DEAR DOCTOR K:

My blood pressure medication has side effects that are difficult to tolerate. What else can I do to lower my BP?

DEAR READER:

If you’re a regular reader of this column, you’ve heard me say more than once that diet and exercise sometimes can eliminate the need for medications for a variety of conditions. That’s true — and it surely is true for high blood pressure.

However, sometimes diet, exercise and stress management lower blood pressure only part of the way. Medications may still be necessary. Every medicine ever invented can cause side effects in some people. But the other side of that coin is that medicines often do not cause side effects. And just because one medicine causes side effects does not mean that another will.

Fortunately, there are many different medicines to treat high blood pressure. In my experience, you can usually find a blood pressure medication that is both effective and free of side effects. But even when that’s true, it’s still important to get back to basics: a healthy lifestyle.

A healthy lifestyle is the cornerstone for preventing and treating hypertension. It may allow you to lower your medication dose or stop taking medication altogether. At the very least, you’ll feel better:

• First and foremost, if you smoke, quit. Your blood pressure will start to decrease within hours after your last cigarette. Your doctor can recommend resources to help you quit.
• Another important step is to reach and maintain a healthy body weight. Being overweight or obese itself raises your blood pressure.
• Even if you don’t need to lose weight, eating the right foods can make a difference. The key features of a blood-pressure-friendly diet include plenty of fruits, vegetables and whole grains; several servings daily of low-fat dairy products; some fish, poultry, dried beans, nuts and seeds; and minimal red meat, sweets and sugar-laden beverages. Also try to limit your sodium intake to less than 1.5 grams of sodium per day. You can find the sodium content of prepared foods on the Nutrition Facts label.
• Limiting alcohol can help. Have no more than two drinks per day if you’re male, or one drink per day if you’re female. That’s drinking in moderation. Drinking in moderation may even help lower blood pressure, while drinking more can definitely raise blood pressure.
• Regular exercise lowers high blood pressure. Aim for at least 30 minutes of moderate-intensity exercise on all or most days of the week. Examples include walking or riding a stationary bike. Regular exercise is a potent tonic for lowering your blood pressure — even if you don’t lose weight.
• Finally, relax. Ongoing stress raises your blood pressure. Learn relaxation techniques, such as meditation, progressive muscle relaxation, deep breathing or yoga. I have a patient who took up tai chi several years ago and does it daily. I can’t prove there’s a connection, but I can tell you that her blood pressure has never been so low, and she says she feels great.