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The winning combination to dramatically lower blood pressure includes weight loss, exercise, reduced salt intake, and a healthy diet, according to a national study called PREMIER, conducted at Johns Hopkins and three other leading institutions.
The news could hardly come at a better time. Revised blood pressure guidelines released in May by the federal government say that blood pressure readings once thought normal actually are high enough to signal "pre-hypertension"--placing once "safe" people at risk for high blood pressure, heart attacks, and strokes later in life.
Researchers say once-normal or borderline readings can actually damage arteries and increase the risk of heart disease. The new recommendations, developed by the National Heart, Lung, and Blood Institute, classify normal blood pressure as below 120 over 80, and urge people with readings from 120 over 80 up to 140 over 90 to exercise and make dietary changes to stave off hypertension. High blood pressure measures 140 over 90 or more, and that level has not changed.
Results of the PREMIER study of more than 800 adults prove that multiple lifestyle changes effectively lower blood pressure.
"Our study shows that people can simultaneously make multiple lifestyle changes that lower their blood pressure and improve their health," says study chair Dr. Lawrence Appel, professor of medicine, epidemiology, and international health at Johns Hopkins School of Public Health. "The key issue now is helping people maintain these changes so they don't revert back to less healthy behaviors."
The study group that had the best outcomes received counseling on the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, and low-fat dairy products. The diet highlights whole grains, poultry, fish, and nuts, and reduces consumption of fats, red meat, and sweets. Exercise, weight loss, and reduced salt intake were also advised.
Research suggests that the DASH diet's high mineral levels can help the body get rid of excess salt, just as water pills (diuretics) do.
Dr. Appel acknowledges that adopting multiple changes can be a challenge. "For people who have a hard time with this, start with one change, like exercising, and then add others as you can."
The recipe at the left meets the healthful requirements of the DASH eating program.
The DASH Diet
Here are the number of servings you should consume daily
from each food group. Serving amounts are based on a diet of
2,000 calories per day.
Legend for Chart:
A - 1 serving =
B - Food examples
A B
Grain & grain products (7 to 8 servings daily)
1 slice bread Whole-wheat breads,
½ cup dry cereal English muffins, pita
½ cup cooked rice, bread, bagels, cereals,
pasta, or cereal oatmeal, grits
Fruits & vegetables (4 to 5 fruit & 4 to 5 vegetables
serving daily
6 oz. fruit or vegetable juice Apricots, bananas, grapes,
1 medium fruit oranges, grapefruit,
½ cup frozen or canned fruit melons, strawberries,
1 cup raw, leafy or ½ cup tomatoes, peas, carrots,
cooked vegetables potatoes, broccoli, squash,
leafy greens
Dairy Foods (2 to 3 servings daily)
8 oz. skim milk Skim or 1% milk, nonfat or
1 cup yogurt low-fat yogurt, nonfat or
1 1/2 oz. fat-free or "lite" part-skim cheese
cheese
Meats, poultry, & fish (2 or fewer servings daily)
3 oz. cooked meat, poultry, Lean meats only; trim
or fish visible fat, remove skin
from poultry; broil, roast,
or boil
Nuts, seeds & legumes (3 to 4 servings weekly)
1/3 cup nuts Almonds, peanuts, mixed
2 tablespoons seeds nuts, sunflower seeds,
½ cup cooked legumes kidney beans, lentils
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