Lifestyle Changes
Healthy lifestyle changes are an important first step for lowering blood pressure. These include:

Exercise at least 30 minutes a day

Maintain normal weight

Reduce sodium (salt) intake

Increase potassium intake

Limit alcohol consumption

Consume a diet rich in fruits, vegetables, and low-fat dairy products while reducing total and saturated fat intake.

Quit smoking

Dietary Recommendations:

Limit sodium (salt) intake to no more than 2,300 mg a day (a maximum intake of 1,500 mg a day is an even better goal).

Reduce saturated fat to no more than six per cent of daily calories and total fat to 27 per cent of daily calories. (But, include dairy products that are non- or low-fat. Low-fat dairy products appear to be especially beneficial for lowering systolic blood pressure).

When choosing fats, select mono-unsaturated oils, such as olive or canola oils.

Choose whole grains over white flour or pasta products.

Choose fresh fruits and vegetables every day. Many of these foods are rich in potassium, fibre, or both, possibly helping lower blood pressure.

Include nuts, seeds, or legumes (dried beans or peas) daily.

Choose modest amounts of protein (no more than 18 per cent of total daily calories). Fish, skinless poultry, and soy products are the best protein sources.

Restricting Salt And Increasing Potassium
Salt: Some sodium (salt) is necessary for health, but the amount found in most of our diets is vastly higher than what is needful. High salt intake is associated with high blood pressure (hypertension). It is a good idea for everyone to restrict their salt intake to less than 2,300 mg (about one teaspoon) a day. Some people over age 50, older adults, people with diabetes, overweight people, and people with a family history of hypertension or who have high blood pressure, may need to reduce sodium intake to less than 1,500 mg daily. This lowering of blood pressure may also help protect against heart failure and heart disease.

Potassium: A potassium-rich diet is important for reducing blood pressure. For people without risks for potassium excess, potassium-rich foods can help offset dietary salt intake. These foods include bananas, oranges, pears, prunes, cantaloupes, tomatoes, dried peas and beans, nuts, potatoes, and avocados. For people without risk factors for excess potassium levels, the recommended daily intake of potassium is 3,500 mg a day.

Fibre: Increasing fibre in the diet may help reduce blood pressure levels.

Fish Oil and Omega 3 Fatty Acids: Omega 3 fatty acids (docosahexaenoic and eicosapentaneoic acids) are found in oily fish. Medical studies have shown that they may have specific benefits for many medical conditions, including heart disease and hypertension. They appear to help keep blood vessels flexible and may help protect the nervous system. Fatty acids are also available in supplements, but their long-term effects on blood pressure are unknown.

Calcium: Calcium regulates the tone of the smooth muscles lining blood vessels. Medical studies have found that people who have sufficient dietary calcium have lower blood pressure than those who do not. Hypertension itself increases calcium loss from the body. The effects of extra calcium on blood pressure, however, are mixed, with some even showing higher pressure.

Weight Loss: Even modest weight loss in overweight people, particularly in the abdominal area, can immediately lower blood pressure. Weight loss, especially when accompanied by salt restriction, may allow patients with mild hypertension to safely reduce or go off medications. The benefits of weight loss on blood pressure are long-lasting.

Exercise: Regular exercise helps keep arteries elastic, even in older people, which in turn ensures blood flow and normal blood pressure. Doctors recommend at least 30 minutes of exercise on most days. High-intensity exercise may not lower blood pressure as effectively as moderate intensity exercise and may be dangerous in people with hypertension. Older people and those with uncontrolled hypertension or other serious medical conditions should check with their doctors before starting an exercise programme.

Good Sleep Habits: Certain sleep disorders, especially sleep apnea, are associated with hypertension. Even chronic, insufficient sleep may raise blood pressure in patients with hypertension, placing them at increased risk of heart disease and death. Stress hormone levels increase with sleeplessness which can activate the sympathetic nervous system, a strong player in hypertension. Patients who have chronic insomnia or other severe sleep disturbances (particularly sleep apnea) may want to consult a sleep expert. Patients with hypertension, who are habitually poor sleepers, should consider long-acting blood pressure medications to help counteract the increase in blood pressure that occurs in the early morning hours.

Stress Reduction: Stress reduction may help blood pressure control. Yoga, and relaxation techniques such as meditation may be beneficial.

Drug therapy
There are several classes of drugs used to treat hypertension. The doctor will prescribe appropriate medications.

To be continued next week.