is needed for control of hypertension. Adding non-pharmacological measures to medications, will increase compliance as the individual gets a hope that there is a chance to get off medication.

One simple way to control hypertension is by reducing extra weight. Roughly the blood pressure might come down 1 mm Hg for every kilogram of weight reduction. Generally, a decrease in weight will also bring down the waist circumference. Increase in waist circumference indicates visceral obesity, which correlates with risk of cardiovascular disease.

Regular exercise is another good way of controlling hypertension. Even though blood pressure rises steadily during exercise according to intensity of exercise, regular exercise brings down the resting blood pressure.

150 minutes of moderate intensity physical activity is recommended per week. This can be divided into 30 minutes a day or even smaller chunks of convenience. Regular physical activity can bring down the blood pressure about 5 to 8 mm Hg.

Aerobic exercises like walking, jogging, cycling and swimming are the most suitable. Older persons will need detailed evaluation to rule out silent coronary artery disease before starting a strenuous exercise program. Otherwise there is a chance that silent coronary artery disease may become manifest during exercise.

Importance of a healthy diet cannot be overstressed. Whole grains, fruits, vegetables, low fat food minimizing trans-fat and restriction of salt can bring down the blood pressure by about 10 mm of Hg in those with elevated blood pressure.

High salt foods like pickles have to be avoided by hypertensives. Most bakery items and processed food will have higher salt content and have to be restricted. Relaxation in salt intake may be needed in elderly persons prone for recurrent hyponatremia.

Relationship between alcohol and blood pressure can be described as a U curve relationship. While small quantities can reduce blood pressure, larger amounts can increase blood pressure. But this does not mean that alcohol can be recommended as a measure to control hypertension. Alcohol can have other social and health implications. It is being mentioned as the intake needs to be curtailed in those who are already habituated to alcohol.

Cigarette smoking can increase the blood pressure for even several minutes after smoking. Other adverse effects of smoking on cardiovascular events are well known. So, quitting smoking is essential both for controlling hypertension and other multiple health benefits.

Some persons have an increase in blood pressure of around 10 mm of Hg with intake caffeinated drinks. But this may not occur in those who are regularly consuming such drinks. This can be assessed by checking blood pressure within half an hour of taking a caffeinated drink. One of the criteria for a good blood pressure recording is that caffeinated drinks should not have been taken within half an hour of the measurement.

Reducing stress is another method of controlling hypertension.  But it is easily said than done in this era of highly stressful life situations and may mean cutting down ambitions! Planning activities in a way to avoid potential stressful situations may be useful. Destressing by taking a holiday, taking a walk or even engaging in hobby activities can be useful in bringing down the blood pressure.

With the availability of automated home blood pressure monitoring devices, it is easy to track progress of hypertension control. Measurements should be taken only after taking adequate rest and not when stressed or tired. Record of home measurements should be reviewed during the clinical evaluation. Recording too many values every day might cause unnecessary anxiety and become counterproductive.

While applying the blood pressure cuff, make sure that there is no tight clothing which can interfere with the measurement. It is always ideal to verify the accuracy with clinic recordings whenever feasible. Clinic visits could be utilised to train the correct method of home blood pressure measurement.