Blood pressure is the measure of the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and contributes to hardening of the arteries, or atherosclerosis, and to the development of heart failure.

What Is “Normal” Blood Pressure?

A blood pressure reading has a top number (systolic) and bottom number (diastolic). The ranges are:

• Normal: Less than 120 over 80 (120/80)
• Pre-hypertension: 120-139 over 80-89
• Stage 1 high blood pressure: 140-159 over 90-99
• Stage 2 high blood pressure: 160 and above over 100 and above

People whose blood pressure is above the normal range should consult their doctor about steps to take to lower it.

Causes of High Blood Pressure

The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development, including:

• Smoking
• Being overweight or obese
• Lack of physical activity
• Too much salt in the diet
• Too much alcohol consumption (more than 1 to 2 drinks per day)
• Stress
• Older age
• Genetics
• Family history of high blood pressure
• Chronic kidney disease
• Adrenal and thyroid disorders

Which lifestyle modifications are beneficial in treating high blood pressure?

Lifestyle modifications refer to certain specific recommendations for changes in habits, diet and exercise. These modifications can lower the blood pressure as well as improve a patient’s response to blood pressure medications.

• Alcohol

People who drink alcohol excessively (over two drinks per day*) have a one and a half to two times increase in the prevalence of hypertension. The association between alcohol and high blood pressure is particularly noticeable when alcohol intake exceeds five drinks per day. The connection is a dose-related phenomenon. In other words, the more alcohol consumed, the stronger is the link with hypertension.
*The National Institute on Alcohol Abuse and Alcoholism considers a standard drink to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Each contains roughly the same amount of absolute alcohol- approximately one-half ounce or 12 grams.

• Smoking

Although smoking increases the risk of vascular complications (for example, heart disease and stroke) in people who already have hypertension, it is not associated with an increase in the development of hypertension.

• Coffee and caffeinated beverages

In one study, the caffeine consumed in five cups of coffee daily caused a mild increase in blood pressure in elderly people who already had hypertension, but not in those who had normal blood pressures.
What’s more, the combination of smoking and drinking coffee in persons with high blood pressure may increase the blood pressure more than coffee alone. Limiting caffeine intake and cigarette smoking in hypertensive individuals may be of some benefit in controlling high blood pressure.

The American Heart Association states there is no consistent evidence that daily consumption of 1-2 cups of coffee (or its equivalent) increases blood pressure to any significant degree in people who do not already have high blood pressure.

However, a study reported the Journal of the American Medical Association in 2005 found that while coffee consumption was not associated with an increased risk of hypertension, consumption of sugared or diet cola did cause modest increases in blood pressure, though no recommendations on cola consumption were made.

Energy drinks often contain high levels of caffeine. The American Heart Association points to research which suggests people with high blood pressure or heart disease should avoid energy drinks because they could affect their blood pressure.

• Salt

The American Heart Association recommends that the consumption of dietary salt be less than 6 grams of salt per day in the general population and a lower level (less than 4 grams) for people with hypertension.
To achieve a diet containing less than 4 grams of salt, do not add salt to food or cooking. Also, the amount of natural salt in the diet can be reasonably estimated from the labeling information provided with most purchased foods. Note: Take care if using salt substitutes, as some contain sodium!

• Other dietary considerations

Add potassium to your diet. Studies show that people who consume more potassium have lower blood pressures. Good sources of potassium include:

• bananas,
• melons,
• oranges,
• spinach and
• zucchini.
• Obesity

Obesity is common among hypertensive patients, and its prevalence, especially in aging patients, can contribute to hypertension in several ways. In obese people the heart has to pump out more blood to supply the excess tissue.
The increased cardiac output then can raise the blood pressure. In addition, obese hypertensive individuals have a greater stiffness (resistance) in their peripheral arteries throughout the body. Insulin resistance and the metabolic syndrome also occur more frequently in the obese.

Finally, obesity may be associated with a tendency for the kidneys to retain salt. Weight loss may help reverse obesity-related problems and may lower blood pressure.
Blood pressure may be decreased 0.32 mm Hg for every 1 kg of weight lost down to a person’s ideal body weight.

• Exercise

A regular exercise program may help lower blood pressure over the long term. Activities such as jogging, bicycle riding, power walking, or swimming for 30 to 45 minutes daily may lower blood pressure by as much as 5 to15 mm Hg.
There also appears to be a relationship between the amount of exercise and the degree to which the blood pressure is lowered. So the more you exercise (up to a point), the more you lower the blood pressure.
This beneficial response occurs only with aerobic (vigorous and sustained) exercise programs. Any exercise program must be recommended or approved by a physician.

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