Oct 18, 2002

By Linda Carroll

NEW YORK (Reuters Health) – New government recommendations released on Tuesday emphasize that high blood pressure can be staved off largely through lifestyle modifications such as diet and exercise.

The guidelines also caution consumers about certain widely publicized approaches to lowering blood pressure such as fish oil (omega-3 polyunsaturated fatty acids) and calcium supplements, which only lower blood pressure slightly or in people who already have hypertension.

People should also be careful when it comes to herbal supplements, as these substances get very little scrutiny, according to an advisory put together by the National Blood Pressure Education Program (NHBPEP) and published in the Journal of the American Medical Association (news – web sites).

Americans can keep blood pressure low if they keep trim, exercise, cut back on saturated fats, limit alcohol and sodium, increase dietary potassium and eat plenty of fruit and vegetables, according to the NHBPEP.

Numerous studies have shown these lifestyle changes to be effective in reducing blood pressure in people with normal or slightly high blood pressure readings, Dr. Jiang He, an associate professor of epidemiology and medicine at the Tulane University School of Medicine in New Orleans, told Reuters Health.

He emphasized the importance of keeping blood pressure from rising in the first place.

“New data…shows that people with high-normal blood pressure have an increased risk of cardiovascular disease compared to those with normal blood pressure,” said He, a coauthor of the report.

Blood pressure is considered to be high-normal if systolic (the first number in a blood pressure reading) pressure is 130 to 139 mmHg and/or diastolic (the second number in a blood pressure reading) pressure is 85 to 89 mmHg, He said.

“This report focused on prevention of hypertension because once a patient develops high blood pressure he has to be on medication his whole life,” He said. “And that’s very expensive. Also, being on medication your whole life means having a poorer quality of life. So it’s best not to develop hypertension in the first place.”

The newest recommendations–adding fruits, vegetables and potassium to the diet while decreasing consumption of saturated fats–are based on the results of several new trials. People can increase dietary potassium by consuming fruit, such as bananas, that are rich in the compound, He said.

Ultimately, even small decreases in blood pressure can lead to big gains in health, said study co-author Dr. Paul Whelton, senior vice president for health sciences at the Tulane University Health Sciences Center and co-chair of the NHBPEP working group that developed the recommendations.

“A reduction as small as 2 mmHg in the average American’s systolic blood pressure could save more than 70,000 lives per year,” he added. “Epidemiological data suggest that if we could lower the average systolic blood pressure among Americans by 5 mmHg, we’d see a 14% drop in deaths from stroke, a 9% drop in heart disease deaths, and a 7% drop in overall mortality.”

SOURCE: Journal of the American Medical Association 2002;288:1882- 1888.