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Expert Q&A: Eating to Control High Blood Pressure

An interview with Dean Ornish, MD.

Does exercise have an impact in preventing or controlling hypertension? continued...

It turns out that just walking 20 or 30 minutes a day has almost the same benefits as doing more intensive exercise. You don't have to walk all that far or all that fast or all at once. A single exercise session can lower your blood pressure by 5 to 7 millimeters of mercury, and that may persist for as long as the rest of the day.

But it works both ways. When you stop exercising, after one or two weeks your blood pressure starts going up again. What we are learning, particularly with blood pressure, is how quickly it can get better and how quickly it can get worse.

How does stress affect blood pressure?

Lifestyle is more than just exercise and diet. Emotional stress also affects your blood pressure. Emotional stress makes your arteries constrict and your blood pressure rise -- just as tightening the nozzle on a hose makes the water pressure go up.

Chronic anger and hostility -- and particularly depression and hopelessness -- also have a strong effect on blood pressure. There is nothing wrong with an increase in blood pressure in times of stress. But when these mechanisms that evolved to protect us are chronically stimulated by the stresses of modern times, they can harm us or even kill us.

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.

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