HealthNotes

• By Maureen Williams, ND

The “Secret” to Lower Blood Pressure? Eat Well, Exercise, Lose Weight

Widely promoted by the National Heart, Lung, and Blood Institute; the American Heart Association; and other organizations, a set of recommendations known as the Dietary Approaches to Stop Hypertension (DASH) is directed at lowering blood pressure. One study found that adding weight loss and exercise to the DASH diet led to better blood pressure–lowering results.

Take the three-pronged approach to control blood pressure

Triple threat is best for blood pressure

The study, published in the Archives of Internal Medicine, included 144 overweight or obese men and women. To qualify for the study, they had to have stage 1 hypertension, or prehypertension, defined as a systolic blood pressure of 130 to 159 mm Hg or a diastolic blood pressure of 85 to 99 mm Hg. They were randomly assigned to:

• a DASH diet group,
• a DASH-diet-plus-weight-loss group, or
• a usual-diet group for four months.

The people in the DASH diet groups received instruction and support for eating a diet rich in fruits and vegetables and low- or non-fat dairy foods, while limited in fats and sodium. Those in the weight loss group were also instructed in behavioral strategies and ways to think about food to modify eating habits, and participated in supervised 45-minute exercise sessions three times per week.

The results:

• The DASH-diet-plus-weight-loss group lost more weight (an average of 8.7 kg, or almost 20 pounds) and improved most in fitness, compared to the other groups which did not improve in either weight or fitness.
• Participants’ blood pressure was lowered in both DASH diet groups compared with the usual-diet group.
• Hypertension was reduced most dramatically in the DASH-diet-plus-weight-loss group.
• At the end of the study, only 12% of the DASH-diet-plus-weight-loss and 15% of the DASH-alone groups were hypertensive, while almost 39% of the usual diet group were hypertensive.

Take the three-pronged approach to control blood pressure

“The DASH diet with or without a behavioral weight loss program results in clinically significant reductions in blood pressure. Adding exercise and weight management to the DASH diet also appears to confer even greater reductions in blood pressure as well as additional improvement in… other markers of cardiovascular risk,” lead study author James Blumenthal, PhD, professor of medical psychology at Duke University, said in a press release.

So, if you are managing high blood pressure, work with your doctor to create a program that includes these important basic steps:

• Don’t skimp on the vegetables and fruits: 8 to 10 servings per day is your goal.
• Eat plenty of other fiber-dense foods like beans, lentils, nuts, seeds, and whole grains.
• Limit your intake of meat and poultry, and try to have some cold-water fish once or twice a week.
• Limit fats, especially animal and trans fats, and empty calories from refined carbohydrates and simple sugars.
• Cut sodium by preparing your own food instead of eating from cans and packages or eating out.
• Make room in your schedule for four or more hours of aerobic exercise every week.
• If you need to lose weight, cut calories by eating fewer high-calorie foods, not fiber-and-nutrient rich foods like vegetables.

(Arch Intern Med 2010;170:126–35)