Tuesdays With Kim

September 23, 2008 

Over the last several weeks I have been working on designing a program related to lowering blood pressure. This program is intended to provide a way for those with high blood pressure to pick and choose what lifestyle change they will implement over a series of 3 consecutive weeks. The format of this program and its implementation is based on two main observations.   One, a more systematic approach needs to be implemented for change to occur. And two, lifestyle changes are difficult and by implementing a single lifestyle change at a time, not only is it more manageable but we can better access the minimal lifestyle change needed to alter blood pressure readings to within normal ranges.  

What Lifestyle Changes Can I Implement to Lower Blood Pressure?  

In this program there are three categories to choose from: exercise, nutrition, and stress management. 

Exercise 

Since health professionals know that cardiovascular exercise is the most effective exercise for lowering BP, if you choose to pick a lifestyle change from this category your choices may include any exercise where you use the largest muscles of your body and your heart rate is accelerated slightly. Examples may include but are not limited to walking, dancing, biking, elliptical, jogging, hiking, and skating. 

Nutrition 

Since it’s also known that a diet focused on fruits, vegetables and whole grains can help lower blood pressure, there are several choices that can be implemented. For example if you like vegetables you can choose to add 2 more vegetables daily, or if you like fruit you can choose to implement 2 more pieces of fruit daily to your diet. If whole grains is your choice, you can add 2 more whole grains daily to your diet such as whole grain pasta or whole grain bread.  

Stress Management  

Lastly, stress management also plays an important role in reducing blood pressure readings. Sometimes our lifestyles become so normal to us that we do not realize we are under stress. Under this category there are several options. Examples may include: breathing techniques, time out walks, music, yoga, or planned intervals of quiet rest.   

How Does it Work?  The Difficulty Only Lies in the Recording of the BP Readings Over 3 Weeks Since You Choose What Lifestyle Change Suits You  

Let’s start with an example. 

- Robert 59 with mild hypertension 

- Dr. suggested lifestyle changes before prescribing medication 

- Robert picks one change from category One: Exercise 

- Robert will walk for 20 minutes every day for 3 weeks 

- Robert will record his BP 2 times a day at the same time for 3 weeks 

- Robert will assess if BP is lowering. 

After Three Weeks 

If Robert’s BP is lowered to within normal ranges, then he should continue with his daily 20 minute walk. He need only check his BP weekly.  If, however, Robert’s BP has not dropped to within the normal ranges he has several options.  

If Robert’s BP is showing a downward trend but is not yet within normal ranges then he should continue the same daily walk for three more weeks and assess his BP daily until it either lowers to the normal range or stagnates at a higher than normal reading.  

If Robert’s BP has stagnated at an above normal level then he should consider implementing an additional change. He may choose to exercise longer, say walk for 30 minutes per day instead of 20, or walk at a more vigorous pace, or walk with weights on his wrists.  Or, he may choose from another category such as using stress reducing breathing techniques. 

If Robert’s goal is to minimize changes in his lifestyle then an important factor in Robert’s success will be in assessing and recording which changes are working to keep his BP within normal ranges.  

Later, if Robert determines that 20 minutes 3 times a week is more suited to his weekly time frame then he could add another change category to the reduced walking schedule. The assessment process will then start over again until he is satisfied that his lifestyle and health needs are being met.