About 1/4 of the entire world has hypertension. High blood pressure is a major risk factor for cardiovascular diseases and events such as stroke, congestive heart failure, myocardial infarction, peripheral vascular disease, and overall mortality. (1) Luckily, blood pressure is often manageable naturally with lifestyle changes.
High blood pressure, specifically hypertension, is defined as a systolic blood pressure ≥ 140 mm Hg and/or a diastolic blood pressure ≥ 90 mm Hg. The measurements must be an average of 2 or more seated blood pressure readings from 2 or more separate office visits. The top number is the systolic reading, and the bottom number is the diastolic reading. (1)
Prehypertension is defined as a systolic blood pressure of 120-139 mm Hg and/or a diastolic blood pressure of 80-89 mm Hg.
Resistant hypertension is harder to treat and is defined as blood pressure ≥140/90 mm Hg while taking 3 medications or having a controlled blood pressure with ≥4 medications. (2)
I always believe that natural and alternative approaches should be tried first, IF POSSIBLE. If drug therapy must be used immediately, then alternative approaches should be used in conjunction immediately as well. The ultimate goal is to reduce symptoms, i.e. high blood pressure, and hopefully decrease or eliminate the need for medication.
The kidneys play a large role in blood pressure via fluid filtration and reabsorption, which are regulated by hormones and the renin-angiotensin system (RAS). Cardiac contractility, cardiac output, and peripheral vascular resistance also influence blood pressure, and can be controlled by our autonomic nervous system (sympathetic and parasympathetic). (2)
High blood pressure increases your risk for cardiovascular disease and renal impairment, which is a double whammy since the kidneys help regulate blood pressure. (3)
In terms of lifestyle changes, it’s important to understand that the higher a person’s blood pressure, the greater it is lowered by diet, exercise, etc. Those with normal or close to normal blood pressure may not see a lowered blood pressure by these lifestyle changes, simply because their blood pressure is already good.
*Be sure to talk to your doctor before starting any exercise routine, diet, or supplements.
Self Monitor Your Blood Pressure
You should monitor your blood pressure on your own. This is pretty self explanatory, but this really comes in handy if you want to check on whether one thing might be working for you or not. Check it a few times throughout the day, and it's also a good idea to document it as well for reference.
You can buy automatic blood pressure monitors on Amazon or Walgreen/CVS.
First things first, vegetarian diets are associated with lower blood pressure than omnivorous diets. (4)
Vegetarians and vegans tend to have lower blood pressure. (1) Not a big surprise here. Just be sure to stick to whole foods. Oreos are vegetarian, but they won’t do much good for your health.
If you’re fond of meat, then the clinically proven Dietary Approaches to Stop Hypertension (DASH) diet is very good option. The DASH diet has been proven to lower blood pressure, which emphasizes the consumption of more fruits, vegetables, and low-fat diary, and encourages a lower intake of meats, sugar-sweetened beverages, and saturated and total fats. Basically with the DASH diet, your diet should consist of more fruits, vegetables, low-fat dairy, whole grains, poultry, fish, nuts, and less fats, red meat, and sweets. In my opinion, the DASH diet is basically common sense. We know plant foods reduce blood pressure because consuming more of them increases our intake of potassium, fiber, phytonutrients, antioxidants, and more, all of which have a favorable effect on blood pressure and health. The DASH diet lowers blood pressure even when sodium intake is kept the same, which means the DASH diet independently lowers blood pressure, and not because of a lower intake of sodium (although, sodium does have an effect on blood pressure, which I discuss below). The DASH diet also increases nitric oxide (NO) bioavailability, which lowers blood pressure by promoting smooth muscle relaxation and vasodilation. (5) Nuts are encouraged on the DASH diet, and are a great source of L-arginine, which is an amino acid that is a precursor to nitric oxide (NO).
Sodium and Potassium
Reduced sodium intake has been proven to reduce blood pressure. (6) Our bodies maintain a balance of osmolality. Sodium balance is maintained by the kidneys via glomerular filtration and tubular reabsorption. 65-75% of sodium reabsorption is controlled by angiotensin II, norepinephrine, aldosterone, and atrial natriuretic peptide. (1)
When we have more sodium in our blood stream, more water will be retained to offset the sodium. This increased fluid volume increases blood pressure. When we have less sodium, we retain less water, which decreases blood volume, and thus decreases blood pressure.
Decreased sodium intake is strongly recommended by many health professional organizations as a means to treat high blood pressure. Sodium is usually restricted to somewhere between 1,500 mg and 2,300 mg a day. This is a general recommendation, and as with everything discussed in this article, you should consult your doctor and/or registered dietitian.
Interestingly and surprisingly, many studies find mixed results when it comes to sodium restriction. Many studies have actually found that lower sodium intakes are associated with harmful side effects, such as increased all-cause and cardiovascular mortality, increased fasting plasma glucose and insulin, and the development of end stage renal disease. In other words, sodium restriction is somewhat contraindicated, and is not necessarily right for everyone. That being said, many studies have clinically shown that sodium restriction decreases blood pressure in both those with normal blood pressure and those with high blood pressure. When sodium restriction is combined with the DASH diet, the combined effects decrease blood pressure substantially. (1)
Potassium is inversely associated with blood pressure, which means that the more potassium you consume, the lower your blood pressure will be (low enough to what’s considered normal blood pressure). The blood pressure lowering effect of potassium benefits those with high blood pressure the most. Lower intakes of potassium are also associated with sodium retention, which then leads to higher blood pressure. (1)
Potassium has the following beneficial effects on blood pressure:
- Increases sodium excretion
- Suppresses renin secretion (Renin is stored in the kidneys, secreted by the kidneys, and increases the production of angiotensin. Angiotensin promotes the secretion of aldosterone, which leads to an increase in blood pressure through more sodium retention.)
- Increases urinary output and excretion
- Relaxes smooth muscles through increased nitric oxide production and/or through the stimulation of potassium (K+) channels which leads to vasodilation (vasodilation decreases blood flow resistance, which decreases blood pressure)
- Decreases free radical formation
- Protects against vascular injury in those who are sensitive to salt
4700 mg is the Recommended Dietary Allowance (RDA) for healthy adults; those with kidney disease or prone to hyperkalemia may need to consume less (check with your doctor or registered dietitian). Most adults in the US do not consume the recommended amount of potassium. (1)
The studies are fairly inconsistent with magnesium lowering blood pressure, but since magnesium is involved in so many different process throughout the body, it’s likely that adequate dietary intake of magnesium will be beneficial for blood pressure to some degree.
Magnesium acts as a natural calcium channel blocker, competes with sodium on vascular smooth muscle, induces vasodilation, and improves endothelial dysfunction. It also regulates intracellular calcium, sodium, and potassium, which is crucial for regulating blood pressure. It appears that magnesium alone will not do much unless calcium, sodium, and potassium intake recommendations are met. (7)
Quercetin is a powerful antioxidant flavonol found in food such as apples, berries, onions, and red wine. It has been found to lower blood pressure in stage 1 hypertensive patients, and is associated with a reduced risk of coronary heart disease and stroke. 365 mg of quercetin twice per day for 4 weeks was found to be enough to lower blood pressure. (8)
Increased fiber intake has been found to be independently associated with lower blood pressure, but the American Heart Association does not believe there is sufficient evidence on the fiber recommendation alone. (1)
If you eat more fruits and vegetables, you’re going to be consuming more fiber anyway, and it likely won’t hurt you unless you’ve got a digestive concern like diverticulitis.
Garlic significantly reduces blood pressure compared to placebo. (1)
You could take it in supplemental form, but just cooking with it regularly should be good.
Those who don’t drink caffeinated drinks tend to experience elevated blood pressure when they do consume them, but habitual caffeine drinkers’ blood pressure are unaffected. (1)
If you already drink caffeinated beverages, try to at least limit them to 1 serving a day. If you don’t drink caffeinated beverages, then just be aware that if you start, your blood pressure will likely increase. Therefore, either start really slow with caffeine, or just plain stay away from it. Decaffeinated beverages could be a potential replacement, i.e. decaf coffee or tea.
I recommend staying away from licorice. Licorice is potentially dangerous for those with high blood pressure, because the glycyrrhetinic acid increases sodium and decreases potassium in the body, which increases blood pressure. (1) Licorice is found in candy, chewing tobacco, spices, and in supplemental form. Some supplements have the glycyrrhetinic acid removed, which is known as deglycyrrhizinated licorice (DGL).
Still, I would stay away from licorice all together.
Overweight and obesity are risk factors for high blood pressure, as well as many other conditions. If you’re overweight, weight loss should be a major component of treatment to lower blood pressure. (9)
Weight loss has even been found to be better at managing blood pressure than pharmaceuticals. Even modest amounts of weight loss have allowed people to reduce or completely eliminate the need for blood pressure medications. (10)
30 minutes of aerobic exercise on most days of the week has been proven to reduce blood pressure. (6)
Endurance training (speed walking, jogging, running, dancing, cycling, swimming, elliptical machines) has been proven clinically to lower blood pressure. Endurance aerobic exercise lowers blood pressure by decreasing sympathetic nervous system activity and the renin-angiotensin system. With any exercise, including endurance training, you have to be cautious because those who aren’t “fit” are at a risk for a lot of stress on the cardiovascular system. The idea is to take it slow, and not push yourself too hard. At least 30 minutes of aerobic exercise on most days of the week is recommended, and blood pressure reductions are usually seen within a few months. (6)
Isometric Resistance Exercise is when muscles are placed in such a way that they are contracted, but there is no change in movement. One example of an isometric exercise is going half way down on a push up, and holding that half way position. One review found a whopping 10% decrease in blood pressure among individuals who performed isometric handgrip exercises for 4 weeks. However, isometric exercises do temporarily raise blood pressure. Now handgrip exercises aren’t super hard for most people, so doing full body isometric exercises could potentially be more beneficial. (6)
One meta-analysis found that dynamic resistance training (weight lifting) 2 to 3 times a week lowers blood pressure by 2.7 mm Hg, and another meta-analysis found that it only reduced blood pressure by about 1 mm Hg. However, some studies have found a worsening cardiovascular health, such as decreased arterial elasticity. That being said, dynamic resistance training is not contraindicated for most people with mild stage I hypertension. (6) A study did find that resistance training is contraindicated in those with unstable cardiovascular conditions and those with severe hypertension. (6)
I would stay away from heavy lifting resistance training if you have high blood pressure, since there are more appropriate forms of exercise.
Although meditation is steadily gaining popularity, it’s been around for thousands of years.
Transcendental Meditation (TM), Zen meditation, and breathing awareness meditation have been found to reduce blood pressure. (6)
I recommend researching Transcendental Meditation yourself, and either taking a course, find some videos on Youtube, or learning via some other method on how to perform this type of meditation. It’s generally about learning how to achieve pure consciousness without judgement, and uses a lot of repetitive mantra. 15-20 min a day should be sufficient to achieve results once you understand how to do it. (13)
The mechanism to which meditation lowers blood pressure is still unclear. However, using common sense and intuition, the practice of meditation generally causes a reduction in stress and the sympathetic nervous system, and enhances our ability to handle stress. A couple of bonuses for meditation is that it’s free, doesn’t have negative side effects, and will likely improve other areas of your life and your health.
Deep breathing, which is part of meditation, yoga, and relaxation techniques, has been shown to reduce blood pressure in as little as 30 seconds in a clinical setting. (6) This is awesome, really awesome.
There is actually a device that measures breathing rates, and then sends musical tones via headphones so that one can match the breathing pattern effortlessly. The device is FDA approved and can be found at http://www.resperate.com. The device is also clinically proven.
As with yoga and meditation, the mechanism that deep breathing lowers blood pressure is generally stated as balancing out the autonomic nervous system, and likely decreasing the activity of the sympathetic nervous system. Evidence suggest that 15-minute sessions 3 to 4 times a week using the device-guided breathing is needed to reduce blood pressure. (6)
The device likely isn’t needed once you get the pace and technique down. Breathing on your own deeply and slowly throughout the day should be sufficient.
Yoga originates as a means to enter a contemplative state, reduce mental activity, and reach a higher level of consciousness. Yoga and meditation are kind of similar, and yoga can be used as a process of active meditation and a form as exercise as well.
Yoga has been found to reduce blood pressure after 12 weeks. The different forms of yoga that have been found to reduce blood pressure are hatha, pranayama, Iyengar, Ashtanga Vinyasa, and a yogic pranayama breathing called Bhastrika with hatha yoga. The mechanism to which yoga lowers blood pressure is unclear, but some evidence suggests it has favorable effects on the autonomic nervous system, which I’ve already pointed to as being a really broad statement. Sometimes we don’t need to know the exact mechanisms behind things, we just need to know that it works. (6)
There aren’t any specific recommendations in regards to what type of yoga is best. However, yoga can be difficult, so I recommend starting slow, and only performing the yoga that works best for you and does not increase stress levels. If you can’t do “yoga”, then light stretching done in conjunction with deep breathing exercises should provide some benefit. Youtube is a great free source for yoga.
People who own pets, are petting an animal, or talking to an animal have lower blood pressure. Having a pet around also helps prevent high blood pressure situations. As an example, when a dog is in the room of a person giving a speech, the person giving a speech has lower blood pressure. (14)
If you can take care of a pet, get one. If you can’t get one, then find a place to visit them.
Oxidative stress contributes to high blood pressure. (5)
Decreasing inflammation is going to require its own post because it’s more complicated than what I stated in the previous sentence, but just being aware and avoiding inflammatory triggers should help lower blood pressure.
Moderate alcohol consumption, 2 alcoholic beverages a day for men and 1 for women and lighter-weight persons, is associated with decreased blood pressure and risk of a heart attack. Drinking more than this is associated with higher blood pressure. (1) If you drink, it’s probably best to stick with 1 alcoholic drink or less a day, and make that drink red wine.
Sleep deprivation has been found to increase blood pressure, and people who sleep less than 6 hours a night are more likely to have higher blood pressure than those who sleep 7-8 hours a night. (2)
Also, our blood pressure is naturally lower during sleep, partly due to a decrease in sympathetic nervous system activation. (19) Maintaining a normal circadian rhythm and not “fighting” sleep deprivation is important.
1 hour of head-out water immersions of 32°C (89.6°F), 20°C (68°F), and 14°C (57.2°F) have been found to significantly lower blood pressure, but 32°C (89.6 °F) and 20°C (68°F) lowered blood pressure more than 14°C (57.2°F). (20)
Pools are somewhere between 25-28°C (77-82°F), so that could work if you don’t mind all of the chemicals they put in pools. Taking a bath at home at this temperature range is a better idea, since you can avoid pool chemicals, and you could throw some essential oils like lavender in there to further reduce blood pressure.
The World Health Organization reported that acupuncture is a suitable treatment for early hypertension back in 1996. A few studies have found that acupuncture reduces blood pressure, but like many other topics studied, some studies have found that acupuncture doesn’t significantly reduce blood pressure. (6)
Acupuncture is relatively safe, but there is the rare potential for pain and bleeding at needle sites. At this time, there is no recommendation as to what specific acupuncture technique should be used to reduce blood pressure. I’ve never tried acupuncture, but if I were, I would definitely find someone who has had extensive training and experience. This is probably the last thing I would try if I needed to lower my blood pressure naturally. (6)
The best natural remedies for lowering blood pressure are the ones that you can follow consistently. The more of these you can do consistently, the better, because they tend to have a combined blood pressure lowering effect.