Some thoughts 19 years after getting a BP reading of 160/100
1. BEWARE of medication side effects. I left NY City in 2001 with a BP of 135/80. Started taking a medication with a thiazide component. After 3 years when the BP wouldn't budge, and realizing I kept gettin flu-like feelings for several days a monty - which were stated to be a common side effect of these meds, I stopped cold turkey (DONT DO THIS - I WAS LUCKY). BP dropped to 130s and 80s within a few days and has generally stayed there, though with the help of a low dose of a diuretic medication.
2. SALT INTAKE: Be careful with this. Everyone just says "have less salt" Well, I went down from the recommended max of 1500 milligrams a day to almost nothing and kept reading the research, which also said SOME PEOPLE CAN HAVE TOO LITTLE SALT. So just stay mindful of this.
3. BREATHING: SOME people, without spending $300+ dollars on the Respirate machine (FDA approved to lower blood pressure) can lie down 15 minutes, 4 times a week, inhale and exhale for about 4-6 cycles a minute, and dramatically lower their blood pressure. I have no doubt it's helped to keep my BP lower, but again, this is not merely "anecdotal" evidence; there's enough evidence that the FDA (without under the table payments from Respirate!) has approved. If nothing else, it will improve your physical and psychological health in many other ways, and it has no negative side effects, and its' free - so, unless your BP is OVER 160/100, I strongly recommend AT LEAST 2-3 weeks of this before taking meds (of course, check wtih your doctor about the meds)
4. Intermittent fasting or longer fasts.
Of the two things that have been most helpful in terms of lowering BP (a 30 pound weight loss over the 3 months following that initial reading in 2003 didn't make any difference; but the research says it does for most; just didn't for me) lengthening the time without eating is one. Going from grazing, small meals several times a day, to 2 meals a day no snacks definitely lowered the BP a few points.
5. EXERCISE EXERCISE EXERCISE
The REALLY great news is much research shows mild to moderate exercise - especially in older (over 50, I think) folks can be BETTER than strenuous exercise for lowering BP. The research is vague on resistance training; if you have especially high BP be extra careful with resistance training but if you use light weights or bands, it shouldn't be a problem (I'm a psychologist, not an MD so again, check wtih your doctor about this - if you can find one who knows ANYTHING about exercise!!)
Those are really good places to start and they're all either free or VERY inexpensive, they make you feel better as well, and they have no negative side effects and a LOT of wonderful side benefits.
One more thing about the most commonly recommended intervention - I personally have NOT found the DASH diet to help me, but I generally ate whole foods most of my life. The research is pretty clear if you eat a lot of low quality, highly processed carbs, lots of sugar, tons of salt (yes there can be too much), changing even to a slightly healthier diet is going to help.