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An interview with Dean Ornish, MD.

You know lifestyle can keep high blood pressure at bay. But what if you've already got it?

It's not too late, says Dean Ornish, MD -- even if you already have hypertension or heart disease. The only question is how much better you want to feel.

In his new book, The Spectrum, Ornish points out that there's a wide range of lifestyle changes. Somewhere in that spectrum is the kind of change that's right for you.

WebMD spoke with Ornish about the way lifestyle change can prevent or reverse high blood pressure.

Can I really make the kinds of lifestyle changes that will lower my blood pressure?

Changing your lifestyle is a very personal decision. I never tell patients what to do. But what concerns me, and why I appreciate the chance to talk with WebMD, is that many people don't even know they have a choice.

They go to their doctor or dietitian or nurse and get put on a very moderate diet -- less red meat, more fish and chicken, three or four eggs a week, and so on. It doesn't do too much. Then they are told, "Now you have failed diet, and we have to put you on these drugs for the rest of your life."

What I would like to see people told is, "OK, for some people small changes are enough, because there is a spectrum of healthy choices. But for you, if moderate change doesn't work, it just means you need to make bigger changes than someone else."

Our genes do play a role. But they are more of a predisposition, not a death sentence. If you are genetically unlucky, you just have to make bigger changes. For most people, if the changes are big enough, under their doctor's care they can reduce or get off these drugs. That's what makes our work radical. It gets to the root of the problem.

Salt. If you've got high blood pressure, everyone blames salt. Does everyone need to restrict their salt intake?

Your body keeps a very narrow concentration of sodium. To do that, it can either dilute it or excrete it.

Most people who eat too much salt just pee it out. But when you have high blood pressure, it starts to damage the kidney and that makes it harder to get rid of excess sodium. This causes the blood pressure to go even higher. It's a vicious cycle.

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