Medical Edge Newspaper Column

Self-Care May Help Avoid High Blood Pressure

June 6, 2008
Dear Mayo Clinic:
I am a very healthy, active and slender woman of 50. I have prehypertension. Hypertension is hereditary in my family. I hope to avoid prescription medication. Are there other treatment options, such as yoga or breathing therapies that would help me?

Answer:
Hypertension is another word for high blood pressure. A person's blood pressure is determined by the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.

A blood pressure reading, measured in millimeters of mercury (mmHg), has two numbers. The first, or upper, number measures the pressure in arteries when the heart beats (systolic pressure). The second, or lower, number measures the pressure in arteries between beats (diastolic pressure).

Normal blood pressure is below 120 systolic/80 diastolic. High blood pressure is above 140/90. Prehypertension is any measurement between those two. Prehypertension describes the condition when blood pressure averages less than 140/90 but more than 120/80.

Any factor that increases pressure against the artery walls can lead to prehypertension. In some cases, an underlying medical condition can cause the rise in blood pressure. Possible conditions include sleep apnea, kidney disease, heart disease or diabetes. If you haven't already done so, talk to your doctor about screening for these conditions to ensure that they aren't causing prehypertension.

In addition, some medications can temporarily raise blood pressure such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs. Once the possibility of contributing factors has been ruled out, prehypertension usually can be controlled without prescription medication. Lifestyle is important to keeping elevated blood pressure in check.

You already have a good start by being active and slim. Blood pressure often increases as weight increases. Maintaining a healthy weight and exercising regularly are linked to lower blood pressure levels.

Watch what you eat and drink. Make sure your diet is rich in whole grains, fruits, vegetables and low-fat dairy products, and low in saturated fat, cholesterol and sodium. This eating plan — the DASH (Dietary Approaches to Stop Hypertension) diet — is often recommended for people who have elevated blood pressure. For more details about the DASH diet, talk to your doctor or get information online at MayoClinic.com. Type DASH in the search box.

In addition, try to limit alcohol intake. Drinking more than moderate amounts of alcohol can raise blood pressure by several points (mmHg). Most physicians recommend no more than one drink a day for women and two a day for men.

For some, caffeine may also increase blood pressure. Although not everyone's blood pressure rises due to caffeine, it's wise to limit consumption to no more than 200 milligrams a day — about the amount in two cups of coffee.

Also important is avoiding tobacco products and secondhand smoke. Nicotine in tobacco products can raise blood pressure by 10 mmHg or more for up to an hour after smoking. For those who smoke throughout the day, blood pressure may remain constantly high. In addition, tobacco use can damage arteries directly.

Breathing therapies may help, too. The Food and Drug Administration (FDA) has approved a device called Resperate for reducing stress and lowering blood pressure. It analyzes a person's breathing pattern, creates a personalized melody, and transmits it to earphones. Then, the listener synchronizes breathing to the melody. The goal is slow, deep breathing — 10 breaths a minute — with long exhalation.

The theory behind breathing therapy is that many people who have elevated blood pressure also have increased activity in the part of the nervous system that controls blood flow (the sympathetic nervous system). Regular use of deep, controlled breathing exercises reduces this activity, allowing blood pressure to return to normal. Studies indicate such therapy works, but it's not permanent. If you stop doing the breathing exercises, your blood pressure will rise again.

If you prefer not to spend the money on Resperate — the device costs about $300 and is not always covered by insurance — it may be possible to achieve similar results by doing yoga on a regular basis.

By following these healthy lifestyle choices, perhaps you can successfully control blood pressure and avoid or delay the need for medication.

— Sheldon G. Sheps, M.D., Mayo Clinic, Rochester, Minn.