As a key contributor to the leading cause of death among adults, getting blood pressure under control is of critical importance—here are some natural ways to do so.
Let this sink in: high blood pressure is the single most important risk factor for dying prematurely, and 90 percent of Americans are predicted to develop it by the age of 65. Nearly half of adults currently have hypertension, but only 24 percent have their condition under control. It should come as no surprise that 4 of the top 10 prescribed drugs in the US are blood pressure medications. Getting a handle on your blood pressure is incredibly important to overall health and well-being. The good news is that, for many people, drugs are not necessary, and getting blood pressure under control can be achieved through diet and lifestyle modifications, along with some key supplements.
Blood pressure is the pressure of blood pushing against the walls of your arteries, which carry blood from your heart to other parts of the body. It is the measure of systolic pressure (maximum pressure during one heartbeat) over diastolic pressure (minimum pressure between heartbeats).
Normal, healthy blood pressure is considered anything at or less than 120 mm Hg systolic (the upper number on the blood pressure monitor) and 80 diastolic; 120-129 mm Hg is considered “elevated”; 130-139 mm Hg systolic and 80-89 diastolic is stage 1 hypertension, and anything over 140 mm Hg systolic and 90 diastolic is stage 2 hypertension.
In 2017, the threshold for high blood pressure was lowered from 140 mm Hg to 130 mm Hg, meaning millions more Americans were classified as having stage 1 hypertension. For most people with hypertension in the conventional medical system, that means taking at least one blood pressure-lowering medication. No doubt, then, that Big Pharma was salivating when the threshold for high blood pressure was lowered, as it would deliver them millions of new customers.
It may be that some people do need a medication to help lower their blood pressure, but diet and lifestyle modifications can also help many people lower their blood pressure to healthy levels. Consider that high blood pressure affects only one percent of hunter-gatherer populations following their traditional diet, but its prevalence increases when these cultures move towards a Western-style diet (processed foods, sedentary behavior, excess sugar, etc.). Clearly, diet and lifestyle have a lot to do with blood pressure.
In fact, the authors of the major study that was the impetus for lowering the threshold for high blood pressure (the SPRINT trial) suggest that patients newly diagnosed with hypertension who fall between 120-129 mm Hg should start with diet and lifestyle changes. The problem is that this suggestion will likely fall on deaf ears, as our medical system is not geared towards guiding patients through such changes. Doctors may pay lip service to these concepts, but more often than not, patients will return a few weeks later with blood pressure unchanged, at which point the doctor will prescribe blood pressure-lowering medications.
The problem with using medications to lower blood pressure is that they do not address the root causes of high blood pressure: a sedentary lifestyle, stress, too much alcohol, smoking, poor diet, being overweight or obese, among others. These medications also come with a host of side effects. Depending on the medication, they can cause gout, insomnia, erectile dysfunction, asthma symptoms, hacking cough, loss of taste, dizziness, constipation, dizziness, headaches, and more. Further, a meta-analysis from the Cochrane Collaboration concluded that treating mild hypertension (140-159/90-99) with blood pressure-lowering medications did not reduce coronary heart disease, stroke, or total cardiovascular events. The whole point of lowering blood pressure is to avoid these outcomes.
For those who are otherwise healthy who have blood pressure exceeding 120/80 mm Hg, diet and lifestyle changes along with targeted supplementation should be the first course of action. There seems to be broad agreement among integrative experts about the core components of this approach.
Diet is key, particularly a Mediterranean-type diet or Paleo diet. Paleo diets have been found to be effective in reducing blood pressure. The Mediterranean diet has also been shown to have beneficial effects on blood pressure and heart health, particularly in older adults. The Ornish diet has been approved by Medicare to reverse heart disease. This is a low-fat, plant-based diet filled with fruits, vegetables, whole grains, and legumes. A 2014 meta-analysis published in JAMA 2014 shows that vegetarian diets such as this are associated with lower blood pressure. The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended. A 2016 meta-analysis found that diets such as the DASH, Nordic, and Mediterranean diets lowered blood pressure by 4.26 mm HG/ 2.35 mm HG. These diets are all characterized by high intakes of fruit, vegetables, whole grains, legumes, seeds, nuts, fish, and dairy.
Both high fat (Paleo) and low fat (Ornish, DASH) diets have evidence behind them to lower blood pressure. One potential issue with the lower-fat diets discussed here is that the lower fat content can mean less satiety, which can drive over-indulgence in carb-rich foods that are allowed by those diets (breads, potatoes, etc.) promoting insulin-resistance, weight gain, and increases in blood pressure. A commonality in these diets is eating more plants: lots of fresh vegetables and some fruits.
Certain foods that promote high blood pressure should be avoided: caffeine, refined carbs, and sugars. Salt is often mentioned alongside these other foods, but mounting evidence has shown that universal salt restriction guidelines are incorrect; the story is more complicated. Lowering salt intake may be appropriate for some “salt sensitive” individuals, however.
Other diet and lifestyle changes for lowering blood pressure include:
- Caloric restriction. Studies have demonstrated that caloric restriction can help address hypertension and other aspects of heart health. The usual method is to reduce caloric intake by 10-30 percent of normal energy consumption.
- Intermittent fasting. Eating little or nothing on certain days of the week or eating only during certain hours of the day has many health benefits, including for lowering blood pressure.
- Increased potassium intake. Higher intakes of potassium, as observed in many hunter-gatherer societies, is associated with lower blood pressure. Foods high in potassium include bananas, oranges, cooked spinach, cooked broccoli, sweet potatoes, peas, zucchini, cucumbers, and leafy greens.
- Weight loss. Losing weight is known to lower blood pressure.
- Exercise. Regular exercise has been associated with average reductions in blood pressure of 3.2-3.8 systolic. A sedentary lifestyle is associated with multiple cardiovascular risk factors, including higher blood pressure, unhealthy weight gain, increased cholesterol levels, and impaired glucose metabolism. Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort, so the force on your arteries decreases, lowering your blood pressure. Sitting for long periods of time can also raise blood pressure, so try to break up these periods with some form of physical activity.
- Limited alcohol intake. High alcohol consumption is associated with hypertension. More than two drinks a day for men and one drink a day for women was associated with higher blood pressure.
- Reduced use of Acetaminophen and NSAIDs. These and other over-the-counter medications are known to drive up blood pressure; antacids high in sodium, weight-loss stimulants, and caffeine pills also contribute to high blood pressure.
- Incorporating practices like acupuncture, Tai Chi, meditation, and yoga into your life have all been linked to lower blood pressure. This likely has something to do with managing stress. When under stress, the body produces hormones like adrenaline that make your heart beat faster and your blood vessels narrow—this is the fight or flight response. Narrower blood vessels can lead to high blood pressure. Strategies to reduce or manage stress, then, help lower blood pressure.
- Quercetin acts as an angiotensin receptor blocker.
- Melatonin helps relax blood vessels and inhibits the sympathetic nervous system.
- Fish oil reduces oxidative stress and inflammation, normalizes blood vessel function, and inhibits the formation of blood clots and atherosclerosis.
- CoQ10 boosts production of prostacyclin, a potent vasodilator that prevents blood clotting.
- Magnesium relaxes blood vessels and improves arterial blood flow.
- Olive polyphenols are among the main reasons the Mediterranean diet is heart-protective. A study showed polyphenol-rich olive oil lowered blood pressure compared to a control intervention of refined olive oil.
- Hawthorne increases coronary artery blood flow, improves circulation, and lowers blood flow.
- Resveratrol mimics biological effects of calorie restriction.
- Pomegranate juice inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure.
Also important to note is that high blood pressure is more prevalent among black adults than white adults; researchers speculate that this is due in part to the day-to-day experience of racial discrimination.
Some people may not be able to lower their blood pressure to optimal ranges using the above-mentioned strategies, in which case medications may be called for. The best regimen to use here is best determined in consultation with an integrative doctor. One important note is for diabetic patients: evidence from a large clinical trial has indicated that intensive drug treatment to lower blood pressure below 120 mm Hg did not lead to fewer cardiovascular events. Further, a 2016 meta-analysis found that antihypertensive treatment in diabetics with systolic blood pressure under 140 mm Hg led to increased risk of cardiovascular death.
There is another caveat to the general advice given above. Older patients with pre-existing vascular disease and other medical problems often require higher blood pressure to allow blood to reach critical organs in the body.
We hope this has provided a useful introduction to the ways that blood pressure can be managed with natural medicines in addition to diet and lifestyle changes. As always, you should consult with your (preferably integrative) doctor to assess what the best regimen and approach is for you based on your individual needs.