Which lifestyle change can help lower blood pressure most effectively?

This study investigated the effect of different kinds of lifestyle changes in patients with high blood pressure (BP) in the beginning stages (prehypertension) and full-blown hypertension.

They found that a life-long change in eating called Dietary Approach to Stop Hypertension (DASH) has the most positive impact on a BP reduction.

Hypertension is a diagnosis that affects millions of people around the world. While in the beginning stages the symptoms might seem mild, it is necessary to take this diagnosis seriously. The severity and specific type of hypertension can be determined by observing the BP in the contraction phase of the heart (systolic BP – SBP) and in the release phase (diastolic BP – DBP).

Hypertension can lead to severe consequences like stroke and heart attack. Therefore, a well-supervised treatment plan should be developed. Studies showed that changes in the patients’ lifestyle are an effective and drug-free way to improve BP  and lower long-term risks with minimal side effects. Lifestyle changes include heart-friendly exercise that improves the oxygen metabolism (aerobic), gentle static exercise (isometric), regular and slow breathing under pressure (breathing control), and the permanent change to a low-salt (low-sodium) healthy diet. DASH is a program developed to permanently implement a healthy diet into the patients’ life. It includes portion control, low-salt, and nutrient-rich foods like fruits and vegetables. 

How well each of the lifestyle measures individually impacts BP, is yet to be determined.  

This study analyzed the data of 120 studies including 14,923 patients with high BP overall. Patients were either in the prehypertension-stage or in the manifested stage. Patients taking or not taking medications to lower BP were included. 22 different kinds of lifestyle changes were evaluated. The study observed the BP before and after a lifestyle change for an average follow-up time of 12 weeks. The results were compared to another treatment approach, mostly with BP-lowering medication. 

Lifestyle changes that proved to lower SBP more significantly than usual care were Tai-Chi (lowered BP by an average of 13.47 mm/Hg), dietary programs like DASH (by 6.97 mm/Hg), aerobic exercise (by 6.60 mm/Hg), and DASH plus aerobic exercise (11.20 mm/Hg). Lifestyle changes that proved to lower DBP more significantly than usual care were Tai-Chi (by 7.76 mm/Hg), DASH (by 3.54 mm/Hg), and aerobic exercise (by 4.44 mm/Hg). For overweight patients, exercise plus a healthy, low-calorie diet had a higher impact on lowering BP than exercise alone.

Overall DASH, aerobic exercise, isometric training, low-salt diet showed to have the highest impact to lower BP, followed by controlled breathing and meditation.

The authors recommend lifestyle changes such as DASH, aerobic exercise, isometric training, low-salt diet, controlled breathing, and meditation to lower BP in patients with high BP.

The average follow-up time relatively short to measure the effects of permanent lifestyle changes. The studies analyzed were very different. More controlled studies are needed to compare different lifestyle changes to lower BP.

Ask your doctor for assistance on how to implement healthy lifestyle changes.