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    What is the connection between alcohol consumption and hypertension?

    For some people, the stress management part of drinking helps to reduce their blood pressure. For others, the alcohol itself ups blood pressure. But even for those whose blood pressure goes down, is this the best way to reduce stress?

    There are lots of ways to manage stress that are not centered around alcohol. Social support and love and intimacy will not only reduce your blood pressure but also reduce your risk of developing heart disease independent of its effects on blood pressure.

    What else, besides diet and exercise, affects blood pressure?

    Robert Nerem found that rabbits that were touched and talked to and petted and played with had 50% less blockage in their arteries than rabbits that had been ignored, even though their blood pressure and cholesterol levels were about the same. So it is important to talk about psychosocial factors when we are talking about high blood pressure.

    You need a sense of community, a sense of love and intimacy. You need to make time to be with your beloved; you need to go on walks with your friends. My lovely wife, Anne, says, "Walk your dog, whether you have one or not."

    These simple changes are just as important as the exercise we get and the food we eat. They have direct benefits for high blood pressure, mostly in terms of reducing stress. But they also have indirect benefits.

    We are more likely to smoke or overeat or drink too much or work too hard or abuse ourselves if we don't address the underlying issues of loneliness and depression and isolation. These things are really epidemic in our culture and often underlie the high blood pressure that we doctors see.

    How does weight loss affect blood pressure?

    For many people losing weight is enough to get their blood pressure down, because your heart doesn't have to work as hard. One of the easiest ways to lower your blood pressure is to lose 5 or 10 pounds.

    For many people, that is the difference between having to be on medications for the rest of your life and getting off these drugs altogether.

    My approach has always been if you address the underlying cause of the problem, the need for drugs and the need for surgery is often reduced or eliminated. For many people, this is a great motivator.

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