Very aggressive control of high blood pressure helps to prevent heart attacks, strokes and premature death far more effectively than less stringent control (N Engl J Med, 2021 May 20;384(20):1921-1930). You cannot cure high blood pressure with drugs, you can only control it as long as you continue to take the drugs (Hypertension, 2002;40(5):612-618). Most of the time, your blood pressure cannot be controlled with just one drug and most people end up with three or more drugs to treat their high blood pressure. On the other hand, some people are able to cure their high blood pressure just by making lifestyle changes.

High blood pressure is defined as systolic blood pressure greater than 130 mmHg or diastolic blood pressure greater than 80 mmHg, and about half of North American adults have high blood pressure. The blockbuster SPRINT study of almost 10,000 people showed that systolic blood pressure above 130 increases risk for death (N Engl J Med, Nov 26, 2015;373:2103-2116). High blood pressure causes heart attacks, strokes, and kidney disease and puts you at increased risk for developing dementia in later life. High blood pressure can be intimately associated with high blood sugar levels after meals, and high blood pressure is one of the criteria for diagnosing diabetes.

Resistant Hypertension Responds to Lifestyle Changes
The recently published TRIUMPH Study found that lifestyle changes help to control high blood pressure even in those with resistant hypertension (Circulation, Sep 27, 2021;144(15):1212–1226). Resistant hypertension means that you have high blood pressure that does not respond to three or more drugs to lower high blood pressure (Heart, 2019;105:98–105; Hypertension, 2018; 72:e53–e90). People with resistant hypertension were able to lower their high blood pressure (BP) just by starting a regular exercise program (JAMA Cardiol, Aug 2021;6(11):1317-1323). In this study, men and women with resistant hypertension, average age 60, who followed a 12-week program of three 40-minute supervised aerobic exercise sessions per week lowered:
• 24-hour systolic BP by 7.1 mmHg
• diastolic BP 5.1 mmHg
• daytime systolic BP 8.4 mmHg
• daytime diastolic BP 5.7 mmHg
• doctor’s office systolic BP 10.0 mmHg

Other lifestyle changes to treat high blood pressure include:
• Eating a plant-based diet with plenty of vegetables, fruits, beans, nuts and other seeds.
• Restricting sugared drinks, sugar-added foods and red meat.
• Restricting refined carbohydrates.
• Avoiding smoking. Smoking damages every cell in your body.
• Avoiding being overweight.

Recent Studies on Blood Pressure
In 2021 alone, I have reported on several new studies on high blood pressure and the importance of lifestyle changes. Please reread them and make the necessary changes in your habits that apply to you. If you are not able to control your blood pressure with these lifestyle changes, work with your doctor to add medications as needed to bring it below 120/80 mmHg. I cannot over-emphasize the importance of this: high blood pressure is a silent killer.
High-Plant, Low-Salt Diet to Lower Blood Pressure
High Blood Pressure Increases Risk for Dementia
Many Common Drugs Can Raise Blood Pressure
Less Salt, More Potassium to Help Prevent Heart Attacks
How Your Diet Affects Your Blood Pressure
Blood Pressure is Often Higher in Wintertime

My Recommendations
All people who have blood pressures above 130/80 should immediately adopt lifestyle habits that can lower it, and check with their doctor about proper medications if needed. Anyone who is prone to high blood pressure should commit to lifelong habits to control it. Many cases of high blood pressure can be controlled with a high-plant, low-salt diet and other lifestyle changes that include:
• trying to exercise every day
• maintaining a healthful weight
• avoiding alcohol
• avoiding smoking and second hand smoke
• keeping blood levels of hydroxy vitamin D above 30 ng/mL
See Check Your Own Blood Pressure

Caution: Exercise can cause heart attacks in people who already have blocked arteries. Check with your doctor before starting an exercise program or increasing the intensity of your existing program.