Does Lifestyle Really Matter?

You have covered various aspects of the topic of high blood pressure (hypertension). It seems that treatment is effective and that the complications of hypertension are decreasing. I am 40 years old and take my blood pressure tablets regularly. Do I really need lifestyle changes?

Hypertension (high blood pressure), or the “silent killer,” has been the topic of a number of questions we’ve received over the past 15 years. This is because it’s a common problem. In 2015 it was estimated that:

More than 1.3 billion people worldwide had high-normal/early hypertension with a blood pressure (BP) reading of 130-139/85-89 millimeters of mercury pressure.

Between 1975 and 2015 average BP readings had stayed about the same for men and slightly decreased for women.1

These estimates are concerning, as there has been a strong emphasis on awareness and also treatment of hypertension. Despite health education and awareness efforts globally, only 57 percent of people with hypertension know their condition, and only 40.6 percent receive antihypertensive drug treatment, with 13.2 percent optimally controlled. This disparity between the number of hypertensive patients, their access to treatment, and BP control is greatest in middle- and low-income countries.2 These figures are alarming and deserve considered, intentional action.

Recently the American Heart Association and American College of Cardiology have lowered the definition of high blood pressure to allow for earlier intervention. The greatest impact expected is in younger people under the age of 45. The implication, or warning light, for not only the United States but for blood-pressure management around the world is that we need to be lowering blood pressure, with the main emphasis on nondrug approaches.

We carefully follow peer-reviewed health science literature. There has recently been a notable increase in articles, reviews, and recommendations related to the management of hypertension. The main message has been the key role of lifestyle approaches and interventions. These include:

• weight loss and maintenance of ideal weight/body mass index
• Daily exercise
• cessation of smoking/tobacco use
• avoidance of alcohol
• diet rich in vegetables, fruit, whole grains, nuts, and unsaturated fats
• avoidance of red meat, saturated fats, refined carbohydrates (cakes, sugar-containing beverages, and sweets)
• reduced sodium (salt) intake

Medications are needed by many for BP control. Lifestyle modifications are essential for all in the control and even reversal of high blood pressure. The word “reversal” is used with caution because once the lifestyle measures help achieve the desired goal, they need to be maintained for life. Not surprisingly, all the above lifestyle interventions are intrinsic to the Adventist health message! This information can help us to be a positive influence in our communities as we actively make the difference to health and wellness through screening programs, and identify risk factors such as hypertension.

Lifestyle matters! We can identify safe walking routes, start exercise clubs, teach healthful nutrition, share hope, and encourage wholeness even though we are broken. This can be true comprehensive health ministry that extends the healing ministry of Jesus.

1 http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence/en/

2 http://www.paho.org/hq/index.php?option=com_content&view=article&id=13257%3Adia-mundial-de-la-hipertension-2017-conoce-tus-numeros&catid=9283%3Aworld-hypertension-day&Itemid=42345&lang=en

Peter N. Landless, a board-certified nuclear cardiologist, is director of Adventist Health Ministries at the General Conference.
Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.