Is it possible to reduce blood pressure without the use of drugs?
Non-drug program to reduce blood PRESSURE is recommended for all patients regardless of the severity of hypertension and the need for medication.
With uncomplicated hypertension (until myocardial infarction, cerebral circulation or renal failure have developed) in patients without comorbidities (for example, diabetes mellitus or coronary heart disease), treatment should begin with non-drug methods. The duration of non-drug treatment before switching to drugs can vary from 6 to 12 months depending on the effectiveness of non-drug methods and the impact of comorbidities.
However, even after prescribing drugs, non-drug treatment should continue. This usually allows you to increase the effectiveness of therapy, do smaller doses of drugs and, thus, reduces the likelihood of unwanted effects of drugs.
What are the main methods of non-drug therapy that reduce blood pressure and reduce the risk of complications of hypertension?
Non-drug treatments are sometimes referred to as lifestyle measures.
In hypertension, the effectiveness of the following measures has been proved:
- Weight loss with excess body weight.
- Restriction of alcohol consumption.
- Increase of physical activity (struggle with sedentary activity).
- Reducing sodium intake with food (mainly table salt).
- Maintenance of normal intake of potassium.
- Maintenance of normal intake of calcium and magnesium.
- Reduce consumption of foods containing saturated fats and cholesterol, and increase the amount of fresh fruits and vegetables in the diet.
What role does weight loss play in the treatment of hypertension?
Obesity is a scourge of modern society and is one of the well-established factors of metabolic and cardiovascular diseases, as well as premature death. Currently, the number of patients with obesity is constantly increasing. In order to find out if You are overweight, you need to calculate the indicator “body mass index” (BMI).
In addition to the actual increase in body weight, the distribution of adipose tissue is important for health. If fat accumulates between the internal organs, then the figure of a person becomes like an Apple (the upper type of obesity). This type is most common in men and is very unfavorable for health, indicating a high risk of complications from the cardiovascular system. Another type of accumulation of adipose tissue is the deposition of fat in the buttocks and thighs, with the figure becoming like a pear (the lower type of obesity). This type is most common in women, it increases the risk of diseases of the spine, joints and veins of the lower extremities.
There is also a calculated definition of the type of obesity. For this purpose, use the ratio of waist circumference to hip circumference (from: about). With values of more than 0.9 in men and more than 0.8 in women, the upper type of obesity is diagnosed.
Reducing excess body weight in itself is accompanied by a decrease in blood PRESSURE: getting rid of 5 kg of excess weight leads to a decrease in systolic blood PRESSURE by 5-7 mm Hg. and diastolic at 2.5-4 mm Hg. art.
In addition, weight loss reduces the risk of diabetes, coronary heart disease and some cancers.
Should patients with hypertension completely refrain from drinking alcoholic beverages?
Everything needs to be measured. Complete abstinence from drinking alcoholic beverages for patients with hypertension is not required (if there are no other contraindications). However, excessive alcohol consumption is the cause of 5-7% of cases of hypertension. Many mass studies have shown a direct relationship between the amount of alcohol consumed and the severity of increased blood PRESSURE. This dependence in different people varies quite widely and is associated with individual tolerance of alcohol, metabolic status, hereditary factors and comorbidities. To standardize research around the world, alcohol consumption is estimated by “standard-size drinks” (so-called drinks) expressed in ounces (28.35 ml). One “standard drink” is equivalent to 15 ml of pure ethyl alcohol and corresponds to 1 glass (45 ml) of strong alcoholic beverage (vodka, whiskey, rum, gin, tequila, etc.), 1 glass (150 ml) of wine or 1 can (bottle) of beer. For men it is considered acceptable to use 10 “standard drinks” per week, for women this amount is 2 times less. It is clear that in everyday life it is not necessary to catch up if by the end of the week you have not done a single “drink”. I must say that moderate alcohol consumption gives some positive effect in terms of prevention of atherosclerosis. This in no way means that people who have never consumed alcohol need to start drinking urgently. Basically, we are talking about a good quality red wine, which contains a large number of so-called isoflavanoids that improve the condition of the vascular wall.
How to really reduce sodium intake with food?
Some people are more sensitive to table salt, others are less sensitive, but in any case, its use directly affects the level of blood PRESSURE. In small quantities, table salt is necessary for the normal functioning of the human body, but increasing the use of salt can be harmful, especially in arterial hypertension. Usually a person consumes about 10 g of table salt per day.
With arterial hypertension, it is desirable to reduce the daily intake of table salt to 5 g.
Cooking with a low salt content will be beneficial for all family members. In some cases, with low blood PRESSURE, only one reduction in consumption of table salt can already lead to normalization of blood PRESSURE. In individuals with higher blood PRESSURE, these measures can help to improve the effectiveness of treatment and reduce the dose of drugs.
How to really reduce the use of table salt?
• First, do not add salt during cooking or keep the salt shaker on the table – the temptation is very great. At first, of course, the food will not seem very tasty, but soon you will get used and stop noticing “lack of salt”.Second, use more “unprocessed” foods, i.e. fresh vegetables, fruits, fish, poultry and meat, as they contain very little salt.
We must not forget that a number of products contain sodium in the form of other salts (for example, sodium benzoate or glutamate), and not only in the form of sodium chloride. Sodium glutamate is widely used in the food industry to impart flavor. In General, sodium glutamate does not significantly increase total sodium intake. On the contrary, combining sodium glutamate with ordinary table salt, you can achieve a reduction in sodium intake by almost 40 % as a result of flavor enhancement. It should be noted that sodium is found in a number of drugs, for example, in some antacids and antibacterial drugs in the form of salts. However, the short duration of use of these drugs and their low sodium content make their effect on blood PRESSURE in patients with hypertension unlikely.
Is there a need to use food supplements containing potassium, calcium and magnesium?
Usually there is no such need, you just need to balance your diet so that the daily diet includes enough products containing potassium, magnesium and calcium with a low sodium content. These products include fresh vegetables (asparagus, corn, beans, zucchini, potatoes, broccoli), fresh fruits (bananas, oranges, peaches, apricots), fresh meat and fish, soy flour and soy protein, etc.
Food additives are possible in the diet mainly in winter and spring, when food comes less vitamins and trace elements.
Very low sodium content < 35 mg
What changes in the diet should be made in relation to the use of fats?
Fats are an essential component of the normal human diet. However, fat consumption in most developed countries of the world exceeds reasonable limits, which causes a number of negative consequences, including those associated with an increased risk of cardiovascular complications. Fats should be no more than 30 % of the total energy value of food, while saturated fats-no more than 10 %.
Patients with hypertension need to reduce the total consumption of fats, primarily animal saturated fats, and increase the consumption of vegetable, unsaturated fats. Especially useful foods rich in omega-3 and omega-6 fatty acids. Omega-3 fatty acids are found in large quantities in fish and fish oil, omega-6 fatty acids-in vegetable oils, such as soybean oil.
Try to buy products with low fat content: milk and fermented baked milk 1.5 %, kefir 1 and 1.8 %, sour cream 10-15 %, low-fat cottage cheese and yogurt, lean meats and fish. Avoid fatty foods: smoked meats, bacon, mayonnaise, margarine, fatty meats and fish, expensive fatty cheeses (more than 40 % fat), butter, canned food. Fry with a minimum amount of oil or no oil at all, in a non-stick pan or on a grill. When cooking, skin the poultry and remove visible fat from the meat.
Try not to fill salads with fat sour cream, mayonnaise; use vegetable oil or salad sauces. However, the exclusion of animal fats from food and the transition only to vegetable oil is also unjustified. Vegetable oils consist mainly of triglycerides, the excess of which is also a factor contributing to the development of atherosclerosis, so the diet should be balanced.
Should patients with hypertension limit the use of coffee and drinks containing caffeine?
The use of coffee and drinks containing caffeine is considered individually in each case. In mass studies, to date, no data have been obtained that coffee consumption is accompanied by an increase in the risk of cardiovascular complications in patients with hypertension. There is also no evidence that coffee contributes to a persistent increase in blood PRESSURE. At the same time, some people have an increased sensitivity to caffeine, and coffee consumption in them will be accompanied by a short-term increase in blood PRESSURE in combination with tachycardia and episodes of heart rhythm disorders. Such people are better to replace coffee with special coffee drinks containing chicory, barley or rye.
A glass of black tea contains about 40 mg of caffeine, a Cup of cocoa-6 mg, a glass of Coca-Cola-25 mg.
Are there any special diets designed for hypertensive patients?
For many years, diet therapy hypertension paid great attention. In many countries, special diets have been developed. In the Soviet Union, it was the famous diet number 10 by M. S. Pevsner. This is a dietary regime, the main principles of which were the restriction in the diet of table salt (hypochloride diet) and reducing fluid intake. It is not only about water, but about the total amount of liquid consumed (soups, juices, milk, kefir, etc.). A day in uncomplicated forms of hypertension do not exceed the amount of liquid than 1.5 liters. In severe hypertension and the appearance of signs of heart failure, the daily amount of fluid consumed should not be more than 1 liter.
In 1997, specialists of the National Institute of health (USA) developed a special diet, which was called DASH by the first letters of the study (Dietary Approaches to Stop Hypertension – a Dietary approach to the treatment of arterial hypertension). Subsequently, a fairly high efficiency of this diet was obtained, since when it was observed without medication, it was possible to reduce systolic blood PRESSURE by an average of 6 mm Hg. diastolic blood PRESSURE-an average of 3 mm Hg. however, in patients with initially higher BP figures, the effect was more impressive-11 and 6 mmHg. art. In addition, it should be noted the early effect of the diet-after 2 weeks!
The DASH diet is high in fruits, vegetables and low in total fat and saturated fat, cholesterol, high in fiber, potassium (4.7 g), magnesium (500 mg) and calcium (1240 g). The daily energy value is 2000 kcal.
Recently, the Mediterranean diet has become very popular, which is classified by UNESCO as a factor of world cultural heritage. But this-diet not in direct sense words, so as is important and image life,and even the very attitude to food, consumption fruits, vegetables, cereals and bread from whole grains, fish (especially fatty varieties), low-fat meat, dairy products with low-fat content.
It is proposed to replace saturated fats with the above products, as well as mono – and polyunsaturated fats from vegetables and seafood in order to reduce the proportion of fats in the amount of energy consumed to less than 30 % (of which saturated fats should account for less than 1/3). This diet provides that during the day you need to drink about a liter of water and no more than two glasses of red wine. Some nutritionists, when discussing the Mediterranean diet, say that at the base of the pyramid of this diet lies, first of all, the physical activity of patients. A recent study published in the British medical journal found that a more rigorous Mediterranean diet is accompanied by a significant improvement in health, as evidenced by a significant reduction in overall mortality (9 %), mortality from cardiovascular disease (9%), morbidity and mortality from cancer (6%), as well as the incidence of Parkinson’s and Alzheimer’s disease (13%). These results are important for public health, in particular, provide grounds for the introduction of the Mediterranean type of nutrition for the primary prevention of major chronic diseases.
What is the role of physical activity in the treatment of hypertension?
A number of studies have shown that there is an inverse relationship between physical activity and the frequency of hypertension and its main complications. Physical activity has a positive effect on the Central nervous system and allows you to neutralize the accumulated negative emotions. The global decline in the physical activity of the population today is of particular importance due to the sharp increase in the number of people engaged in “sedentary” work, as well as a significant flow of information and an increase in occupational stress on the nervous system, and changes in recreation (movies, television, reading, etc.). D.). It is proved that in patients with hypertension, regular exercise leads to a decrease in blood PRESSURE by 5-10 mm Hg. – However, not every physical activity is equally useful. A positive effect is given by dynamic or isotonic loads (the most natural type of load is walking), training endurance, and static or isometric loads (lifting weights, etc.) are not recommended for patients with hypertension. When exercising, especially at the beginning, careful monitoring is necessary. Do not allow fatigue, discomfort and severe shortness of breath. Alternation of walking with Cycling and swimming is useful. Exercise preferably at least 40 minutes 3 times a week. The common view that running is “Wellness” has not found support recently. Patients with hypertension running is contraindicated.
Should I stop Smoking a patient with hypertension with long-term experience of a smoker?
Cessation of Smoking is one of the prerequisites for successful treatment of hypertension.
Smoking itself is not accompanied by an increase in blood PRESSURE, moreover, smokers in General blood pressure MAY be even lower than other people. Abrupt cessation of Smoking by a person who has smoked for many years, can be accompanied by a number of negative phenomena, including an increase in blood PRESSURE. Why stop Smoking? Smoking is one of the most powerful risk factors for complications of hypertension, not to mention coronary heart disease, stroke and cancer. People with long-term Smoking experience should consult a doctor to develop an individual program of quitting this habit.
What value in the treatment of hypertension have methods of psychoreactive?
Independent value in the treatment of patients with hypertension, these methods do not have. However, psychological factors still play a role in the development of hypertension, so some patients it makes sense to include these methods in the complex of non-drug treatment.
Is it possible to use medicinal herbs for the treatment of hypertension?
Herbal medicine can give a certain positive effect, especially at the beginning of the disease and in combination with other non-drug treatments. For the treatment of hypertension, medicinal plants are usually used: vasodilating, antispasmodic, diuretic, calming action. This grass Astragalus sherstistotsvetkovogo, shoots bagulnika marsh, grass periwinkle small, leaves belokopytnika medicinal, fruits and flowers of hawthorn blood-red, leaves and fruits of cranberries, etc. Medicinal herbs and fees should be used under the supervision of a doctor. Phytotherapy has no independent value in the treatment of arterial hypertension.
What are the positive and negative sides of non-drug treatment of hypertension?
The positive aspects are as follows:
- These methods help to reduce blood pressure. They also affect other risk factors for cardiovascular disease (overweight, high blood sugar and cholesterol).
- No significant side effects.
- Sufficiently high efficiency with careful adherence to all recommendations.
The downsides are as follows:
- Lifestyle changes alone do not significantly affect life expectancy and complication rates.
• To obtain a tangible effect often requires a sufficiently large cost of money and time.
- Low adherence to this treatment of most patients-many “enough” only for the first few months.