Q: I'm a 47 year old male in generally good health but recently found out that my blood pressure is higher than it should be.  I'm worried that I may be at risk for heart disease.  What steps can I take to lower it naturally, so that I don't have to use medication?

A: You're right to be slightly concerned.  Not only is elevated blood pressure (or hypertension) a major risk factor for heart disease, it also increases your chances of suffering from stroke, kidney disease, peripheral artery disease, and retinopathy (damage to an inside layer of your eye).

But while high blood pressure does put you at a higher risk for cardiac disease, there are many things that can be done to help treat it without medications.

Lifestyle modification can help immensely in lowering blood pressure and should be included in any hypertension treatment plan. For those with only mildly elevated blood pressure, it may even be all that is needed. Although it is possible that you may also require medication if your blood pressure is high enough, these lifestyle changes can often lower the dose of medications needed. In addition, they certainly make sense to improve your overall health. You should also have your healthcare provider rule out any other medical conditions or problems that may be causing your blood pressure to be high.

Once outside factors are ruled out, I recommend that you evaluate the following aspects of your lifestyle and modify them if necessary to help lower your blood pressure:

  • Diet. Most people will benefit from reducing their sodium intake to a maximum of 2,400 milligrams of sodium a day.  In addition to easing up on the salt shaker, you should check the sodium content of the food that you purchase (especially if it's processed) and eat at restaurants, if the information is available. Adopt a DASH (Dietary Approaches to Stop Hypertension) eating plan. A DASH diet is low in saturated and total fat and rich in fruits, vegetables, and low-fat dairy products. More information can be found here.
  • Weight Reduction. Being overweight, especially if the extra weight is mostly around your waist, can increase blood pressure. Maintain a normal body weight for your height, expressed as body mass index (or BMI).
  • Physical Activity. Engage in regular aerobic physical activity--such as brisk walking, cycling, or using an elliptical trainer or similar machine--for at least 30 minutes per session on most days of the week. Exercise helps you to lower blood pressure while also helping you to lose weight and improve your overall cardiovascular fitness.
  • Alcohol Intake. Alcohol can raise blood pressure. Limit your consumption to no more than two drinks (e.g., 24-ounce beer, 10-ounce glass of wine, or 3-ounces of 80-proof whiskey) per day in men and no more than one drink per day in women.

Dr. Myerson graduated from Columbia University, Barnard College, received her medical degree from the State University of New York and completed her internal medicine residency from Duke University Medical Center. She subsequently completed a clinical fellowship in Cardiology from Columbia College of Physicians and Surgeons. Dr. Myerson also holds a doctorate in Applied Physiology from Columbia University and post-doctoral work in preventive cardiology and epidemiology and in basic lipid research. She is board-certified in both internal medicine and cardiovascular disease. She joined St. Luke's-Roosevelt in 2005, as the Director of the Cardiovascular Disease Prevention Program.