Many patients struggling with high blood pressure may be able to reduce or even stop taking their medication through significant lifestyle changes, according to health experts. While blood pressure pills are crucial for preventing serious conditions like heart attacks and strokes, nearly half of patients do not take them regularly, and around a fifth stop altogether, often due to side effects or concerns about long-term safety.
High blood pressure, or hypertension, affects about a third of adults in the UK and is a leading cause of death. It occurs when the force of blood against artery walls is consistently too high, which can damage blood vessels and increase the risk of cardiovascular events. Blood pressure is measured with two numbers: systolic pressure (when the heart contracts) and diastolic pressure (when the heart relaxes between beats). A normal reading is typically around 120/80, with readings consistently above 140/90 considered high.
Common side effects from blood pressure medications can include dizziness, dry coughs, headaches, swollen ankles, and an increased need to urinate. Some studies have also raised concerns about potential links to other diseases, such as kidney disease with certain types of drugs like calcium-channel blockers. Experts note that while these drugs are often life-saving, the side effects can be difficult to manage. Patients may be able to adjust their dosage or switch medications, but lifestyle changes offer a powerful alternative.
"Many patients don’t like taking their blood pressure medicines because, in the short-term, they can trigger side effects and have no obvious benefit because high blood pressure is symptomless," said Professor Amitava Banerjee, a heart expert at University College London. "The problem is that, in the long-run, these drugs save lives."
However, Professor Banerjee also stated, "Many patients assume they have to be on them for life, but that’s not always the case. Yes, there are patients who will need to keeping taking the pills indefinitely, but for some, lifestyle changes can get blood pressure down to a point where you no longer need to take the tablets."
Key Lifestyle Interventions
Several lifestyle adjustments can contribute to lowering blood pressure:
- Weight Loss: Extra weight strains the heart, leading to higher blood pressure. A US study found that losing 10% of body weight could allow patients to stop at least one hypertension drug. While weight loss can take time, it can significantly improve blood pressure readings.
- Reduced Salt Intake: High salt consumption causes the body to retain water, increasing blood pressure. The majority of salt intake comes from processed foods, meats, and ready meals, rather than salt added at the table. Cutting down on these sources can lead to a drop in blood pressure within a month.
- Increased Fruit and Vegetable Consumption: A diet rich in fruits and vegetables can improve circulation and has been shown to significantly reduce blood pressure within two months.
- Moderating Alcohol Intake: For those consuming more than two alcoholic drinks a day, eliminating alcohol can have a marked impact on blood pressure. Ideally, intake should be kept to a minimum, with no more than 14 units spread throughout the week and at least two to three alcohol-free days.
- Regular Exercise: Aerobic exercises like running, swimming, or cycling are particularly effective. About 150 minutes of moderate-intensity activity per week is recommended. For those who are less active, shorter, more frequent sessions are beneficial. The effects of exercise typically become noticeable in blood pressure readings after one to three months of consistent activity.
- Stress Management: Tackling stress, anxiety, and poor sleep can also lower blood pressure. Chronic stress can lead to an adrenaline response that raises heart rate. Furthermore, poor mental health can negatively impact other healthy habits like diet and exercise. Mindfulness programs have shown sustained reductions in blood pressure even after the course concludes.
While these lifestyle changes can be highly effective, experts emphasize that they may not enable everyone to stop medication entirely. Some individuals have stubbornly high blood pressure that persists even after significant lifestyle adjustments and medication. In cases of 'resistant hypertension,' underlying health conditions might be the cause, requiring further medical investigation.
Bettina Wallace, a 73-year-old charity worker, shared her experience of successfully managing her blood pressure through dietary changes, particularly reducing salt intake, and increasing exercise. She hopes to eventually stop her medication due to side effects like swollen ankles. "I would like to come off them eventually. I know people who have maintained their healthy blood pressure through good diet alone. It’s something I’d like to try," she said.
Experts suggest that for many patients, a proactive approach to lifestyle can be instrumental in managing hypertension and potentially reducing reliance on medication. Professor Raj Thakkar, president of the Primary Care Cardiovascular Society, stated, "It can take some time and commitment but lifestyle changes really can get blood pressure down. Hypertension is so prevalent in Britain and patients can’t rely on treatment from the NHS alone to get their levels down. It’s up to the individual. And with the right advice it can be done."