Shed ten pounds :

Experts say excess weight can cause a two- to six-fold increase in your risk of developing high blood pressure. Losing the weight can have a significant positive. One study of 301 overweight people found that losing about 20 pounds can shave ten points off your systolic reading and eight points off the diastolic reading. “Weight loss remains one of the most important ways to lower blood pressure without medication,” says Dr. Kaplan.
A bonus: If you’re already taking blood pressure medication, studies show that losing weight makes the drugs significantly more effective.

Toss a teaspoon 01 salt over your shoulder

Instead of on your food, that is. One to one and a half teaspoons of salt represents about half of most people’s intake of salt each day. “Reducing salt intake by half will probably lower blood pressure an average of three to five points systolic and three to four points diastolic in some people;’ says Marvin Moser, M.D., clinical professor of medicine at Yale University School of Medicine and senior advisor to the National High Blood Pressure Education Program. You cut it in half by swapping the salt shaker in your kitchen and on your dinner table for spicy, nosalt herb blends. Then, opt for no-salt or low-salt versions of processed foods, such as sauces, low-fat lunch meats and dairy items such as cottage cheese and low-fat cheeses, whenever they’re available.

Go easy on the hard stull

It’s well established that if you’re a heavy drinker-three or more alcoholic beverages each day-you’re more likely to develop high blood pressure than people who drink less. Experts suggest that you should limit yourself to an absolute maximum of two drinks a day. But you may reap even more blood pressure benefits by drinking even less.

Get a morning or midday workout

That may help ward off the effects of daytime stress on your blood pressure, according to a published study. Researchers at Wake Forest University in Winston-Salem, North Carolina, exposed a group of 48 women to two stressproducing tasks as they monitored the women’s blood pressure. One day, the women simply rested before the stresses; on the other day, those same women rode stationary bicycles for 40 minutes at 70 percent of their heart-rate reserve (moderate work intensity). Then, after 30 minutes of rest, they were exposed to the stressful situations a second time.
The women’s blood pressures during the stressful experiences were significantly lower after they exercised than on the day they didn’t exercise. Data from another study suggest that these effects may last up to four or five hours after exercise.

Learn to relax

Researchers say that job stress, public speaking, even the stress of arguing and lying can cause temporary spikes in blood pres sure that may, if experienced long term, result in high blood pressure. Exercise is only one way to ward off the effects of stress. Small, preliminary studies have hinted that relaxation methods-like meditation, progressive relaxation (where you tense and then relax the muscles in your body in succession) and biofeedback-may help lower blood pressure in people with hypertension.

Get measured

Get your blood pressure checked by a trained professional. “In many cases, it’s the only way you’ll ever find out that you have high blood pressure;’ Dr. Toto says. Once a year is enough unless your doctor says otherwise.
Even if you regularly take your own reading, be sure to visit the doctor-or take advantage of free screenings that hospitals sometimes offer in shopping malls and other places.

Walk it down

Exercise is another key to lower blood pressure. Reports from the American College of Sports Medicine show that even moderate exercise-like walking 20 to 30 minutes a day, three to five times a week-can help lower pressure by as much as ten points on both the systolic and diastolic readings in people with mild hypertension. If you have high blood pressure, see your doctor before beginning an exercise routine.

Eat rocks and live

The minerals known as electrolytes-potassium, calcium and magnesium-have shown varying amounts of promise in battling blood pressure. Of the three, potassium appears to have the strongest link, Dr. Toto says. That’s because it appears to counteract the effects of excess sodium in the body. Experts haven’t settled on the ideal amount you need to do the trick- but it certainly wouldn’t hurt to pump up your potassium intake. Dr. Toto warns not to take potassium supplements without first seeing a doctor, since too much potassium can cause kidney problems.

Calcium

can also be effective in the fight against high blood pressure. Although research studies vary in their findings of its effects, Dr. Toto says the best advice for now is to get your DV of 800 milligrams. Good sources include low- fat plain yogurt (415 milligrams per eight-ounce container), skim milk (302 milligrams per cup) and canned salmon (181 milligrams per threeounce serving). As with potassium, don’t take supplements until you talk to your doctor. Too much calcium can cause kidney stones in some people.
Magnesium seems to be fading as a high blood pressure fighter, Dr. Toto says. But just in case, he says it’s still a good idea to take the DV of 350 milligrams. Good sources include dried pumpkin seeds (152 milligrams per ounce), halibut (91 milligrams per three-ounce serving), almonds (87 milligrams per ounce), lima beans (50 milligrams per ounce) and fortified ce reals (varies).

Butt out

Smoking may not cause high blood pressure but it can worsen the effects by damaging veins and arteries. “You should stop smoking under any circumstances. But if you have high blood pressure, it’s very important to quit;’ Dr. Kaplan says.

Grin and beer it

Moderate drinking isn’t likely to raise your blood pressure. But the key word here is moderate. Some research shows that 3 ounces of alcohol a week is as much as you should drink. You get about 1 ounce of alcohol in a 12-ounce beer or a mixed drink containing one shot (11/2 ounces) ofliquor.

Evidence is growing that wine, both red and white, may actually help lower blood pressure, says Dr. Ferrario. He says that may be because grapes contain phytoestrogens, a plant-based form of estrogen. He suggests no more than one or two fiveounce glasses of wine per day. When it comes to your blood pressure, what you don’t know can hurt you-a lot. The key to effective treatment is information, so stay informed. Be aware of the causes, the symptoms and the treatment for high blood pressure. By taking charge of the matter you’ll be able to work with your health care professional to help get it under control.

Besides a change in diet, there are numerous other natural remedies for easing high blood pressure.

Aromatherapy

Blue chamomile is great for people with high blood pressure;’ says Victoria Edwards, an aromatherapist in Fair Oaks, California. Carry the essential oil with you and inhale directly from the bottle whenever you feel flushed or agitated, suggests Edwards. She also recommends a daily massage using an everlast massage oil, which combines 1 drop of everlast (also called immortelle or helichrysum), 2 drops of blue chamomile and 10 drops of lavender in one ounce of olive, almond, sunflower or another carrier oil. (Carrier oils are available in most health food stores.) Massage this blend into the area under the collarbone every day at bedtime, she says.

Food Therapy

One of the best ways to lower blood pressure is to eat more celery, which contains an oil that can lower blood pressure, adds registered pharmacist Earl Mindell, R.Ph., Ph.D., professor of nutrition at Pacific Western University in Los Angeles and author of Earl Mindell’s Food as Medicine and other books on nutrition. Celery oil allows muscles that regulate blood pressure to dilate, says Dr. MindelJ, and scientific studies show that rats who consumed the equivalent of four stalks of celery a day lowered their blood pressure an average of 13 percent.

Juice Therapy
Celery juice has a mild diuretic effect, similar to many drugs that are prescribed for high blood pressure;’ says Elaine Gillaspie, N.D., a naturopathic physician in Portland, Oregon. She recommends an eight-ounce blend of one part celery juice, one part carrot juice and one part water, taken at least once a day. “This juice is highly nutritious and can be helpful for people with high blood pressure,” says Dr. Gillaspie.

Herbal Therapy

Eating up to three or four cloves of garlic every day may lower blood pressure, according to Varro E. Tyler, Ph.D., professor of pharmacognosy at Purdue University in West Lafayette, Indiana. If you’d rather not eat fresh cloves, try garlic supplements. Dr. Tyler recommends the enteric-coated capsules for maximum absorption of allicin, the blood-pressure-lowering ingredient in garlic. He says to follow the dosage recommendations on the label of the product you choose.

Imagery

To soothe your blood pressure, imagine going to your refrigerator and taking out three or four ice cubes, writes Gerald Epstein, M.D., a New York City psychiatrist and author of Healing Visualizations. Picture yourself slowly washing your head, face and neck with the ice. Feel the coolness seeping into every pore and entering your bloodstream in the brain. Envision an icy feeling tumbling down through your neck and trunk and into your fingers and toes. At that point, sense that your blood pressure is within a normal range.
Dr. Epstein suggests doing this imagery for three to five minutes three times a day or whenever you sense that your blood pressure is elevated.

Relaxation and Meditation

Studies suggest that meditating for 20 minutes twice a day can help lower high blood pressure, says Sundar Ramaswami, Ph.D., a clinical psychologist at the F. S. Dubois Community Mental Health Center in Stamford, Connecticut.

Sound Therapy

Listening to relaxing music for 20 to 30 minutes each day can slow the heart rate and help lower blood pressure in some people, says Steven Halpern, Ph.D., composer, researcher and author of Sound Health: The Music and Sounds That Make Us Whole. To get started, turn on the music, then sit or lie comfortably, close your eyes and take a deep breath. Dr. Halpern suggests that you wear headphones to focus your attention and avoid distraction. He recommends, however, that you keep the speakers playing, so your body absorbs the sound energy. While the music plays, let your breath slow down and become steady. Listen not just to the notes but to the silence between the notes. Dr. Halpern says this will keep you from analyzing the music and allow you to relax.

Vitamin and Mineral Therapy

Along with conventional therapy, the best ways to lower high blood pressure are to cut back on sugar, salt, caffeine and alcohol and to reduce or eliminate meats in your diet, says David Edelberg, M.D., an internist and medical director of the American Holistic Center/Chicago. he also says that people with high blood pressure may want to use the following vitamin, mineral and herbal regimen to help control the condition: 500 milligrams of calcium twice a day; 400 milligrams of magnesium twice a day; one tablespoon of flaxseed oil a day; 400 international units of vitamin E a day; 30 milligrams of coenzyme Q-I 0 three times a day; one hawthorn berry capsule three times a day and one ginseng capsule twice a day. Flaxseed oil and coenzyme Q-IO, hawthorn berry and ginseng supplements are available in most health food stores.

Yoga

Two yoga poses, the corpse and the knee squeeze are especially helpful with high blood pressure, according to Alice Christensen, founder and executive director of the American Yoga Association. These two poses help improve blood circulation and relieve tension, which is a major contributor to high blood pressure, she explains. An association study found that people with mild high blood pressure could lower it by doing these two poses every day. Christensen recommends meditating twice a day for 10 to 20 minutes each time. Lie on your back on either the floor or a mat. Be at your sides, with the palms of your hands legs should be straight, with your feet in a relaxed Relax all of your muscles, close your eyes and hold the pose for 30 seconds to several minutes, until your muscles completely relax. Breathe deeply and scan your body to feel tension. If you feel tension, concentrate on the area and relax the muscles.

NOTE: If you feel pain in your lower back, try bending your legs. Raise your knees and place your feet flat on the floor. Hold this position for 30 seconds to several minutes, following the instructions above.

The world has smart bombs. Tanks. Giant-size guns. But a lowly spear may be all you need to knock down high blood pressure. A spear of asparagus, that is, Mother Nature ingeniously tipped that spear with folate, a nutrient that may turn out to puncture overinflated blood-pressure levels. Folate is believed to lower a blood factor called homocysteine (a factor, by the way, that’s been linked to high risk of heart disease and stroke), In a recent study, researchers saw high homocysteine levels in 179 people with a high-blood-pressure condition called isolated systolic hypertension. Homocysteine was significantly lower in 171 people with normal blood pressures. Researchers theorize that homocysteine may do to your arteries what sunshine, chlorine and time do to spandex swimsuits: It makes the stretchy parts lose their stretchability. When arteries are too stiff to help move blood around effectively, the heart has to pick up the slack and work even harder, This can push pressure ever upward, explains study leader Kim SuttonTyrrell, DrPH, an epidemiologist at the University of Pittsburgh, She suspects that in this way, homocysteine could have a role in other forms of hypertension, as well.
Researchers’ next hope is to show that B vitamins like folate might be able to stop this stretchability breakdown enough to help prevent high blood pressure, In fact, Dr. Sutton- Tyrrell’s group has already proposed such a study. Until the results are in, “people should be paying a lot of attention to what they’re eating and should be making sure they’re getting enough foods with these types of vitamins in them;’ she says, “But exactly how much folate could help blood pressure is the next question, and I really don’t think that is known yet.” For general health, the Centers for Disease Control and Prevention recommends getting 400 micrograms daily. So it’s wise to start filling up on the most chock-filled folate finds: asparagus (250 micrograms per cup), brussels sprouts (125 micrograms per cup), beans (100 to 300 micrograms per cup) and fortified breads and cereals .

Now we switch from what you need less of to what you need more of. “You can think of potassium as the opposite of sodium;’ says Dr. Simon. Just as a high sodium intake can raise blood pressure, so too can a low potassium intake, since potassium works as a blood-vessel dilator. But this doesn’t mean huge amounts of potassium are needed.
The DV for potassium is 3,500 milligrams, “but it’s safe to consume substantially more than that;’ says Dr. Simon. The trick is getting enough potassium in your daily menu, without going on the chimpanzee diet. Actually, bananas are not the highest source of potassium, which can be found in a wide assortment of fruits and vegetables. And there are some surprisingly rich sources. (See “Postssium and Magnesium Sources” on page 34.)
One caution: If you’re taking a potassium-sparing diuretic, which causes the kidneys to hoard the mineral, you should not increase your potassium intake without discussing with your doctor any changes you’d like to make.

Calcium and Magnesium Connection

Along with potassium, you can add calcium and magnesium to the list of minerals that may help lower your blood pressure through some unknown ways. People with hypertension tend to have lower consumption of all three. African Americans seem to be especially vulnerable to low calcium intake. As with potassium, you don’t necessarily need these minerals by the shovelful. Instead, you simply need to be certain you’re getting enough calcium and magnesium.

There are two ways to make certain blood-pressure drugs (ACE inhibitors) are more effective. One is to take more drugs. Another may be to add flavors like pepper, rosemary or basil to your cooking instead of salt, according to a recent study that comes to us from the United Kingdom. When 11 high-pressure people on ACE inhibitors needed to lower their pressures more, they got the same results from a low-salt diet as they did from taking extra drugs called thiazide diuretics.

What’s more, the low-salt diet was still flavorful. People were asked simply to leave out the salt in cooking or at the table and avoid salt-laden foods such as pickles, olives and anchovies Still not convinced that doing it yourself may be better than drugs? Let’s look at side effects. When thiazide diuretics are used to bolster ACE inhibitors, uninvited sidekicks can include loss of that heart-rhythm-sustaining nutrient potassium; loss of libido and maybe even an increased risk of heart attack. Side effects of favorite flavorings like rosemary or basil: We don’t know of any.
It’s not a particular surprise that a low-salt diet has the same power as a diuretic, says John H. Laragh, M.D., director of the hypertension center at Cornell Medical Center, New York City. “Diuretics are what I call a ‘poor-willpower-man’s low-salt diet;” he says. A diuretic thwarts a blood-pressure rise by preventing the kidneys from holding salt. A low-salt diet prevents you from holding salt by avoiding it in the first place.
There are two things that sustain high blood pressure. One is rennin, a hormone secreted into the bloodstream by the kidneys.Its action is blocked by ACE inhibitors.) The other is the body’s sodium content, also regulated by the kidneys, says Dr. Laragh. Taking away dietary sodium under a doctor’s supervision might be O.K., but Dr. Laragh warns against being overzealous about it. (You need at least 2,000 milligrams a day.) If you take in too littie sodium, your body may become too dehydrated and illequipped to withstand the daily stress of exercise or infection since the blood flow to the tissues is reduced. In this regard, a new study links low amounts of sodium in the diet with an increased risk of heart attack. Too little sodium in the blood and” … the blood volume and flow to the capillaries won’t be as luxurious as it could be. Blood flow to the brain and kidneys will be reduced, exercise tolerance will be reduced and resistance to infection will be reduced;’ says Dr. Laragh. “This leads me to believe that it makes good sense to have a moderate salt intake whenever possible. The optimal amount of salt in the diet is not the same for everyone;’ he says. Work with your physician to find the level that’s right for you.

Odium free: Less than 5 per serving, No need to restrict yourself, since 400 servings a day would still keep you at 2,000 milligrams of sodium!

Very low sodium: Thirty-five milligrams or less per serving. You’re still in the safe zone.

Low sodium: One hundred forty milligrams or less per serving. Don’t get reckless. A few servings can add up in a hurry.

Reduced sodium: Three-quarters less sodium than is typical for that food. Fact is, many foods are typically high in sodium, so reducing that amount may not be as helpful as you think. Also, the container may not say simply “salt,” but if it says any
of these, you can bet it is salt. Don’t be fooled by:

• sea salt
• garlic salt
• onion salt
• seasoned salt
• brine

NOTE: If a serving size is very small, for example two table-
spoons of salad dressing, then 35 to 140 milligrams can still be quite a high concentration of sodium for such a small portion.

Cut back on the saltshaker first. “That’s what we go after;’ says Dr. Kaplan. “Salt poured on food is the thing people have the most immediate control over.”

Then go after the foods Dr. Kaplan calls “salt mines,” for example, anchovies, sauerkraut, pickles and salami. “All we’re talking about here is taking a few of life’s pleasures away;’ says Dr. Kaplan. “It won’t be easy for those few people who are addicted to salami. But it’s usually not a major sacrifice.” The greatest salt mine may be potato chips. “You’d need to eat 10 whole potatoes to get the amount of sodium in just 10 potato chips;’ says Dr. Simon.

The next sodium source on your list should be processed foods because salt and other sodium compounds act as preservatives and flavor enhancers and are often used liberally in them. Not surprisingly, processed foods (which include some of the worst salt mines already mentioned) are the biggest source of sodium in the American diet, perhaps accounting for more than 70 percent of our intake. Canned foods are the worst offenders. But you can find a high sodium content in some frozen foods, baked goods and many staples at fast-food restaurants. Reading food labels is critical to finding your way past the salt mines in the supermarket. (See “Label Shakeout” at left.)

How much of a difference does all this sodium-searching really make? Well, for many people, for each teaspoon of salt they eliminate, they can expect a five-point drop in systolic (top number) pressure and half that in diastolic (bottom number) pressure. For millions of Americans, this would be enough of a drop to eliminate the need for medications.

Being “sodium sensitive” means that your blood pressure rises in reaction to increased sodium intake. ”All people are, more or less, sodium sensitive. And there is no sharp break between those who are more sensitive and those who are less;’ says Dr. Kaplan. “It’s like height or any other biological phenomenon. It varies a great deal among individuals. Some people are exquisitely sensitive. If they touch salt, their blood pressure goes way up. For a few others, their intake hardly seems to matter.” About half of people with high blood pressure fit into the category of highly sodium sensitive. For many of these people, sodium restriction is definitely a good idea. Among those people who are not salt-sensitive, restricting salt too much-to less than half a teaspoon a day-also may raise their blood pressure. So if you happen to be hypertensive, what should you do?

Reducing Sodium

The best approach is to start by making sure that you get no more sodium than your body needs. The average American consumes about 4,000 milligrams of sodium each day. That’s quite a few shakes beyond the 2,400 milligrams that the National Academy of Sciences suggests as a maximum intake for just about everyone. A level teaspoon of salt contains about 2,400 milligrams of sodium, so if your current intake is 3,500 milligrams or less, you can get yourself to the adequate-intake zone by getting rid of about half a teaspoon of salt each day.

If you have high blood pressure (defined as a reading of 140/90 and above), you do want powerful medicine to control it. This doesn’t have to mean drugs. As study after study has shown-diet is powerful medicine. It can’t always replace pills and other medical means when blood pressure is elevated, but it often does. And it can frequently either boost the effect of medication or allow for a lower dose. More good news: Those who are most helped by good eating are the ones who most need help. The higher your blood pressure, the more it is likely to fall if you use your head when you fill your belly.
Diet therapy to reduce high blood pressure calls for the following:

•     An eating plan geared to weight control. For those people who are overweight, a low-fat (made up of less than 20 percent of calories diet, high in unrefined complex carbohydrates is ideal.
• Limiting sodium intake to 2,400 milligrams a day (the amount in a level teaspoon of table salt). Discuss with your physician whether it would be wise to limit your sodium intake even more.
• Including in your diet a variety of fruits and vegetables that together provide at least 3,500 milligrams of potassium a day.
• Getting your Daily Value (DV) for magnesium and calcium.

If you already have high blood pressure, doctors may need to prescribe medication to bring it under control. There are four main classes of drugs. Diuretics, which help the body excrete extra fluids to lower blood pressure, are usually tried first. Betablockers are designed to slow the heart rate and reduce the amount of blood the heart pumps. AC’E inhibitors help reduce the chemicals that cause your blood vessels to constrict. And calcium channel blockers also help to relax and widen blood vessels.
However, although they are often prescribed by doctors, drugs should be your last option. They all have side effects, ranging from fatigue to headaches to depression. Besides, there’s a lot you can do to help lower blood pressure on your own. And keep in mind that every little bit helps. For each point you drop in the diastolic measure, for example, Dr. Goldberg says you cut your risk of heart attack by 2 to 3 percent. And a massive study of approximately 350,000 Americans found that life expectancy in the United States would jump by 1.5 years if the average systolic blood pressure reading fell just 10 points, from 130 to 120.

One of your best defenses against hypertension is blood-pressure reading, and you need the right it Here’s a list of the different types commonly available macies and discount drugstores. Your doctor may also have units to loan out. If you decide to bUy one, though, test drive the new machine alongside your doctor’s to make sure the two are in sync. (It’s also a good idea to recheck your machine with your doctor’s at least once a year to make sure it’s still accurate.You don’t want a new unit that needs to be recalibrated, so before you plunk down cash, check the refund policy.

Mercury Meter.

Commonly used by physicians, it measures pressure with a pool of mercury that rises up a tube as air is pumped into the cuff. Accuracy is exceptional, but because it’s a manual machine, you need some coordination to use itthe hand that pumps air in and out of the cuff must also hold the stethoscope. You could also ask a spouse or friend for help. If you’re on your own, look for units with convenient features, like a stethoscope sewn into the cuff.

Aneroid Unit

This, too, is a manual device, but unlike the mercury monitor, it measures pressure with a spring gauge. Used properly, this liquid-free device can yield measurements close to those obtained with the mercury machine, only it’s less expensive.

Electronic Arm Model.

It costs more than the manual type, but it can do everything except wrap the cuff around your arm. It’s battery operated and comes in semi- and fully-automatic models. Some have microphones built into the cuff and have pressure numbers displayed as vividly as movie credits on a digital screen. Some even inflate the cuffs automatically.