Q: Hello Dr. I have been to a high blood pressure routine check for 3 weeks and yesterday I was diagnosed for it. I know I take in lot of salt and fatty food. I’m not ready for the treatment because they said once I use it I won’t have to stop it. Dr. is it possible to avoid treatment and regain normal pressure if I reduce fats and salt in my diet? My last blood pressure was 180/90 and they said I might have a stroke. How can I avoid this doctor?

A: High blood pressure used to be defined as blood pressure reading of 140/90mmHg or more. Not anymore!
The new guidelines by the American College of Cardiology and the American Heart Association state that only blood pressure readings below 120/80mmHg can now be considered normal blood pressure.
A systolic blood pressure reading between 120 and 129mmHg is considered elevated blood pressure.
Stage 1 high blood pressure is between 130 to 139mmHg systolic blood pressure reading and between 80 to 89mmHg diastolic blood pressure reading.
Grade 2 high blood pressure is any reading above 140/90mmHg

Do you understand what systolic and diastolic blood pressures mean? Here are a few facts to guide you:

• Blood Pressure is the pressure with which blood pushes against your vessels as it passes through your body. A normal blood pressure allows blood to flow and deliver oxygen and food to different parts of the body.
• We measure blood pressure with two numbers (ie, 124/84 mmHg). The first number is called the systolic blood pressure and the second is called the diastolic blood pressure. These two numbers are written as ‘systolic/diastolic’ followed by the unit of measurement.
• Systolic blood pressure is your highest blood pressure measurement and is recorded when your heart contracts.
• Diastolic blood pressure is your lowest blood pressure measurement and is recorded when your heart relaxes and fills with blood

For elevated blood pressure, the new recommendations point to non-drug interventions like the follow:

• Reduce your risk generally by imbibing lifestyle modifications:

• Be physically active for 30 to 60 minutes on most days of the week. Try walking, biking, swimming, dancing or any other physical activity that you enjoy. Remember that even a little bit of physical activity is better than no activity at all.

• Eat a lot of fresh fruits and vegetables, low-fat dairy products and other foods low in fat and salt. Avoid fast foods, canned foods or foods that are bought prepared, as well as any foods where you can see the fat in them.

• If you are a man and take more than two alcoholic drinks each day or a woman and you take more than one alcoholic drink, drinking less will help to lower your blood pressure. A regular-sized bottle or can of beer or a regular-sized glass of wine are each equal to a single alcoholic drink.

• Keeping your body weight within a healthy range also prevents high blood pressure. If you are overweight, losing about 10 lbs (5 kg) will lower your blood pressure, and reducing your weight to within a healthy range will lower your blood pressure even more.

• It is important to stop smoking if you have high blood pressure. Smoking increases the risk of developing heart problems and other diseases. Ensuring that you live and work in places that are smoke-free is also important.

• Other lifestyle modifications include weight control, diet watch (portion control, use of less salt, using less oil in our foods and when we do use oil to focus on the heart healthy oils) etc

Changing your diet to the type described above can bring down systolic blood pressure by as much as 11 points, and each additional healthy habit you adopt can bring it down another four to five points.

For stage 1 hypertension with no cardiovascular disease and low risk for developing it, lifestyle changes still work.

However, 1) the presence of cardiovascular disease and stage 1 hypertension or  a combination of no existing cardiovascular disease but a significant risk of developing it, or stage 2 hypertension means that lifestyle changes have to be combined with medications.

How do you know your risk of cardiovascular disease? Click on this link and assess yours. It’s easy to use.

Therefore, I suggest, you have a long discussion with your doctor but be guided by him/her. If after careful monitoring, your blood pressure falls into any of the combinations that mean you should take medicines, please start on them. Taking a pill a day is a small price to pay to be here for your family and enjoy your life. And don’t forget the lifestyle modifications. Salt should be used very sparingly and the only way to this is really re-training our taste buds to ‘accept’ less salt as tasty. Remember that you can use spices to ‘jazz’ up your food.

All the best!