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Updated March 2020

Blood pressure is likely the best predictor for a future heart attack or stroke, and the best measure of the function and well-being of your arteries. When your blood pressure is elevated, that means that your arteries are sick and dysfunctional, likely constricting and limiting blood flow.

A normal blood pressure should be less than 120/80, anything above this is elevated. If it reaches 140/90 that is the standard cut off for hypertension, the point when you qualify for medication therapy, as your hypertension has made you high risk for a cardiovascular event. And despite that medications can lower blood pressure and help to decrease your future risk for a heart attack or stroke, they can have numerous side effects, including:

  • Dizziness
  • Depression
  • Decreased energy
  • Erectile dysfunction
  • Wheezing
  • Decreased exercise performance
  • Decreased libido
  • And a variety of more serious side effects as well.

My goal is to help you have normal blood pressure, without needing medication. I don’t think of blood pressure medications as being bad per se, and for some people they may be essential, but they often have many unpleasant side effects, and my hope is that you won’t need them if you follow the easy-to-follow steps noted below. If you are taking medications to lower your blood pressure, please do not stop them on your own without talking to your own medical provider.

Below are six steps that are as effective as adding a medication, without those side effects, and they are pretty easy to implement, too:

Step 1: Eat five cups of vegetables and fruits every day

Vegetables and fruits provide nutrients such as potassium, vitamin K, vitamin C, flavonoids, and an array of other compounds that make your arteries dilate.  Everyone should eat at least five cups of produce every day, and the more colorful the better. It is amazing that doing something so simple is as effective as taken a drug.

Step 2: Exercise for 30 minutes daily

No doubt about it, exercise is great for blood pressure control. Dance, walk, bicycle, or go to the gym and find something that makes you sweat. Anything that gets your heart rate improve your blood vessel function and will improve your blood pressure control.

Step 3: Lose 10 pounds

I won’t say weight loss is easy, but it is super effective at lowering blood pressure (BP). Losing 10 pounds is as effective in controlling BP as taking a BP drug.

Step 4: Spend 10 minutes meditating daily

If you are not good at meditating, then try using an app like HeartMath, which gives you feedback and makes meditating easier. Studies show that for many people adding meditation or using HeartMath is as effective as using blood pressure medication.

Step 5: Specific probiotic supplement species have been shown to improve blood pressure control.

Recent studies have shown that having the right probiotic species in your gut will improve blood pressure control, and taking the right probiotic species is similarly effective to taking a blood pressure medication. Whether you get these probiotic species from food (such as yogurt or kefir) or get them from taking a capsule is up to you and both can be effective with the right species and the right dosages for the proper time.

The following species when used as a supplement have been shown to be effective at improving blood pressure control:

  • Lactobacillus plantarum,
  • Lactobacillus reuteri,
  • Streptococcus thermophilus,
  • Lactobacillus acidophillus

Studies have shown that several factors make using a probiotic supplement more successful:

  1. Use species that are proven to work.
  2. Combining 2 to 3 or more species is better than only taking a probiotic with 1 species.
  3. Total dosage should be at least 10 billion microbes and up to 25 billion every day
  4. Take a probiotic daily for at least 2-3 months. Treating for less time may not be adequate to modify the gut flora.

Step 6: Yes, limit salt intake, but more important is to limit your sugar!

For people with hypertension, decreasing salt intake from a typical American sodium intake of 3,800 mg per day to 2,500 mg per day lowers the top blood pressure reading (systolic) about 5 mm of Hg points, and the lower blood pressure reading (diastolic) 2.5. Yet for the average American with elevated blood pressure, the typical benefit from cutting your salt intake is only a 2 point reduction.

On the other hand, new research suggests that sugar has a bigger impact on blood pressure than salt. The challenge in making this distinction is that most processed foods are often loaded with both.

A study published in Open Heart by Drs.  DiNicolantonio and Lucan compares the effective of sugar on salt on blood pressure levels. (DiNicolantonio JJ, Lucan SC. Open Heart 2014;1:3000167)

Their findings show that:

  • Eating more sugar increases systolic blood pressure 6.9 mm Hg points and diastolic blood pressure 5.6 mm Hg in the short term, and 7.6/6.1 mm Hg if followed for more than 8 weeks.
  • Drinking a 24-ounce soft drink can increase blood pressure by 15 systolic and 9 diastolic points and raise heart rate by 9 beats per minute.
  • People who consume 25% more calories from sugar (which is easy to do) have a 300% increase in death rate due to cardiovascular disease.
  • A high-fructose (sugar) diet for just 2 weeks increases blood pressure 7 mm Hg systolic and 5 diastolic, but also raises pulse rate, triglycerides, fasting insulin and is associated with fatty liver.
  • The good news is there is no harm noted from eating more fruit, so don’t fret over having an apple, a peach, or a cup of berries. Do avoid fruit juice and dried fruit.

For the best results, combine as many of these six steps together for the best results.

I wish you the best of health!

Steven Masley, MD, FAHA, FACN, FAAFP, CNS

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