Blood pressure edging up? Try these lifestyle changes

If your blood pressure is in the pre-hypertensive stage, you might be able to control it by making healthier lifestyle choices and avoid the need for medication. — TNS

Help! My GP (general practitioner) says I may be starting to develop high blood pressure (BP). The last three times it was measured at the clinic, my BP was slightly over 140/90mmHg. Are there any lifestyle changes I can make to lower my BP back to normal?

If you’re just beginning to develop high blood pressure (also known as the pre-hypertension stage) or if you already have it in the early stages, you can make some lifestyle changes that may help you reduce your blood pressure, or even prevent your need to start anti-hypertensive medication.

You can try doing the following:

  • Eating a healthy diet with plenty of fruits and vegetables, and avoiding too much salt in your food.
  • Stop smoking or do not even start.
  • Avoid drinking too much alcohol.

    If you want to consume alcohol, make sure it is only two drinks per day for men and one drink a day for women.

    Alcohol really raises your blood pressure acutely.

    Hypertensive patients who drink also appear to be more resistant to anti-hypertensive drugs.

  • Make sure your weight and body mass index (BMI) is within the normal range.

    Do not let yourself tip over into the overweight or obese range.

    If you can lose around three to nine percent of your body weight, your blood pressure can correspondingly come down as much as three to six mmHg.

  • Do not stress yourself out or let others stress you out too much.

    If you are easily stressed, take meditation or mindfulness courses.

  • Make sure you get regular exercise.

    Do not forget that exercise prolongs your life and improves your health in many ways.

    Go for 30 minutes of moderate activity on most days of the week.

OK, I have tried all that for six months, and my BP is still high. My doctor now wants to put me on medication. What is the best BP medicine for me?

If you have only hypertension and no other co-morbidities (other diseases and health problems), the doctor will usually prescribe a first line anti-hypertensive agent.

These can be:

  • Thiazides

    This is a type of diuretic that many doctors use this as a first choice.

    Thiazides may be better at preventing heart failure than calcium channel blockers.

    Their main side effect though is that they can make you urinate more often than usual.

  • Calcium channel blockers
  • ACE (angiotensin-converting enzyme) inhibitors
  • ARBs (angiotensin receptor blockers)

You should be started on just one medication at first. This is called monotherapy.

What if I have other health issues aside from my high blood pressure? What sort of anti-hypertensive drugs should I get?

It will depend on the other health conditions you have.

If you have high cholesterol, ACE inhibitors, calcium channel blockers or ARBs are preferred.

If you have diabetes, ACE inhibitors or ARBs are preferred.

If you have coronary artery disease, beta-blockers, ACE inhibitors or ARBs are preferred.

A beta blocker also acts to prevent chest pain, lower your heart rate, and hence, decrease your overall risk of death.

If you have heart failure, diuretics, beta-blockers, ACE inhibitors or ARBs are preferred.

Does my age matter as to what sort of antihypertensive drugs I would get?

Yes, actually.

If you are above 65, up to 80, years of age, without any other co-morbidities, diuretics or calcium channel blockers are preferred.

If you are above 80 years of age without any other co-morbidities, diuretics or ACE inhibitors are preferred.

What if my BP is not controlled by the first drug?

Your doctor has several options then.

He or she can increase the dose of the drug, substitute that first drug with another class of drug, or opt to add on a second drug.

Substitution with another class of drug is usually done when you experience intolerable side effects from that first drug.

In general, women seem to be at higher risk of getting side effects from anti-hypertensive medications compared to men.

What if I really, really cannot take the side effects of the BP medications? Can i just control my BP with lifestyle changes?

Lifestyle changes will only get you so far.

It is a risk-benefit consideration.

For many patients, their hypertension can only be controlled with drugs.

Doctors can cut the doses of some drugs known to give you certain side effects, and add on others, to help lower both the side effects and your BP.

Or doctors can substitute the drugs until you find one, or a combination of drugs, which work well for you in terms of both less side effects and good BP control.

But whatever it is, if the side effects of the new drugs persist and are not too many, and they are more or less tolerable, try to stay on your medication.

The complications of high blood pressure can be devastating, or even fatal.

When your hypertension is not controlled, you stand the risk of getting:

  • Chronic kidney disease, which can lead to kidney failure
  • Coronary artery disease
  • Diabetes
  • Heart attack or stroke
  • Heart failure
  • Swelling or thickening of the left chamber of the heart (left ventricular hypertrophy).

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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