Exercise or drugs? Where to start in reducing blood pressure?

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High blood pressure is the number one risk factor for heart disease, stroke and dementia, so keeping it healthy is vital. But where should you start?

Traditionally, patients whose blood pressure climbed above 140/90 mm Hg were recommended for treatment, but in the US it’s recently been recommended that doctors start treatment at lower levels.

This is based on the results of a study showing that aggressive treatment to get the top figure down to 120 mm Hg can reduce the risk of disease even more.

While that study involved high-risk patients, this new guideline is being applied to low-risk patients too, even though the evidence isn’t there to support doing that.

Of course, this shift will substantially increase the number of people now labelled as hypertensive, and it’ll be interesting to see how Australian medical authorities respond.

Another recent study has investigated the existing research to compare the effect of exercise and medications on reducing that top figure.

A direct comparison is difficult because there’ve been many more trials with drugs than with exercise. In addition, participants in the exercise trials have tended to be healthier, so their blood pressure was lower to start with.

But the evidence indicates that that virtually any kind of exercise will lower blood pressure. This study concluded that a combination of continuous-style exercise (e.g. walking, dancing, swimming) and resistance exercise was particularly effective.

Practitioners often report that high stress levels are a major issue for their blood pressure patients, so stress reduction needs to be a high priority.

So does eating real food, getting enough sleep and getting outside — all of which can lower stress. Supplements such as magnesium and CoQ10 can help as well.

So which is more effective, exercise or drugs?

The bottom line is they both work.

But if you possibly can, start with regular exercise and a healthy lifestyle. Then if you need to lower your blood pressure more, you have the drug option.

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