If six or more servings of fruits and veggies daily seems impossible, it’s probably because most of us have unrealistic visions of a serving. "A serving might only be 1/2 cup, so a big banana could be equivalent of up to two servings by itself," says Vollmer.
Getting PREMIER Results
"Lifestyle changes are among the major recommendations for controlling HBP. The latest report recommends regular physical activity for 30 minutes daily which can be anything you enjoy, including brisk walking, gardening, or swimming," says Mark Samuelson, M.D., a doctor at Linden Ponds, a Massachusetts community built and managed by Erickson.
The PREMIER study analyzed lifestyle changes for bringing down hypertension. "Instead of just looking at how one lifestyle change—like quitting smoking—affected blood pressure, PREMIER looked at how much blood pressure reduction we could get from multiple lifestyle changes," says Vollmer, who was one of PREMIER’s leaders.
The study divided people into three groups. The control group received short consults on how to bring down BP. The second was given intensive training on how to lose weight, lower fat and sodium in their diet, and increase physical activity. The third group was similar to the second, but their training included how to follow the DASH diet. "When they started, participants were consuming an average of 4,000 mg of sodium daily. It dropped to about 2,300 mg by study’s end," says Vollmer.
Before the training all the participants had hypertension (HBP). After 18 months, 37 percent in the control group no longer had HBP. That number rose to 60 percent in the second group and to 62 percent in the lifestyle-plus-DASH group. "The interventions compare very favorably to single drug therapy, which reduces blood pressure to normal levels in about half of patients," says Vollmer.
What’s the Stress Connection?
One major lifestyle change recommended is reducing stress. "Stress calls forth an old response called ‘fight or flight,’ in which our blood pressure rises. However, nowadays we are usually not fighting or running when stressed, and so we don’t work off that raised blood pressure," says Herbert Benson, M.D. Benson is the founding president of the Mind/Body Medical Institute (M/BMI) in Massachusetts, and a pioneer in studies of stress and its affect on people’s health.
"We have an opposing response, called the relaxation response. In brain studies at M/BMI, we have found when someone invokes the relaxation response, nitric oxide is released which opens their blood vessels and helps their circulation," he says.
Medication doesn’t create a relaxation response. Instead, every individual has to determine what brings on their relaxation response. "For lots of people repeating something when the stressful situation arises invokes relaxation. Many religions have such mechanisms; e.g., saying the rosary in Catholicism or davening in Judaism. Certain physical activities, like yoga and tai chi, also bring relaxation through repetition," says Benson.
"Such techniques are appealing to patients for a number of reasons. They are easy to learn, cost pennies (if anything) to implement, require a small time commitment, and have no known negative side effects. They also foster a sense of control and self-determination," says Samuelson.
What About Supplements?
Some people have turned to "nutraceuticals" (nutrients being used as pharmaceuticals) to lower blood pressure. One supplement that Mark Hyman, M.D., endorses is magnesium. "Magnesium is nature’s channel blocker. It’s the relaxation mineral. I’ve seen it used in emergency rooms with patients on whom we couldn’t use other sedatives," says Hyman, editor-in-chief of the medical journal, Alternative Therapies in Health & Medicine.
The jury still seems to be out on other elements, including fish oil and CoQ10. Hyman warns you shouldn’t simply turn to magnesium or any other "natural" supplement for BP control. "Green natural medicine is still medicine. Even with a natural product you are treating the symptoms and not the cause," he says.
If you decide to try another method for reducing your blood pressure, do NOT drop any medication you are on. "That would be irresponsible. Check with your doctor first and decide on a program together, then make sure your doctor monitors you carefully as you integrate it into your routine," says Benson.