VALLEY — If you are over the age of 65, chances are your doctor has given you a prescription for a blood pressure-lowering medication. They are the most commonly prescribed class of drugs in the U.S., and about 70 percent of older adults take them.
Hypertension drives up the risk for heart attack, stroke, kidney disease, and Alzheimer’s disease – it is a condition that must be addressed, but in most cases, it can be addressed without medication. Diet and lifestyle factors cause blood pressure to rise, and improvements in diet and lifestyle can bring it back down.
In older adults, medication aiming to reduce systolic blood pressure (the first number) may lower diastolic blood pressure (second number) too much; this could cause the coronary arteries not to fill adequately, which could lead to a heart attack. In fact, the guidelines established by the Eighth Joint National Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 8) do not advocate prescribing blood pressure-lowering medication to adults ages 60 and older with a high systolic blood pressure in the range of 130 to 150 mmHg, because it is unclear whether antihypertensive medication provides any benefit for those patients.
Blood pressure drugs have side effects worth being aware of, especially since some patients take multiple drugs to manage their hypertension. For example, diuretics and beta-blockers are associated with an increased risk of developing type 2 diabetes, and beta blockers have not been shown to reduce the risk of death in people with hypertension. Women who have used calcium channel blockers and diuretics for 10 years or more have a significant increase in breast cancer risk. Angiotensin II receptor blockers (ARBs) increase the risk of lung cancer.
Because of these potential harms, lifestyle methods are preferable to antihypertensive medications. Regular exercise and reducing sodium intake are important steps toward normalizing blood pressure. I recommend reducing added sodium to a maximum of 400 mg (sodium in packaged foods), in addition to what is found naturally in vegetables and other whole foods. The high-nutrient (Nutritarian) diet style I recommend is rich in a variety of vegetables, beans, seeds, nuts, and fruits. This diet-style lowers blood pressure, and also reduces cholesterol levels and inflammation, and normalizes body weight.
Green vegetables contain nitrate, which helps keep blood pressure down, as do the fiber and potassium in all whole plant foods, and flavonoid antioxidants, especially abundant in berries. A study on the Nutritarian diet found that among 443 people with hypertension who had changed to a Nutritarian diet, the average reduction in systolic blood pressure was 26.4 mm Hg and for diastolic pressure, it was 14.7 mm Hg, which led to a 60 percent reduction in the use of blood pressure-lowering medication.
Exercise, sodium restriction, weight loss, and a high-fiber, high-nutrient diet are the best ways to normalize blood pressure, and medication is often not necessary and may cause harm. If you are on medication, talk to your doctor before and after changing your diet, as medication modifications may be necessary.
Dr. Fuhrman is a #1 New York Times best-selling author and a board certified family physician specializing in lifestyle and nutritional medicine. The Eat To Live Cookbook offers over 200 unique disease-fighting delicious recipes and his newest book, The End of Heart Disease, offers a detailed plan to prevent and reverse heart disease using a nutrient-dense, plant-rich eating style. Visit his informative website at DrFuhrman.com. Submit your questions and comments about this column directly to [email protected]