Take the low road
Parts I and II of this series explain why this is important and how to recognize hypertension. This post is about how to get it all under control.
Your target and how to bullseye it
We need ‘normal’ [young person] levels of <120/<80 to minimise cardiovascular risk. For example, a level of 110/70 would be wonderful.
Two Key Questions:
- How do we get to that level when our BP is up?
- Is this degree of reduction safely achievable?
There are lifestyle and medical approaches.
The best approach is a combined one. Don’t say ”I will try the lifestyle approach first and see about medication if that fails”, because any time spent with high BP is damaging, and the acute events like heart attack and stroke that may occur with untreated BP are life threatening. SO do not delay getting your BP down. Fortunately, as modern BP medication is non-harmful there is no reason to be shy of taking treatment.
The optimum approach is start on medication, get control, do the lifestyle change, too, and maybe later, reduce the meds a bit. Moreover, if you are overweight, a drinker, eat a lot of salt, and have insulin resistance you will only get optimum control by making lifestyle changes to alter those factors alongside your medication. Around 50% of you will need only one drug to get your BP down but equally 50% will need two.
Salt reduction is always helpful but has a low impact; magnesium supplementation at around 300mg daily has a significant effect.
The Short Answer
Reduce alcohol; lose 5-10 Kg depending on how over-heavy you are; try for 10,000 steps a day and a more active life overall; take either candesartan 8mg [potentially increasing to 16mg] or indapamide Slow Release 1.5 mg as your first line agent and add the other drug if you need a combination to get the needed result. It is possible that taking a magnesium supplement as I recommend for all over 60’s may have a beneficial effect.
To get the whole inside story read more
