High blood pressure is a key contributor to diabetes, heart disease, kidney disease, and stroke – and it can add serious complications for COVID-19 patients as well.
It’s common for people with high blood pressure to take one or two pills to control high blood pressure, but is it enough?
A new US study presented at an AHA hypertension conference on Monday found the answer most likely to be no.
Analyzing data from 13,000 adults with hypertension, the study found that younger men aged 20 to 49 were up to 70% more likely to have uncontrolled hypertension than women the same age.
However, the risk changed when women reached the age of 70, while women were 29 to 63% more likely than men to have uncontrolled hypertension.
Also called “resistant” hypertension, a person’s blood pressure is considered uncontrolled when they are still at elevated levels despite using three types of drugs at the same time.
The study defined high blood pressure using the AHA guidelines as anything above 130 systolic (upper number) and over 80 diastolic (lower number).
“Controlling blood pressure remains a major public health challenge that affects even those who are being treated for the disease,” said study author Aayush Visaria, postdoctoral researcher at Rutgers University in New Jersey.
Young men aged 20 to 29 were 59% more likely to have uncontrolled hypertension than women this age.
Men aged 30 to 39 were 70% more likely to be uncontrolled, and men aged 40 to 49 were 47% more likely to be uncontrolled.
“These results indicate that women 70 and older and men under 50 with hypertension may have an increased risk of uncontrolled hypertension and may benefit from more frequent blood pressure monitoring,” a said Visaria.
What to do?
But there is something people with stubbornly high blood pressure can do – and it’s more than just take another pill.
In what the authors call the first such study, people were able to reduce resistant high blood pressure by combining diet, exercise, and reducing salt intake.
“While we generally thought to recommend lifestyle changes, such as losing weight and getting more physical activity before starting medication, this study significantly reinforces the fact that adding lifestyle changes in conjunction with drugs – and when drugs alone don’t do the job – is an effective strategy, ”Bethany Barone Gibbs, of the University of Pittsburgh, said in a statement.
The DASH diet and exercise work
Over a four-month period, 90 adults with uncontrolled high blood pressure received weekly dietary advice on how to follow the DASH diet, which stands for Dietary Approaches to Stop Hypertension.
An award-winning diet, DASH is based on a simple principle: eat more vegetables, fruits and low-fat dairy products; limit foods high in saturated fat; and limit your sodium intake to 2,300 milligrams per day, or about 1 teaspoon of table salt.
The DASH meal plan includes four to six servings of vegetables and another four to six servings of fruit, three servings of whole grain products, two to four servings of fat-free or low-fat dairy products, and several servings each of lean meats. . and nuts, seeds and legumes every day.
In addition to coaching and the meal plan, the 90 people in the study engaged in intensive, supervised training at a cardiac rehabilitation center three times a week.
Another 50 people with resistant hypertension attended a single session with a health educator and returned home with written guidelines on exercise, weight loss and nutritional goals to follow on their own.
The results? People in the guided group reduced their systolic blood pressure by at least 12 points, compared to a reduction of 7 points in the group without structured help.
“While some people may change their lifestyle on their own, a structured program of supervised exercise and dietary modification conducted by a multidisciplinary team of health professionals in cardiac rehabilitation programs is probably more effective,” said said lead author of the study James Blumenthal, professor of psychiatry and behavioral sciences at Duke University School of Medicine.
An important note: People did not stop taking their blood pressure medication during the study, but due to the reduction they got, they may be able to cut back on their medication after a discussion with their doctor.
“The most important point is that it’s not too late to lower blood pressure by making healthy lifestyle choices,” said Blumenthal.
“Adopting a healthy lifestyle pays huge dividends, even for people whose blood pressure remains high despite taking at least three blood pressure medications. “