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:
- Decreased energy
- Erectile dysfunction
- 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:
- Use species that are proven to work.
- Combining 2 to 3 or more species is better than only taking a probiotic with 1 species.
- Total dosage should be at least 10 billion microbes and up to 25 billion every day
- 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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Thank you for this article. These steps should be the first line of defense for controlling hbp. Too often medical professionals jump to medications as the remedy, which do have unwanted side effects.
This was a great article, and much appreciated information. I, for the most part, do these things, but I take a medication for schizophrenia which I believe elevates my blood pressure. I am slowly but surely losing the 10 pounds I picked up last year when I got sick for around 6 months. The rest of it is pretty easy as I don’t like sugar, and not much in the way of grains or flour. Meditation sort of compensates for the medication and helps me keep the BP lowered. Thanks!
I do most of these things, but I take a medication for schizophrenia which I believe elevates my BP.I am losing the 10 pounds I picked up last year when I got sick for 6 months. I don’t like sugar, grains or flour, and meditation helps compensate for the meditation. Thanks!
Thank you so much for the good and extensive information you provide without a sales pitch.
Still, I just bought one of your books!
Great information especially the facts regarding sugar intake. Thanks.
As for the eating of fruit and vegetables. Is that 5 cups of each (fruits and vegetables) for a total of 10 cups or 5 cups combined for a total of 5 cups?
Good question. The 10 cups is a mixture of vegetables and fruits, preferably twice as many vegetables than fruit.
Steven Masley, MD
Your the best! I’m in diastolic heart failure, is there anything for me? My diastolic goes into the forties, except under exertion when bp goes up to over 200/110. I’m not sure I understand if there is different advice for different kinds of failure. Like exercise, I have been trying to please my cardiologist but just can’t do it! Being a widow alone, I’m afraid to let my bp go to high or to low. I’m told there is nothing as too low. Maybe you could help clarify?
I would highly suggest that you keep working with your physician, but also that you follow the eating plan noted in the 30-Day Heart Tune-up to help improve your function. As noted in the book, if you have heart failure, it is essential to keep your salt intake low, so make sure to use not more than 1/2 of the salt mentioned in any recipes.
Steven Masley, MD
very good advice – just one thing; exercise is limited as my husband has
congestive heart failure and there is only so much he can do.
However, the bottom line is we do the best we can, and basically follow
the other 4 suggestions.
thank you. This is very easy and affordable
Is Pomegranate juice to be avoided? Thanks
As I tend to avoid juice because of the high glycemic load, I would rather you eat pomegranates, but for certain health issues, such as elevated PSA levels and for prostate cancer prevention, I’m fine with you having 1 cup of pomegranate juice daily. Best would be to include the juice in a smoothie with protein and berries and fiber to blunt the glycemic load.
Steven Masley, MD
good – information more specific than what we (the public) usually get.
Sorry, but I can’t treat people’s medical issues without knowing you. I suggest you see your own physician.
Please review my recent blog on how to treat elevated blood pressure without medications for additional ideas.
Steven Masley, MD
Dr. Masley, your information is very helpful- thank you.
One question on this article – in regards to the advice on reducing Sugar intake, can you possibly provide any metrics as to how much sugar we should aim for?
For example, the AHA recommends that ” For men, it’s 150 calories per day, or about 9 teaspoons” of added sugars… Your clarification would be greatly appreciated-
The AHA recommends vastly more sugar than is optimal. Your ability to handle small amounts of sugar (such as 1-2 teaspoons of honey daily) will vary with your weight control and your activity. Generally speaking, less sugar is better, none is ideal.
Steven Masley, MD