How to normalize your blood pressure

How to normalize
your blood pressure

Elevated blood pressure is a common health issue today. Almost a third of U.S. adults have high blood pressure – perhaps you or someone in your family does? High blood pressure isn’t necessarily something you can feel, but it increases the risk of serious conditions such as strokes and heart attacks.

The good news is that you can improve your blood pressure by way of simple lifestyle changes.

The usual treatment for elevated blood pressure today is medication. This is often reasonable. But what if you could achieve perfect blood pressure without pills or side-effects – with improved health and weight as welcome side-bonuses, instead?

The truth is that high blood pressure was extremely rare as recently as a few hundred years ago. Something in today’s environment is giving more and more people high blood pressure. What is it?

Contents

  1. What is blood pressure?
  2. How is blood pressure measured?
  3. What’s a “good” blood pressure?
  4. What’s a high blood pressure?
  5. Who needs blood pressure medication?
  6. Causes of blood pressure
  7. Five ways to lower your blood pressure
  8. Blood pressure medication
  9. Measuring blood pressure at home
  10. Further reading and studies

What is blood pressure?

Bloodvessels1
Blood pressure is exactly what it sounds like: the pressure in your blood vessels. With a normal amount of blood, a healthy heart and healthy, elastic blood vessels, you’ll experience a normal blood pressure.

Low blood pressure can make you feel dizzy, especially right when you stand up from having been seated. This is usually harmless and can be the result of dehydration or salt deficiency.

Mildly or moderately elevated blood pressure will rarely give obvious symptoms (a light headache might occur sometimes). A very high blood pressure can give severe headaches, fatigue and nausea. High blood pressure is the result of an increased amount of liquid and salt in the blood, and also of the blood vessel walls being thicker and harder than normal.

As high blood pressure often goes unnoticed, it’s common for people to live with it unawares for some time. As it’s a risk factor, it may be wise to check your blood pressure every few years, even if you’re feeling healthy in general. This advice is especially directed towards people who are middle-aged or older, as high blood pressure is more common with age.

A markedly raised blood pressure leads, in the long term, to an increased risk of heart disease and stroke. The higher your blood pressure, the higher the risk. High blood pressure is often treated medically to reduce health risks; however, you can also lower your blood pressure with lifestyle changes (see below).

High blood pressure is known among doctors as hypertension, a word used frequently on this page.

How is blood pressure measured?

bloodpressuremeasurement
Blood pressure is usually measured by wrapping an inflatable cuff around your upper arm and pumping it up. The cuff pressure which stops the blood flow to your arm is then measured, and this is equal to the pressure in your blood vessels.

Blood pressure readings consist of two numbers, for example 120/80.

  • The first number is the peak pressure (when the heart contracts, “systolic” pressure). This is the highest pressure in your blood vessels.
  • The second number is the minimum pressure, taken when the heart relaxes (“diastolic” pressure).

To get your blood pressure checked, you can get in touch with your GP/medical specialist. You can also get it checked at many pharmacies. Another option is to buy your own blood pressure meter – they are reliable and easy to use at home, whenever you want.

What’s a “good” blood pressure?

happy
If you’re healthy, and not currently on any blood pressure medication, a lower-than-average blood pressure shouldn’t be anything to worry about.

An ideal, healthy blood pressure is not over 120/80. This is what young, healthy and lean people have.

Most people in the Western world, however, have a higher blood pressure than this. An elevated blood pressure is common in middle-aged people and older, especially in those who are overweight.

Between 120-140 systolic pressure and 80-90 diastolic pressure is considered a precursor to hypertension. This is nothing that needs to be treated in otherwise healthy people, but may mean that there is room for improved health by lifestyle changes.

Indigenous populations not eating a Western diet tend to have excellent blood pressure, even at old ages. We can learn and be inspired from them.

What’s a high blood pressure?

highbloodpressure
A reading of over 140/90, measured at at least three separate occasions, is considered elevated blood pressure. Temporarily having a slightly elevated blood pressure (when under stress, for example) is not dangerous.

As blood pressure tends to vary somewhat from day to day, it’s recommended to only diagnose someone with high blood pressure if they have given a repeatedly high reading. If the average of either of the readings (either the systolic or diastolic) is higher than the norm, it will be considered an elevated blood pressure. That is, an average of 150/85 or 135/100 over readings on several occassions will be considered too high.

Almost every third adult in the U.S. has elevated blood pressure, according to the CDC (Centers for Disease Control and Prevention) and the ASH (American Society of Hypertension).

  • Values between 140/90 and 160/100 are considered as slightly elevated blood pressure.
  • Over 160/100 is said to be moderately elevated.
  • Over 180/110 is a severely elevated blood pressure.

The calculated difference between the systolic and diastolic pressures is also of interest. If the difference is large (e.g. 170/85), it could be the sign of stiff arteries – often caused by heart disease. This means the blood vessels can’t dilate enough when the heart sends out a pulse, which forces the blood pressure to increase. (The walls can’t expand, so the pressure rises when the heart tries to pump the blood through.)

White lab coats cause high blood pressure

Many people find that their blood pressure increases because of subconscious stress from confrontation with medical institutions and the staff working there. This is usually called “white coat hypertension”, that is, elevated blood pressure levels from just seeing the white lab coats doctors wear.

This is a common problem: a full 10-15% of people diagnosed with high blood pressure after measurements taken at a hospital or medical facility, later find that measurements taken in their own home or averaged over 24 hours are normal.

If you’re one of the people with “white coat hypertension”, you have approximately the same risk of heart disease as other people with normal blood pressure. People with “white coat hypertension” don’t need blood pressure-lowering medication – but they often get it unnecessarily!

If you suspect a stress-related elevation in your blood pressure, you can borrow blood pressure meters from your medical facility, strap them on for 24 hours to register blood pressure several times an hour. You could also buy your own blood pressure meter to check up on yourself at home.

More on measuring blood pressure at home

When should hypertension be medicated?

pills
If your blood pressure is severely elevated (over 160 systolic or over 100 in diastolic), medication is wise. If you have other risk factors for heart disease (like smoking, diabetes or obesity), medication may be recommended even for a slight elevation in blood pressure (over 140/90).

Up until recently there was no evidence that medication improves the health of otherwise healthy people with mildly elevated blood pressure (140-159 systolic and/or 90-99 diastolic). This meant it was unclear whether it ws worth risking the side effects of the medication if all you have is a slight elevation.

A new large study, however, showed that people with hypertension lived longer and reduced the risk of heart disease if they lowered their systolic blood pressure all the way to 120, using drugs. Unfortunately this benefit comes with significantly increased risk of side effects:

Major New Study: Getting Blood Pressure Below 120 Saves Lives – and Increases Risks

Diabetics often have lower recommendations for blood pressure, the maximum normal value being seen as 130/80-85. However, it’s questionable whether it’s a good idea to medicate your blood pressure levels down to those values. Diabetics can probably stick to approximately the same upper limit as people with heart disease: 140/90 (according to new studies and expert comments, as well as the latest recommendations from the American Diabetes Association, ADA).

To summarize, the following are approximate limits for the levels of blood pressure at which medication becomes appropriate:

  • Otherwise healthy individuals: Over 160/100
  • Diabetics/people with heart disease: Over 140/90

With that said, smaller elevations in blood pressure could be suggestive of a need of some lifestyle changes in order to improve health and decrease the risk of diseases.

Reasons for high blood pressure

There are several rare causes of high blood pressure (such as kidney or adrenal disorders). If there’s reason to suspect  such disorders are the cause of hypertension, the appropriate measures should be decided by medical professionals.

However, the overwhelmingly more common type of elevated blood pressure is the kind that doesn’t have a clear cause, so-called primary hypertension. In these cases it’s often part of what’s called “metabolic syndrome”, also known as the disease of the Western world:
 
High blood pressureengmetabolicbellyfat
engmetabolicsyndromeengmetabolichighbs

engmetaboliccholesterol

The above health problems are grouped together because they so often appear as a cluster of symptoms in one individual. People with elevated blood pressure often carry extra weight around their belly, and they’re also likely to be in the risk zone for high blood sugar and type 2 diabetes.

The good news is: if you can get to the root and cause of this, you can often improve all these markers with one simple lifestyle change.

The common causebadcarbs2

Metabolic syndrome is typically caused by eating more carbohydrate than the body can handle. This primarily true for high-glycemic carbs that are quickly digested, such as white flour and pure sugar. Depending on how sensitive you are, you might be experiencing the same symptoms from more complex, lower GI carbs.

Carbohydrate starts getting broken down into simple sugars as soon as it arrives in your stomach (for example, starch in bread and pasta becomes glucose) which raises your blood sugar the moment it’s taken up by the bloodstream. The body then produces more of the hormone insulin, in order to take care of this blood sugar.

Insulin is the main fat-storing hormone in the body, and too much insulin can therefore lead to overweight in the long run. In large amounts, this can also disturb the cholesterol metabolism in your body. What’s more, it can also affect your blood pressure.

High insulin and high blood pressure

Raised insulin levels seem to lead to the accumulation of fluid and salt in the body. This increases blood pressure. In addition, high levels of insulin can thicken the tissue around blood vessels (the so-called smooth muscle), which also may contribute to an elevated blood pressure.

Eating less carbohyrate has repeatedly been shown to decrease insulin levels and also blood pressure. Perhaps this is because a low-carbohydrate diet also tends to discourage the body from accumulating fluids, and increases the elimination of salt via urine.

Lifestyle changes for a healthier blood pressure

There are several possible lifestyle changes you can make to lower your blood pressure. I’ll go through five of them below. The first one is, in my experience, the most important. It eliminates the most common cause of high blood pressure:

1. Cure the Western disease

An elevated blood pressure is often the product of so-called metabolic syndrome, especially in people with some excess weight. This means you can accomplish great benefits to your health by reducing your intake of (bad) carbohydrates.

Multiple studies on low-carbohydrate diets show improved blood pressure and more improvements than on other diets. As a bonus, a low-carbohydrate diet also usually leads to weight loss and improved blood sugar levels:

This does not only work in scientific studies but also in real life. Many patients and readers of mine have tried it with positive results.

A low-carb diet for beginners

2. To salt or not to saltsalt

Eating less salt may lower your blood pressure a little. Research has shown that this effect is, however, minimal in the long term: an average of only 1 mmHg reduction was recorded.

We lack contemporary evidence that less salt in our food will affect the risk of heart disease or death. This was shown in a recent meta-study of all research on the subject. It’s unclear whether you will become healthier by eating less salt or not. Nobody knows.

Much of the salt we ingest comes from fast food, ready-made meals, bread and soft drinks – things to avoid when on a low-carbohydrate diet. This will lower your salt intake automatically. Furthermore, the hormonal effects of LCHF make it easier for the body to dispose of excess salt through urine; this can explain the slight lowering of blood pressure.

In summary, the demonising of salt is exaggerated. At any rate, if you stick to a low carb diet, you should be able to enjoy salt in moderation with a clear conscience.

More about salt and health

3. Avoid other things which increase blood pressure

Blood pressure can be lowered simply by avoiding the things that drive it up. Here are the most common causes of elevated blood pressure:

  • Common painkillers (so-called non-steroidal anti-inflammatory drugs, NSAID), can increase your blood pressure by inhibiting the production of salt in your kidneys. This includes over-the-counter pills such as Ipren, Ibumetin, Ibuprofen, Diklofenak and Naproxen as well as the prescription drug Celebra. Painkillers with the active substance paracetamol are better for your blood pressure.
  • Cortisone pills, such as Prednisolon
  • Birth control pills (for some people)
  • Coffee (caffeine)
  • Alcohol in large amounts
  • Nicotine (smoking, other forms of tobacco) can give short-lived rises in blood pressure of 15-20 units
  • Drugs such as amphetamine and cocaine
  • Licorice in large amounts

This doesn’t mean it’s imperative to abstain from coffee or alcohol completely; however, if you are a big “user” it may be wise to decrease your intake. On the other hand, it’s always a good idea to completely stop smoking: kicking a smoking habit is excellent for your health in general, not just your blood pressure.

4. Exercise

Regular exercise has been shown to somewhat lower blood pressure. And, if nothing else, at least you’ll be burning carbohydrate and therefore increasing your carb tolerance.

5. Avoid deficiency of omega-3 fats or vitamin D

Studies indicate that omega-3 fats may lower blood pressure somewhat (especially the systolic blood pressure value). More on omega-3.

One study shows the lowering of blood pressure by about 4 units systolic and 3 units diastolic by administration of vitamin D supplements in deficient people (common during the winter half-year). More on vitamin D.

Follow up your blood pressure

Following up a decrease in blood pressure is most easily done at your local medical centre or with the DIY instruments.

Blood pressure medication

BP-woman

At levels of blood pressure which are at least moderately elevated (>160/100), such as those induced by heart disease, medication may be appropriate. Keeping in line with the lifestyle suggestions above is still a good idea, though – they may help ensure that you don’t need to take more medication than necessary for your treatment.

Blood pressure-lowering medication tends to primarily reduce the risk of the having a stroke, heart failure or damage to the kidneys caused by elevated blood pressure.

There are many good options when it comes to such medication. Examples are ACE (angiotensin-converting-enzyme) inhibitors or AII-blockers (angiotensin II receptor blockers) such as Enalapril or Losartan. If this kind of medication doesn’t give the desired effect, you might have to add other medication such as so-called calcium antagonists (e.g. Felodipin) or a mild diuretic (can be found as a combined pill with Enalapril and Losartan).

If possible, avoid using beta blockers to treat blood pressure (this means pills like Atenolol, Metoprolol or Seloken). They are less effective and cause more side effects (such as decreased potency, fatigue and weight gain). These medicines can, however, be of use in cases of heart disease (such as angina).

Coming soon: More on blood pressure medication.

Measuring blood pressure at home

It’s easy to measure your blood pressure with an automatic blood pressure meter – if you do it right. There are, however, common sources of error which can lead to unreliable results.

In order to accurately measure blood pressure, two things are important: good equipment and the right measuring technique.

Equipment

The blood pressure meter should be high-quality, preferably a tested and certified type. It should measure the blood pressure at your upper arm (wrist measurements are less trustworthy). Here are two blood pressure meters I can recommend:

m6-m2

Omron M6 Comfort and Omron M2

The arm cuff needs to be the right size. If you have large upper arms and measure your blood pressure with cuffs for normal-sized arms, you’ll get disproportionately high values – sometimes as high as 20 units more than your actual blood pressure. In other words, it’s possible that the measurement might falsely indicate an elevated blood pressure.

If you’re unsure of your upper arm size, measure the circumference with measuring tape:

A circumference of roughly 8.5-12.5 inches will fit normal-sized cuffs (and Omron M2). Upper arms larger than this might need a cuff size of 8.5-16.5 inches (such as the one accompanying Omron M6 Comfort).

Measuring technique

Blood pressure is best measured when seated, as that’s the way it’s usually measured in the studies determining healthy values. Being systematic and conforming to measuring standards decreases the risk of over-medication following wrongful measurements.

For highest accuracy, blood pressure measurements should be performed like this:

  1. In the half hour before measurement, refrain from exercise, tobacco use or eating.
  2. Rest at comfortable room temperature for 5-10 minutes before the measurement.
  3. Expose your upper arm.
  4. The cuff should be wrapped so that its lower edge is about 0.7 inches above the crook of your arm. The cuff should neither be too tight nor too loose – two fingers should just be able to fit underneath it.
  5. Take a seat with a back rest and make sure your back and feet are at comfortable rest, do not cross your legs.
  6. Rest your arm comfortably and position it so that your upper arm is at the same height as your heart, by e.g. placing it on a table.Measuring blood pressure
  7. Relax and take the measurement.
  8. Repeat the measurement at least once, with one minute’s pause in between. The average of two or more measurements should be noted.

Accurate results

As long as the measurement is conducted correctly, with certified blood pressure meter, you’ll be getting results just as accurate as you would at a medical clinic. In fact, in Sweden, an investigation has shown that medical practices sometimes wrongly take blood pressure measurements with the patient lying down – so you might even be getting more accurate results at home!

The difference between blood pressure sitting up and lying down

In Sweden, blood pressure is often wrongly measured at clinics with the subjects lying down. The differences tend to be small, however: when seated, the systolic blood pressure registers a little lower, and the diastolic a little higher. Trying this on myself, I noted readings of 116/73 averaged over several seated measurements and an average of 119/72 lying down.

Blood pressure measurements lying down can bring errors and the risk of overtreatment in some people, especially elders (in the case of “orthostatism”, i.e. blood pressure drop in sitting/standing).

Fluctuations during the day and year

Blood pressure is usually at its lowest in the morning, and rises slightly towards the afternoon and evening. It tends to be lower during the summer half-year and slightly higher during the winter.

Studies

Treatment of high blood pressure

Treating slightly elevated blood pressure (140-159 systolic, 90-99 diastolic) in otherwise heart-healthy patients does not necessarily result in health gains:

Diao D, et al. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev. 2012 Aug 15;8:CD006742.

Appropriate technique for blood pressure measurements

Overviews:

Williams JS, et a. Videos in clinical medicine. Blood-pressure measurement. N Engl J Med. 2009 Jan 29;360(5):e6.

Pickering TG, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005 Jan;45(1):142-61.

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118 Comments

  1. François
    Andreas, please check your graph on the metabolic syndrome: it seems curiously disjointed on my end.

    Otherwise, excellent summary.

    Isn't it strange? There is a commanality in the treatment of nearly each and every pathological condition.
    Diabetes?: LCHF
    Metabolic syndrome? LCHF
    Heart disease?: LCHF
    Cancer?: LCHF
    Polycystic ovary syndrome?: LCHF
    Etc

    Just saying...

  2. Stan
    Port et al, http://www.ncbi.nlm.nih.gov/pubmed/10675116 (free download at http://www.math.ucla.edu/~scp/publications/mortality.PDF), demonstrated that the interpretation of 140 systolic as elevated blood pressure is historically arbitrary, based on misanalysis of Framingham data by forcing mortality prediction into a simple linear regression model. Their piecewise logistic spline reanalysis, which found that the predictive relationship between systolic blood pressure and mortality is almost flat into the 150s, before rising sharply, accounts for more of the variance and is consistent with the Cochrane data. Thanks for your work.
  3. Tracy
    I've have symptoms of insulin resistance for decades (of course I didn't know this at the time!) due to eating too much sugar but the only time my blood pressure went up was when my magnesium deficiency worsened and hyperthyroidism. When I finally had my insulin tested, fasting insulin was two times higher than the upper end of normal and three times higher after two hours of ingesting glucose.

    I've never had an abnormal blood glucose level, abnormal cholesterol panel (total cholesterol rose in the range when Hashimoto's thyroiditis showed up but I started treatment before levels rose above the range), or fatty liver (normal liver ultrasound back in 2006), and my appetite is suppressed with insulin resistance. If I eat sugar, my appetite will go down rather quickly.

    This goes against a lot of info I've read and watched about insulin resistance. I might be an unusual case perhaps. The only thing I have found to explain why I don't have these metabolic diseases is from Dr Lustig on the video series - The Skinny on Obesity (Ep. 3): Hunger and Hormones - A Vicious Cycle: "The one thing we know, categorically, that can mitigate chronic diseases is reduction in calories.." When I wrote up a food diary, I was eating under 5000 calories a week but you can bet I was eating a high % of sugar in my diet!

  4. Dr Jonathan Gordon
    I just encountered this paper from Port et al. which articulates my discomfort with universal and absolute BP norms.

    You and your enlightened readers may also find it interesting.

    'There is a non-linear relationship between mortality and blood pressure'

    (Eur Heart J, Vol. 21, issue 20, October 2000)

    Here's an excerpt:

    "Our findings show there is no increase in risk with the nominal increase in systolic blood pressure with age. In place of a fixed pressure set by convention, we find there are natural candidates for hypertension cut-points that are based on a fixed percentile of pressure rather than a fixed pressure. Consequently, a universal cut point at a fixed pressure, in particular at 140 mmHg, has no justification; the cut-point for hypertension in terms of systolic blood pressure itself must be age- and sex-dependent."

  5. 1 comment removed
  6. Diane
    Brilliant. Thank you The Diet Doctor.
  7. Cat
    I have high blood pressure, sometimes, it's gotten higher as I've gained weight. I like the idea of the LCHF diet, it makes sense to me, but everything we're told is that high fat = high blood pressure, I'm worried that it will hinder rather than help me in terms of bringing my blood pressure down.
  8. nikky
    This article on blood pressure is life saving to me. I now know how to manage my blood pressure and the right drugs to take. Thank you.
  9. robert lipp
    Hi Andreas
    Great brief chat at the Noakes conference. Thank you for your input appreciated.
    Aide memoire: we spoke about a table of the research supporting lchf. Including anti-statin research and diabetes research.
    The problem, I find, is that ordinary patients like me cannot easily access all (emphasis on all) the relevant research. We don't necessarily know where it is, we some times don't recognize it, it is scattered all over the place (internet) etc. While most blogs, yours included, reference research which is fantabulous, i have sometimes noted different names for the same study which can confuse a patient. Each reference is good and useful to us readers, but we may not know that there are (say) 4 further studies that are relevant. Not knowing means we miss them.
    This makes it difficult for a patient to "challenge" their doctor when the Doc says things like. You have to eats grains and fruit, or LDL is the only measure you need for heart risk assessment, or reduce saturated fat intake it is a heart disease risk, you must not stop your statins, etc. I would love to trot out the available research (in a table) for lchf, or diabetes, or saturated fat is OK, or statins are usually unnecessary for many people etc. etc.
    We believers are only going to be able to support you crusading doctors if we can show the doc research and therefore have the ammunition to challenge our doctors.
    I am sure you get the picture.
    Idea: what if the group of conference specialists had a common site with a table?
    Regards Robert
  10. Ann
    Dear Dr. Andreas, What do you think about a ketogenic diet and intermittent fasting for someone w high blood pressure and chronic kidney disease? Love the article! Thank you.
  11. Sonnenblume
    I get a bit depressed when reading about the stories of LCHF-diet reducing blood pressure by so many, so fast and so significantly. Being diagnosed with Hypertension last year, and taking Ramipril since, the reason for me to start LCHF Lifestyle in January this year was mainly to get rid of the medication.

    After losing 8kg in the first months (current specs 180 cm and 97kg, woman, late thirties, physically active 4-5 days a week, no other medication/diseases, normal blood sugar and cholesterin) and generally feeling wonderful on this 'diet', my BP has not changed. I still get elevated pressures 12 hours after taking the meds, up to 150/97. This happens mostly in the late afternoons, before my evening meds. Curiously, the BP can be as low as 118/68 when I wake up, but due to the "Living hours' BP" I do not see myself being able to drop the medication anytime soon.

    Maybe I am not being patient enough - maybe it's the weight that would need to drop some more (as stated somewhere, maybe my obesity is the reason for the BP) - but after the Initial weight loss I am currently on a plateau since end of April. My eating habits are based on a mixture of Eenfeld and a finnish MD Heikkilä, with carbs being at a Level of ca 30g/day, and limiting my Protein intake to 70-80g a day since January.

    Just sharing in case there are others struggling with the same Problem.

  12. 1 comment removed
  13. Dean
    I have maxed my lifestyle changes out due do heart plaque issues and moderate high pressure. Weight is down from 292 to 168 and power walking 2 miles in 31 to 32 minute range. Resting BP is down to low 120s/80s...and up with activity and the daily cycle. But I started taking a baseline pressure when waking in the morning lying flat after learning that is the best time to get a resting pulse, which dropped from the 72-73 range into 64-65, significant. While taking a BP series lying on my right side both BP numbers dropped 12 to 15 points on every occasion. I have found no reason to explain this.
  14. Alcover
    Can this diet change hard arteries for the better?

    Thanks for all you do!

  15. Susan
    I'm an Emergency Room RN (20 years of experience), and have been an RN for 30 years. I've always felt that there was something very wrong about the way we 'treat' Diabetics (I have Diabetes Type 2, myself), guilting them for every symptom they have, labeling us as non-compliant, lazy types. I knew that calorie counting along with exercise just didn't seem to ever provide results for anyone I knew, or for myself. When my own A1C spiked to 9, I systematically began researching. After a weekend spent reading and searching the internet, I found the Ketogenic diet and listened to the science. For once it all started to make sense! That was in June. It's now August and I've lost nearly 30 pounds and have about 15 pounds to go. I check my A1C next week, and believe it will be much improved, since my am and pm blood sugars range from the low 80's to low 120's, and (I know, I know, but I'm a nurse...) I stopped my Metformin over a month ago. I'm feeling much better and I want you to know that for the first time in years, it seems I have some control over this. You and the professionals you interview are doing an immense service, and deserve kudos. I will continue to follow along and improve my health, in large part, because of you and professionals like you. Thank you.

    It's funny, but my doctor doesn't want my A1C to go below 7, seems they're concerned that my blood glucose might go 'too low.' Are they ALL confused? I'm on no meds. Again, thanks for your efforts!

    Replies: #17, #59
  16. DebbieC.
    I'm one of those "severe white coat syndrome" types. I typically get readings of something like 200/100 in a medical setting. Eeek. But at home it runs much closer to 120/80. One reason I avoid going to the doctor as much as possible! I've calbrated my home machine with the doctor's and they are almost identical so I know my home readings are right. Indeed my doctor had me wear a 24-hour BP monitor at one point and was so surprised to find I was right ~ my BP was perfectly normal the whole 24 hours except in the doctor's office. :)

    However it has inched up a bit over the last 10 years, despite adhering to a LCHF diet since 2006, and I find now that 1-2 cups of hibiscus tea daily keeps it under control (except at the doctor's of course, LOL)

  17. Bjarte Bakke Team Diet Doctor
    Susan, great to hear about your progress!
  18. sandra wetzel collins
    I am sharing this information as Blood pressure knowledge and the dangers and exactly what it means thank you.Sandra Wetzel Collins
  19. Donna
    Dear dr.

    I am 52 and suffer from low bloodpressure since childhood. When I was 15 I fell down all the time and people said I acted but after many yrs a neurologist discovered low bloodpressure by then 80/60.
    When I had surgeries they were shocked how fast the pressure went down when had totall aneastheatics. It was life threatening.
    I sport a lot and also was proff. Sports seem to help. After an accident I have artificial parts so cannot run anymore which makes it difficult to keep up. I suffer epilepsy by times from it when under high stress. Also when stand up a longtime I get extreme dizzy or when I do not move like with a long flight.

    There were medications then who were actually for migraine. They are not to get anymore. I suffer from it. I also have very low bloodsugar and was in a coma from a hypo once.
    I moved to a tropical country sometime ago. The last yr weather is extreme hot more then ever and very humid. My symptomes go worse.

    Do you have a suggestion what I can do to feel better?

    I started to drink a few sips of(I never drank any sodas in life!) Coke zero lately and a few sips a few times a day helps. I also really need coffee. But stopped overdoing only take a mug once in morning and evt.an espresso if I must keep going.

    Some advice please. I come from a country in Europe which is well known for med.knowledge but nothing on this,and where they are not really interested in caring for this. Now living in Asia at last they really care when having surgery(big sugery twice one yr ago) and keep my oxygene in longer and care a lot. Never expected healthcare would be so much better here but again....no info to get on hypotension only "be carefull."
    i have a friend in a very faw away country suffering from the same problem but she has high bloodsugar. I have too low.

    Why o why is there nothing. No place for me to get real info nor is there a cure.

    I live very healthy do yoga and fittness and swim. My weight is perfect and I look much younger then my age. Like my dad who had all the same symtoms he died at 67 looking 43. No kiddin'! Does the low rates have to do with that?

    I don't drink nor smoke. My dad drank a lot(died from it but no high bloodpressure) and smoked.

  20. Carla
    I have taken Lisinopril 10 mg for over 10 years with good results. In the last couple of months, my blood pressure has started to rise. Recently I was in the grocery store and thought I'd take a reading (something I usually do when one is available in a store). I was shocked to see that it was up to 156/85, way higher than normal (although the bottom number had spiked to close to 90 recently). I panicked and walked around for a few minutes thinking that I would try it again. At that point it was up to 181/110! I actually got a warning on the machine about my high reading. I ended up going to the emergency room, where my BP was 192/108. I was given an intravenous medication to lower it, and it still only got down to 155/80. They gave me a prescription for Clonidine and told me to see my doctor soon. I took the Clonidine for a couple of days, and it lowered it but still not as much as I'd like. And it made me feel totally exhausted. My doctor has placed me on Lisinopril 20 mg in the morning, and 5mg of generic Norvasc in the evening. I am just starting this routine, and I very much hope it works because I am still getting way too high readings. I'm also diabetic and take Janumet XR once a day. I hate feeling like a walking chemical factory, but I also asked for and received generic Lexapro to help calm me down. This sudden and frightening change has got my nerves completely frazzled, which is not helping the situation at all, and I hope that the Lexapro will not be a permanent fixture . I need to lose weight and eat better, I readily admit that. But I also admit that it's disheartening to have to cut out some of the foods I love and really watch the sodium content of everything. I'm just so scared that this came on so quickly and strongly, and I have a big history of heart disease in my family. An EKG and CT scan of my head were done at the hospital, as well as blood tests, and other than elevated blood sugar levels they all came back okay. But I know that if I don't get it under control soon there will be serious problems. It's just proving kind of tough to get it under control. Thanks for listening.
  21. Govindraj
    I have hipertension normaly rangeg between 130-140/85-90 nd to cure this I have to used Amlodipine+ Atenolol (5 mg + 50 mg) in combination rather sometimes it doesnt work and remains my BP high. Is low body volume (no food and no liquid) helps to lower blood preesur somewhat.
    Reply: #22
  22. Bjarte Bakke Team Diet Doctor
    Govindraj,

    If you want to make sure your question is answered by one of the Diet Doctor experts, ask it on our membership site.

    I'd recommend following the advice Dr. Eenfeldt provides in the "How to Normalise Your Blood Pressure" section.

  23. bella
    i have high blood pressure, most of time it's around 140/90 but it seems that when i sleep it increases. When the dr asked me to put the bp monitor, he saw that my blood pressure is reaching a peak of 180/100 or 180/110. Now i did all the blood tests, MRIs, everything possible and nothing's wrong. Also, yes im a bit overweight, but within a year i lost about 24lbs, and the problem of high bp started showing 2 or 3 months ago. What really bothers me when my bp is high, is that i shake alot, my legs, hands, and even some people see my mouth shaking when im talking. I think and stress myself a lot, so i was wondering could this actually be related to a psychological issue? Because i really have lots going on in my life, and i never open up to anyone.
  24. Ryan
    Susan,

    You may want to reconsider your decision to not take Metformin. There are some remarkable studies recently released on it's anti-aging effects. :).

  25. kareninca
    I have found that the magnesium stearate that is in most of the supplements I was taking, was raising my blood pressure (unfortunately it is in many medications, too). I learned this when I started taking a lot of a probiotic, and my bp got really high. That led me to do a lot of experimenting, which led to this discovery. Avoiding magnesium stearate has not completely fixed things, but it has made a VERY big difference. I wonder how many people are sensitive to it; it is "generally recognized as safe" but how much bp testing has been done on it?
  26. Owen
    Just a quick question...first some background...
    I first noticed I had a slightly lower pulse rate than 72/min when i started a walk/run regimen when i was in my early 40s that required i took my waking pulse rate daily (typically it was in the low 60s).
    I have ALWAYS had a propensity towards being overweight...
    I am now a healthy 70yo (in spite of my weight - no chronic meds of ANY kind) and have recently (since 4th August 2015) started on a LCHF diet. I have lost 16kgs (from 97kgs to 81kgs) and feel energetic and alive like i haven't in YEARS. I also follow a 5 or 6 days walk/jog/shuffle regimen around a bird sanctuary close to where I live of between 5 or 6 kms a day.
    I am still a blood donor and at my last donation, although my BP was "excellent" (for my age - whatever that means) my pulse rate was 48. I questioned it and when i explained my exercise routine the nurse was quite OK with it. .."so long as it does not go below 45" she said!
    48 is pretty darn close to 45!!!
    Is this indicative of anything besides maybe having become fit for a septuagenarian?
  27. Sharon
    Too much focus on blood pressure can be counterproductive. After several bad experiences, I developed a severe case of White Coat Syndrome. Now just the sight of a BP cuff causes a full-blown panic attack, plus I hate having my arm squeezed so tight that it's painful. (I can't believe that's very good for the vasculature.) I no longer allow medical people to check my blood pressure. The times I have done so at home it was always normal. Maybe I'll get over this phobia at some point, but meanwhile I do everything I can to stay healthy, active, and keep my weight at a normal level. That includes a mostly-Paleo diet, plenty of exercise, and avoiding medications as much as possible.
  28. Nisha
    I am 38 and my bp was 110/70 all the time except during pregnancy..which was 120/80. But last week when i checked my bp as i had headache, it showed 100/150. I am 62 kg with 5'1". Plz help.
  29. LeNa
    Nisha...I think you need to go to a doctor.
    Sharon...I am having the same problems. My arms are too thin and the blood pressure procedure puts me in intense pain. I have ripped that cuff off and told the MA to get her hands off of me...it's mainly one person at the doctors office and now I just tell her No get someone else!! But the pain is not the whole thing she has turned my arm black and blue...I think now my fear of the procedure raises my pressure. and so I try to avoid it as well...it's 139/79 at home...a little high but not too bad
  30. Martha
    My blood pressure for the last 4 or 5 days has averaged 189/100 with pulse 65. I am 5'6" & 120 pounds, I am on 3 BP meds: Lisinopril 40mg, Propranolol ER 80mg, & Metoprolol ER 100mg . I have just the opposite of white coat syndrome--my BP is usually good at the doctor's. I am not on a regular exercise regime, but do it spasmodically.
    I am on & off with eating good & that seems to make no difference. My normal BP is high, but not as high as it has been lately. I am also on 2 antibiotics (Clarithromycin 250mg twice a day & Aziththromycin 500mg once a day) for A-Typical TB which will last the duration of 18 months. Any suggestions?
  31. Mike Jones
    Hi Martha,
    I had a routine BP check for some minor surgery 2 weeks ago and found it abnormally high for me at 144/90 so I bought an Omron meter and tried at home - it was even higher.
    I've never taken medication and am not overweight so I looked around and tried beetroot juice - you can get "Beet-it" from most British supermarkets and you sip a glass of 250 ml a day. Combined with cutting out nearly all salt my blood pressure reading after 2 weeks is 123/79 in the morning and the highest reading 134/73 during the day. The beetroot juice is full of nitrate which combines with saliva and dilates the blood vessels. It has certainly worked for me in the short term.
  32. terry hall
    terry
    my top bp is always higher than the bottom and my heart rate is always low- don,t understand it- 148 over 76 heartrate 59- am I weird or what ??????
    Reply: #33
  33. Peter Biörck Team Diet Doctor
    I think your reading sounds rather OK but your systolic blood pressure seems to be a bit high, the other values are excellent. I think it could be a good idea to go to your physician and discuss this with him/her.

    More reading about blood pressure:
    http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighB...

  34. Arlene
    I've been on BP meds since I was in my mid-30s, and am now in my early 50s.

    So, for the past 15 years or so, I've been on various BP medications, with the medications increasing in number as the BP was simply never controlled (office readings of 165/80 were routine), and getting worse.

    The cardiologist could find no reason for my elevated BP. I was moderately overweight but certainly not obese, and was physically active.

    Last year I started a LCHF diet, along with Intermittent Fasting.

    I've lost approx. 10kg.

    I decided to start taking my BP at home every day.

    My average BP is 108/68 in the AM (average of 3 readings) and 113/72 in the late afternoon (also the average of 3 readings).

    With the consent of my Dr, I've reduced my medications from 3 tabs to a half a tablet. I'm more than likely going to discontinue that too, as my BP continues to get lower, and will hopefully be medication free for the first time in many years.

    A big thanks for this great site and all the info.

    Reply: #38
  35. 1 comment removed
  36. Alex Tennant
    Hello

    I have type 2 diabetes and high blood pressure which is regularly checked by my GP Surgery. Currently 180 over 80. My diabetic nurse took my bloods today to check my thyroid functioning. I work in a very high stress job as a social worker, in a climate of severe cut backs to vital public services. Other colleagues and friends are struggling with their own health issues including burn out and high blood pressure in the case of one social worker now on tablets himself.
    I am trying to cut my carbs down and drinking lots of water. I take metformin to control my diabetes, however I have pain in my knee joints and I wonder if that is a contributory factor in my high blood pressure.
    I have left my recent very stressful job and am looking for a temporary locum position through a number of agencies where I am within reason in control of the process of how I run my life. I now practise guided buddist meditation so I am slowly becoming more mindful of how my mind coupled with a better diet can slowly lower my very blood pressure down to safer levels. Is there anymore advice you can offer to keep me om track? Well done for all you are doing keep up the good work.
    Alex

  37. Aj
    Hi
    I was on hypertension medication Benitec 20mg for 1.5 years, then raised to 40mg for 4 months and back to 20mg. Now my BP is 110/70. Earlier it used to be 130 /80 on medication. Now my doctor has asked me to stop the medication for 15 days.can any one explain why such a drop?
  38. Ade
    Hi Arelene,

    Your story is such a positive and encouraging one. My experience sort of aligns with yours. God helping, I will try what you have shared and be hopeful. God bless you!

    Ade

  39. 1 comment removed
  40. Robert
    I am 63 years years old (almost 64), & was forced to resign my job due to back injury, which required major surgery (8 months ago). Very successful result, & I find I have no pain, & can walk & climb stairs normally. My diagnosed blood pressure (from doctors) has always been high since I was 20 years old. However, last year, a local doctor prescribed medication to reduce my blood pressure. Today, I applied for a very important job which required a thorough medical examination including taking my blood pressure. I am currently taking medication to reduce it, but my blood pressure readings (2) were 195/110, & then 5 minutes later 175/104..... the first reading was the highest every recorded & is classed as "severe". I admit that I was very tense & nervous during the examination today. So before I arrived home, I went to the local pharmacist & bought a brand new, blood pressure monitor for home use. I took 5 readings, resulting in 136/75, 128/71, 119/71, 128/74 & 134/80..... is this a severe case of "White Coat Hypertension"? My blood pressure monitor records all these readings, so I will take it to my local Doctor tomorrow for her opinion. :-)
  41. Cindy
    I have Menieres disease and was told to avoid salt. Can I still do the LCHF diet? I tried Atkins years ago and lost a lot. I was younger then too. I'm in my 50's and have put on a lot of weight and nothing is working for me. I have high blood pressure also and take Amiloride.
  42. Dorothy
    I am currently on 2 blood pressure medications. My BP has always been extremely high, for example 165/98. Kidney disease runs in my family. My mother died from kidney disease and my brother in now on dialysis. I started eliminating and reducing the carbs in late January 2016. As of Wednesday, 05/25/16, I have lost 20 lbs and my BP is in the normal range and below. I will visit my primary doctor next month and hopefully will come off of at least one, if not both medications. This truly works and I tell as many people as possible in hopes that this will change someone else's life. I wished I had done this earlier in life.
  43. 1 comment removed
  44. Chris
    I started low carb and then found this website via one of the videos on youtube. My un-medicated blood pressure was typically about 150/93 (after six months needing prescription), and medicated closer to 130/83 my MD told me to lose about 20 lbs. After a couple weeks on LCHF I felt dizzy at times especially during workouts (especially after heavy squats or deadlifts). I forgot to take my lisinopril 10 mg + HTZ two days in row and took my blood pressure and it was 117/71! I intentionally skipped a my medication for a few more days and it seemed to be 130/93 after a week. I noticed that my BP seemed to go up and down with how much I cheated on carbs / sugars the previous day. When I was really strict is when I got 117/71 and when I ate more potato chips at midnight it would be up to 130/93 in the morning.

    In addition I started adding a teaspoon of raw unprocessed cocoa powder to my coffee (2 per day). Raw cocoa has good impacts on blood pressure, is high in antioxidants, helps with HDL / LDL profiles, and may have performance benefits for athletes.

    My weight is down 10lbs during the month, from 226.6 lbs (137.8 water + 50.0 Dry-Lean Mass + 38.8 Body Fat Mass) to 216.7 (136.1 water + 49.5 Dry Lean Mass + 31.1 Body fat Mass). This is also good news since I wanted to retain muscle and lose fat mass. My workout is 2-3 times per week weight training and the main change was to LCHF diet.

    Cocoa:
    Food Nutr Res. 2016 Mar 31;60:30449. doi: 10.3402/fnr.v60.30449. eCollection 2016.
    Cocoa extract intake for 4 weeks reduces postprandial systolic blood pressure response of obese subjects, even after following an energy-restricted diet.

    Nutr Metab Cardiovasc Dis. 2014 Apr;24(4):416-22. doi: 10.1016/j.numecd.2013.09.017. Epub 2013 Nov 1.
    Oxidised LDL levels decreases after the consumption of ready-to-eat meals supplemented with cocoa extract within a hypocaloric diet.

    Nutr Metab Cardiovasc Dis. 2012 Dec;22(12):1046-53. doi: 10.1016/j.numecd.2011.02.001. Epub 2011 May 6.
    Regular consumption of cocoa powder with milk increases HDL cholesterol and reduces oxidized LDL levels in subjects at high-risk of cardiovascular disease.

    Int J Cardiol. 2013 Oct 9;168(4):3982-90. doi: 10.1016/j.ijcard.2013.06.089. Epub 2013 Jul 17.
    (-)-Epicatechin rich cocoa mediated modulation of oxidative stress regulators in skeletal muscle of heart failure and type 2 diabetes patients.
    Ramirez-Sanchez I1, Taub PR, Ciaraldi TP, Nogueira L, Coe T, Perkins G, Hogan M, Maisel AS, Henry RR, Ceballos G, Villarreal F.

  45. Alex
    Hello,
    I am a 43 years old male. 6' tall weight 170lbs. Eat healthy, don't smoke and don't drink more than 2 glasses of red wine.
    I was put on Bystolic 2.5mg about 3 years ago for a BP reading of 140/90
    Last winter I went to a cardiologist and they ran all the tests from stress test, ultra sound and CT and they said nothing wrong with my heart. They proposed that I can come off of Bystolic if I want and see how it goes.
    I decided to follow their suggestion and I came off of Bystolic. Had withdrawal symptoms the first 5 days ( felt like I had drank 2 cans of redbull) then felt better and I have been off of them for 3 weeks. During this time I have been getting anxiety attackes and sometime my BP would go up to 155/110 for few minutes and then would hover over 140/100 range and then after few more hours back down to 125/83. When I wake up in the morning it's always around 117/77 range. Late afternoon is up around 138/88 range and the by night time back down to 123/83 range. This has been the pattern for while I am off Bystolic.

    So my question is should I go back on Bystolic 2.5mg since I get anexity attackes and BP jumps up to 150 range over 100 range for few hours?
    Do I have BP or anexity problem or is it still witdrawl symptoms and my body is still trying to adjust, so littlest stress makes it jump up and panic?

    Thanks in advance for your reply.

  46. Nivedita
    Nice post, Lifestyle plays an important role in controlling Blood pressure. If you are able to opt healthy lifestyle and start keeping eye on diet and weight and also watch bp using bp monitoring machine at home regularly then you can able to treat it very well.
  47. paul
    I've been trying to gain weight for my Olympic Lifting program i've gone from 160 to 168 in 8 weeks. My diet consists of 2600 calories/day high carb, high protein and low fat (no junk food, carbs consists of potatoes, sweet potatoes, rice). I've noticed that my blood pressure has sky rocketed. Is it due to my change in diet? When resting it'll be anywhere from 140/80-150/90
    Reply: #48
  48. Peter Biörck Team Diet Doctor
    Hi Paul!

    If you change from high fat --> high carb then it's possible that your BP will rise.

  49. toni
    Toni
    I'm on blood presure meds and still my BP is high 162/ 102.
    162/102 is when sitting. Stand up and take it 132/79 or lay down 126/74. not sure what to make of these numbers. HELP ! If you can.
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