World Hypertension Day

• A preventive cardiologist quantifies the impact of exercising, reducing salt intake, maintaining a healthy weight and other lifestyle changes.

Five natural ways to lower blood pressure

May 2024, According to the World Health Organization, one in three adults worldwide has high blood pressure. Left untreated, this condition – also known as hypertension – could lead to strokes, heart attacks, heart failure, kidney damage and many other health problems. The good news is that simple lifestyle changes can significantly help lower blood pressure, says an expert from the global health system Cleveland Clinic ahead of World Hypertension Day on 17 May.

“Blood pressure management is often 70% lifestyle and 30% medication,” says preventive cardiologist Luke Laffin, co-director of the Center for Blood Pressure Disorders. “Although some people can lower their blood pressure with lifestyle changes alone, the two approaches are complementary. If you take blood pressure medication but don’t make lifestyle changes, your medication won’t work effectively.”

Here, Dr. Laffin assesses five effective lifestyle changes and their estimated impact on lowering systolic blood pressure. Systolic blood pressure is the top number in a blood pressure reading and should ideally measure 120 mmHg or less.

1. Eat less salt

“Cutting down on salt is probably the most important way to lower high blood pressure,” says Dr. Laffin. “In fact, studies show that a low-sodium diet has the same effect as one and a half or two blood pressure medications.”

The American Heart Association (AHA) recommends no more than 1,500 mg (or about a teaspoon) of salt a day. However, because this amount is so strictly limited, Cleveland Clinic providers set the limit at 2,300 mg. “The AHA recommendation is an aspirational goal,” says Dr. Laffin. “If you can get there without drastically changing your diet and feeling miserable, that’s great, but getting to 2,300 milligrams or less can go a long way.”

Dr. Laffin notes that it takes 10 to 14 days to adapt to a low-sodium diet, after which some foods will start to taste too salty. He adds that choosing smart salt substitutes, such as potassium chloride, can help. It is also important to check food labels, as sodium is hidden in many foods.

Impact: Reducing sodium intake from 3,500 mg (the average American daily intake) to 2,300 mg could lower a person’s blood pressure by 2 to 3 mmHg. Limiting sodium intake to the AHA limit of 1,500 mg a day should lower it by 5 or 6 mmHg.

2. Eat more potassium

Potassium can help lower blood pressure because it helps the kidneys get rid of excess sodium. “Potassium is the inverse of sodium,” explains Dr. Laffin. “Too much sodium raises blood pressure, and too little potassium raises blood pressure.”

A diet high in fast food, processed foods, carbohydrates, potatoes and meat is likely to be low in potassium, says Dr. Laffin. “Instead, try to get 3,000 to 3,500 mg of potassium a day by eating foods such as bananas, tomatoes, avocado, melon, carrots, grapefruit, kiwi, broad beans, nectarines and spinach.”

Importantly, the Cleveland Clinic specialist notes that this advice does not apply to patients with kidney disease, who should avoid consuming too much potassium, as their kidneys may not be able to get rid of it.

Impact: For people with hypertension and healthy kidneys, increasing potassium intake to recommended levels should lower blood pressure by 4 to 5 mmHg.

3. Adopt the DASH diet

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, was created specifically to lower blood pressure. Dr. Laffin says the research on this diet is so positive that it is now considered one of the most important non-drug measures for controlling hypertension.

“The DASH diet is a really balanced diet rich in fruit, vegetables and whole grains, and it can be combined with a low-sodium diet,” says Dr. Laffin. “It can be really helpful for lowering blood pressure, and people who adopt the DASH diet generally meet low-sodium and high-potassium guidelines and may also lose weight.”

Impact: Following the DASH diet can lower systolic pressure by up to 11 mmHg in just a few weeks.

4. Get fit

“Being sedentary can raise blood pressure,” says Laffin. “What’s more, exercise, especially aerobic activity, is incredibly effective at lowering blood pressure. It forces blood vessels to expand and contract, which keeps them flexible. It also increases blood flow and encourages the creation of new blood vessels, among other benefits.”

Other options recommended by the specialist include dynamic resistance exercises (for example, bicep curls with weights) and isometric resistance exercises (for example, wall push-ups).

Impact: Doing 150 minutes of aerobic activity a week can lower blood pressure by 5 to 8 mmHg. Dynamic resistance exercises have the potential to lower blood pressure by 4 to 5 mmHg, depending on factors such as frequency, the number of repetitions and how heavy the weights are.

5. Reach a healthy weight

As a person’s weight increases, so does their blood pressure, and losing even a few kilograms can have a significant impact on lowering systolic blood pressure, says the doctor. “The fat cells we get around our midsection are metabolically active cells. They secrete all kinds of hormones, which ultimately raise blood pressure,” he explains.

Impact: Every 1 kg (2.2 lb) lost should result in a 1 mmHg drop in blood pressure.

Dr. Laffin adds that smoking, stress, lack of sleep and alcohol consumption can also contribute directly and indirectly to high blood pressure, so they should be avoided.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical centre that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based on the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognised in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 81,000 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,160 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 276 outpatient facilities, including locations in northeast Ohio; Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2023, there were 13.7 million outpatient encounters, 323,000 hospital admissions and observations, and 301,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 132 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic.