Many people would rather not take a blood pressure medication if it can be avoided, but also don’t want to feel they are increasing their risk of stroke and cardiovascular disease. Medications are often the most reliable way to decrease blood pressure but in patients with “mild” or “stage 1” hypertension (140-159/90-99 mmHg) without additional risks (like heart or kidney disease or diabetes) there is limited benefit but lifestyle is recommended. Sometimes hypertension is over-diagnosed and certainly from experience my own personal blood pressure will vary greatly from if I am rushing around or relaxing, so a number of measurements are required.
We are often told that blood pressure is a consequence of aging or if you like an inevitability of “too many birthdays”. Maybe to some extent true but there is a link to other conditions and hyperinsulaemia is certainly one risk factor, this becomes entwined with sugar obesity and other factors like stress. Ultimately blood pressure can be lowered by many different factors. If I were to give advice is to reduce sugar (and fruit), which contains fructose, for which the metabolism was really only recently discovered and is quite complex.
Below is a table of approximate reductions which can be achieved by different methods lifestyle interventions.
| Intervention | Reduction (sys/diastolic) | PMID |
| Dash Diet | 6.7/3.5 | 25149893 |
| Exercise | 3.5/3.2 | 23525435 |
| Salt restriction | 1.1/0.0 | 19121772 |
| Reduce alcohol | 2.7/1.4 | 15752957 |
| Low Carbohydrate diet | 4.8/3.1 | 22905670 |
| Per 1kg weight loss | 1.2/1.0 | 3070038 |
| Meditation | 4.3/2.3 | 25673114 |
| Sugar | 7.6/6.1 | 25717381 |
| 7+ Hours sleep | 3.8/0.9 | 16944668 |
| Magnesium supplementation | 2.0/1.8 | 27402922 |
| Vitamin D deficiency treatment | 6.4/2.4 | 25350782 |
NICE recommends DASH diet, if I were trying to lower blood pressure however my first choice would be fructose and carbohydrate restriction. Salt restriction is interesting as this is recommended but as I cook all my own food my diet is not that high in salt which is higher in processed foods. An article in the Lancet about salt restriction was not convincing of the benefits and indeed there is definitely such as thing as too little salt which was associated with adverse outcomes. It is worth considering causes of hypertension and low levels of magnesium or vitamin D could be explored. If you are overweight addressing this though diet could be beneficial.
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