Mark Sandoval, M.D.
Lifestyle Medicine
Emergency Medicine
Let us look at the steps you can take to help overcome your high blood pressure. Remember, some of these steps will have immediate effects, and others will take a long time. Some will only last for a little while, and others will last much longer. No single step is likely to reverse your high blood pressure. It will be a combination of many of these steps together that help to bring down your blood pressure, so apply everything that you possibly can and enjoy the results of doing so.
Step 1 – fast.
At our lifestyle center, we frequently have individuals fast at the beginning of their 2 ½ weeks with us, and there are several reasons for this. Fasting improves immune function, showing benefit with cancer and autoimmune conditions. Fasting helps to control blood sugar levels in diabetics. Fasting helps increase that really important “muscle” called self-control. Fasting helps undo the damage to the taste buds from high stimulating foods and helps you enjoy simple foods. And, fasting helps to lower your blood pressure. The majority of patients at our center who are fasting will show mild to moderate drops in their blood pressure during their fast. And some will show dramatic drops in their blood pressure when fasting.
Just as with diabetes, I recommend water fasting (where you eat nothing and only drink water) for about three days. After two days, you can add about ½ teaspoon of salt daily to your water to make sure your sodium levels do not drop too low.
If you are on medications, please work with your doctor before you choose to fast. Some medications can kill you if you are fasting (especially diabetes medications), and we don’t want you to die. We want you to get better. If you are only on blood pressure medications, you won’t die if you fast and you take them at the same time, but certain of the blood pressure medications need to be tapered off before stopping them, while others can be stopped right away. Your doctor should know which you can stop and which you need to taper.
Make sure you check your blood pressure a few times each day while you are fasting so you can be aware of how your blood pressure is responding to the fast. You will likely notice that each day your blood pressure is getting lower than the day before, even though blood pressure normally fluctuates a lot during the day.
Step 2 – eat a low sodium diet.
For the best health, to prevent the development of high blood pressure as you age, or to decrease blood pressure in those who have it, you should be consuming no more than 1,500mg (just less than ¾ teaspoon of salt) of sodium daily. But the average American consumes over 5 teaspoons of salt daily. Where do you find sodium in your diet? You find sodium everywhere you find salt—and salt is everywhere.
The six leading sources of sodium in the American diet are: 1) breads and rolls, 2) pizza, 3) sandwiches, 4) cold cuts and cured meats, 5) soup, and 6) burritos and tacos. Other leading sources are snack foods, cheese, eggs & omelets, flesh foods (cattle, poultry, sea food, fish, etc.), pasta dishes, catsup, salad dressings, vegetable oils, milk, ready made cereals, mashed potatoes & French fries, cakes & pies, and rice.
If you make a particular meal at home and you go to a restaurant and eat that same kind of meal, the meal that you ate at the restaurant will have on average twice the amount of salt as the meal you made at home. Keep this in mind when you think about eating out.
Many restaurants are now required to list the nutrition facts of the foods that they provide, so check out how much sodium is in a serving of the foods you are thinking of eating (and how many servings are in the portion you are given). For example, a KFC Crispy Caesar Twister contains 1,616mg of sodium, which is more than a whole day’s worth of sodium (and it has over 10 teaspoons of fat in it!).
Read nutrition labels on the foods that you purchase and pay attention to sodium content and serving sizes. For example, a Doritos Nacho Cheese party size bag, you have 210mg of sodium per serving. But a serving size is only 1 ounce, or about 11 chips. The whole bag contains 15.5 ounces, so that whole bag actually contains 3,255mg of sodium, which is over 2 days worth of sodium (it also contains 31 teaspoons of fat!).
Step 3 – Maintain a high potassium to sodium ratio in your diet.
Potassium helps to dilate or relax your blood vessels so that they don’t squeeze so hard on the blood inside of them and so that the blood pressure is not so high. Sodium, on the other hand, has the opposite effect over time. So, maintaining a diet that provides a lot of potassium and as little sodium as possible is best for high blood pressure treatment and prevention.
Foods that have a high ratio of potassium to sodium include nuts and seeds, legumes (of which soy has the best ratios), dried fruits, whole grains, fruits, mushrooms, greens (especially lambsquarters), squashes and potatoes, and other unprocessed plant foods.
Step 4 – Include blood pressure-reducing foods in your diet.
Studies show that a number of food items specifically help to reduce your blood pressure. These include barley, blond psyllium, celery, flax seed (2 tablespoons freshly ground daily), garlic, olives, and wheat bran.
Step 5 – use blood pressure-reducing supplements.
Studies have shown that several supplements are also beneficial in reducing blood pressure. These include Coenzyme-Q10 (about 200mg daily), Folic acid, guar gum, L-arginine, niacin (vitamin B-3), and vitamin C.
Step 6 – use blood pressure-reducing herbs.
Studies show that a few herbs have been shown to reduce blood pressure. These include hawthorn berry, hibiscus flower, and olive leaf. For these, you use a teaspoon to a tablespoon of the herb in 1 cup of boiling water (if you use 2 herbs, put 1 teaspoon to tablespoon of each herb in 2 cups boiling water) and let simmer for 20 minutes. Cool, and strain, then drink throughout the day. With the hibiscus tea, make sure your rinse your mouth out with water after drinking it, as it is acidic and can erode the enamel of your teeth.
Step 7 – exercise.
Studies show that remaining physically fit helps to reduce blood pressure. Blood pressure actually elevates mildly while you are exercising. But when you exercise regularly, your average blood pressure readings decrease. Exercise is an important part of your routine in reducing blood pressure. How much do you need to exercise? You should aim for about 1 hour of exercise daily, including both cardiovascular exercise (walking, hiking, biking, swimming, gardening, etc.) every day of the week and resistance exercise (lifting weights, resistance bands, push ups, squats, etc.) at least 2 days each week.
Step 8 – avoid caffeine, alcohol and tobacco.
Caffeine, alcohol, and tobacco all raise one’s blood pressure, either temporarily or long-term. And so it is best to avoid these products in an attempt to lower your blood pressure. It is good to avoid these products even if you don’t have blood pressure, because they have numerous other problems, including producing cancer, heart disease, digestive issues, neurologic problems, etc.
Step 9 – lose weight.
The fat tissue in your body produces a hormone called Leptin, which stimulates your fight-or-flight response and increases your blood pressure. The more fat tissue you have, the more leptin is produced, and more it leads to high blood pressure. When you lose weight, you have less fat tissue, less leptin is produced, and your blood pressure decreases. Because of this, weight loss is an important part of winning the battle with high blood pressure.
Step 10 – stay well hydrated.
If the blood is thicker, it takes more pressure to push it through the blood vessels. Drinking lots of water and staying well hydrated helps to keep the blood flowing well. You should be drinking about 1 ounce of water for every 2 pounds that you weigh. But if you are sweating, have a fever, or have diarrhea or are urinating frequently, you should drink more. If you have heart failure or kidney failure, check with your cardiologist or nephrologist before drinking more water.
Step 11 – get good sunshine.
At our lifestyle center, we have found sunbathing to be a great benefit to blood pressure treatment. If someone’s blood pressure is high, we can send them to go sun bathe for about 20 minutes, and after doing so, their blood pressure can come down 20-40 points. The effect of the sunshine on lowering the blood pressure only lasts a couple hours, but every reduction in blood pressure, even if it is temporary, decreases your overall average blood pressure and reduces the damage that the high blood pressure causes to the organs.
Step 12 – get good sleep.
Sleep deprivation can cause the blood pressure to elevate. At our center, we monitor blood pressures every morning, and if I have a patient whose blood pressure is exceptionally elevated one morning, I will usually ask them how they slept the night before. Almost always they tell me that they had a poor night of sleep. I know, because I can see it in their blood pressure.
Step 13 – 4-7-9 breathing.
One of the most rapid ways that I know of to lower your blood pressure is through breathing exercises. 4-7-9 breathing is simple. You simply breathe in slowly for a count of 4, hold your breath for a count of 7, and breathe out slowly for a count of 9. Continue breathing like this 10 times in a row, and repeat it every hour that you are awake. Within 2 minutes, your blood pressure can drop 5-20 points. It only stays low for a few minutes, but again, every time you can lower your blood pressure, it decreases the overall damage that the high blood pressure causes to your organs.
Step 14 – reduce your environmental noise
If you live in a house next to a busy road, studies show that if you sleep in a bedroom that is on the side of the house next to the road, you will have higher blood pressure than if you sleep in a bedroom that is on the side of the house away from the road. Environmental noise increases blood pressure. So do what you can to develop a quiet environment around you, whether that means adding soundproofing to your home or job space, using ear plugs, or moving to a quiet location.
Step 15 – do hydrotherapy treatments.
Hydrotherapy (water treatments) can help in reducing blood pressure as well. When you apply warm or hot water to the skin/body, it causes the blood vessels to dilate. When the blood vessels dilate, the pressure inside of the blood vessels decreases, and your blood pressure decreases. Some simple treatments that you can use to help reduce your blood pressure are hot foot baths and warm baths or a warm/hot shower. For the hot footbath, simply put your feet in hot water and leave them there for about 20 minutes.
If you are diabetic with neuropathy, have poor circulation to your feet, or have blood clots in your legs, do not do a hot foot bath. If your diabetes is mild and there is good circulation in your feet, use a water thermometer to measure the water temperature. Do not use water hotter than 39.5C. If you do not have any of these problems, simply put the water so that it is hot, but not too hot for you. Soak the feet for 20 minutes, then end by running cold water over the feet for about 30 seconds and then dry, cover, and rest for about an hour.
Alternately, you can take a warm bath. This will help dilate your blood vessels and decrease your blood pressure. And if you don’t have a bathtub to take a bath in, you can take a hot shower. This also will help to bring your blood pressure down.
Step 16 – eliminate your stress.
Stress can increase your blood pressure. Issues of guilt, bitterness, anger, frustration, loneliness, depression, anxiety, and others can increase your blood pressure. What you think has an impact upon your blood pressure by affecting your adrenal glands and your fight-or-flight response and the hormones/chemicals that it releases. I know of no better way to control your stress than to trust in God. God is able to deal with all of the things in life that you can’t deal with. To be able to trust in Him to take care of all of the things that you can’t helps to relieve the stress responses that are destroying us on a regular basis.
So, in summary, to win the battle with high blood pressure, you should:
- Fast
- Eat a low sodium diet
- Maintain a high potassium to sodium ratio
- Include a small amount of nuts/seeds daily
- Try BP-reducing supplements
- Use BP-reducing herbs
- Exercise
- Avoid caffeine, alcohol, and tobacco
- Lose weight
- Stay well hydrated
- Get good sunshine
- Get good sleep
- 4-7-9 breathing
- Reduce your environmental noise
- Do Hydrotherapy treatments, and
- Eliminate your stress