Harvard Women's Health Watch

Ask the doctor: Will lifestyle changes help with systolic hypertension?

Q. My top blood pressure number is high, and my bottom number is normal. Can a healthier lifestyle lower my blood pressure?

A. Healthy diet and exercise habits are the cornerstone of blood pressure management. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has estimated how much each of five simple lifestyle changes can reduce systolic blood pressure (SBP)—the top number in a blood pressure reading—in millimeters of mercury (mm Hg).

  • Weight loss. If you are overweight, every 2 pounds of weight lost can reduce SBP by 1 mm Hg. Losing 10 pounds can drop your SBP by 5 mm Hg! That's a lot.

  • Diet. A low-fat diet rich in fruits and vegetables and that includes low-fat dairy (the DASH diet) can reduce SBP by 8 to 14 mm Hg.

  • Sodium. Limiting daily sodium intake to 6 grams (1 teaspoon of table salt) can reduce SBP by 2 to 8 mm Hg.

  • Exercise. Thirty minutes of brisk walking or other aerobic activity most days of the week can reduce SBP by 4 to 9 mm Hg.

  • Moderate alcohol. In women, one drink a day may lower SBP by 2 to 4 mm Hg. However, there may be a very small increase in the risk of breast cancer in women who have one drink a day.

These changes can really add up. If they don't lower your pressure enough, you may need medication to get it under control.

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