Macau Cardiology Association

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How long should one give lifestyle changes a chance to work? At what blood pressure level is medication the first course of action?

Modifying your lifestyle and taking medication is not an either/or choice. Adopting a healthy lifestyle is critical for the prevention of high blood pressure and an indispensable part of managing it. Think of these changes as a “lifestyle prescription” and make every effort to comply with them. They aren't optional!

Lifestyle modifications can reduce blood pressure, prevent or delay high blood pressure, enhance the effectiveness of blood pressure medications, and overall lower your risk of heart attack, heart disease and stroke.

Elements of the "lifestyle prescription"

  • Weight control: Losing as few as 10 pounds reduces blood pressure and/or prevents hypertension in many overweight people (people with a Body Mass Index of 25 or greater), although the ideal is to maintain normal body weight. Learn more about managing your weight.
  • Diet: Healthy eating also improves blood pressure. In particular the DASH (Dietary Approaches to Stop Hypertension) eating plan has proven effective and easy to follow. The DASH diet emphasizes fruits, vegetables, fat-free or low-fat milk and milk products, whole grain foods, fish, poultry, beans, seeds and nuts. It also contains less salt and sodium, sweets, added sugars and sugar-containing beverages, fats and red meat than the typical American diet. According to one study, it reduced systolic and diastolic blood pressure by 5.5 and 3.0 mm Hg compared to the control diet (what the average American eats). Learn more about diet and nutrition.
  • Salt: Healthy people should limit sodium to 2,300 mg or less (about 1 teaspoon) per day. African Americans, middle-aged and older adults and people with high blood pressure need less than 1,500 mg (about 2/3 of a teaspoon) per day. Remember, the majority of sodium typically comes from processed food, not salt added at the table. Learn more about reducing sodium.
  • Physical Activity: Engage in regular moderately strenuous physical activity such as brisk walking at least 30 minutes per day most days of the week. Learn more about physical activity and fitness.
  • Alcohol: If you drink, limit yourself to no more than two drinks per day for men and no more than one drink per day for women. One drink equals one 12-ounce beer, one ounce of hard liquor or one 5-ounce glass of wine. Learn more about alcohol and cardiovascular disease.
  • Tobacco: Avoid all forms of tobacco as well as secondhand smoke. Learn how to quit smoking.

Your doctor will work with you on a plan to monitor your blood pressure while you follow your treatment plan. The American Heart Association recommends home monitoring for all people with high blood pressure to help your doctor determine whether your treatment is working. It’s not possible to make a one-size-fits-all rule about when to begin taking medication. This is a decision for you and your doctor to make. Factors he or she will consider are your age, body mass index, activity level and blood pressure numbers. As reluctant as you may be to take a prescription, the effects of high blood pressure are serious. And those effects are cumulative, so the sooner you begin counteracting them, the better.

 

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