It’s an article of conventional medical wisdom that the right diet and regular exercise are effective strategies for reducing blood pressure. For those of us suffering from a more extreme form of high blood pressure – widely known as resistant hypertension – blood-pressure-lowering drugs are typically prescribed as the solution.

Trouble is, sometimes even drugs don’t work. According to John Hopkins Medicine:

Resistant hypertension is high blood pressure that does not respond well to aggressive medical treatment. Hypertension is considered resistant when all of the following are true:

  • Someone is taking three different blood pressure medications at their maximally tolerated doses.
  • One of the blood pressure medications is a diuretic (removes fluid and salt from the body).
  • Blood pressure remains above your goal – (usually 130/80 mmHg, although individual goals should be discussed with your doctor).
  • If hypertension requires four or more medications to be controlled it is also called resistant hypertension.

Resistant hypertension substantially increases the risk of heart attack, stroke and kidney failure.

Make a DASH For It

A recent article in The Globe and Mail reported that a randomized controlled trial from Duke University School of Medicine in Durham, N.C., demonstrated that the combination of diet, exercise and reducing sodium intake led to significant blood-pressure-lowering effects in people with resistant hypertension.

The Globe and Mail story went on to report:

“Over a four-month trial period, 140 participants with resistant hypertension received either:

  • an intensive lifestyle intervention, or
  • standardized education, and both groups received physician advice.

Both groups were instructed how to use the DASH diet with a calorie and sodium restriction. (DASH stands for Dietary Approaches to Stop Hypertension.)”

Participants in both groups received feedback on their adherence to the diet during weekly 45-minute group sessions led by a dietitian and psychologist.

The lifestyle intervention group participants were put on an exercise regime involving 30 to 45 minutes of biking and/or walking (and eventually jogging) three times a week under the supervision of an exercise physiologist.

Weight-loss targets and exercise goals were distributed to the standardized education group, but they were encouraged to achieve their targets without supervision. All participants adhered to their blood pressure medication regimens during the study.

  • After 16 weeks, both groups experienced a significant reduction in blood pressure, comparable to that seen with blood-pressure-lowering medications.
  • Participants in the intensive lifestyle intervention group, however, achieved the greatest reduction in blood pressure.
  • They also lost significantly more weight over the study period, 15 pounds versus 8.5 for those in the comparison group.

DASH Diet Guidelines

According to Hypertension Canada, by starting a few new food habits, including counting calories and watching portion sizes, you may be able to lower your blood pressure and reduce the medications you need to control high blood pressure.

Here’s how:

  • Buy fresh or frozen vegetables instead of canned or packaged with added sauces.
  • Choose low-sodium vegetable juices and soups.
  • Choose at least 3 higher fibre whole grain foods each day.
  • When buying breads, crackers, cereals, bakery products, desserts and snacks, choose products with higher fibre, lower fat and lower sodium.
  • Limit processed, cured, smoked or deli meats.
  • Choose skim or 1% milk and yogurt more often than cheese.
  • Limit processed cheese slices and processed cheese spreads.
  • Have smaller portions of meats, fish (avoid fish high in mercury or deep-fried), and poultry.
  • Eat a small handful of unsalted nuts and seeds several times a week.
  • Check food labels and choose sweets and snack foods with the lowest amount of sodium and saturated or trans-fat.

According to The Globe and Mail: “A 1,600-calorie DASH diet recommends, for example, eating three to four vegetable servings, four fruit servings, six whole grain servings, two to three low-fat dairy servings, three to six lean protein servings and two unsaturated oil servings daily. A serving of beans, lentils, nuts or seeds is recommended three times per week.”

We recommend speaking to your doctor before making any dietary or lifestyle changes but generally speaking, this sounds like a fairly appealing road to good health!