Looking ahead

For now, the verdict is in. Millions of Americans who previously considered themselves in the safe zone now are finding out they have to reduce their blood pressure even further for the sake of their health. Fortunately, research into strategies for managing blood pressure is also gaining momentum.

One of the most promising possibilities is stress management. A 2001 Archives of Internal Medicine study found that people who participated in a 10-week stress treatment program reduced their systolic blood pressure by 6 mm Hg – 7 mm Hg and their diastolic pressure by 4 mm Hg – 5 mm Hg. The subjects showed an even greater drop in blood pressure at a six-month follow-up. Experiments are also taking place to evaluate the benefits of other calming techniques, such as deep breathing exercises.

Another area being closely examined is exercise. Although the benefits of aerobic exercise in blood pressure reduction have been clear for some time, an article in the August 2003 American Journal of Hypertension reveals that exercising even at levels well below the standard recommendation of 30–60 minutes a day can help control hypertension. In the study, 61–90 minutes of aerobic exercise per week was sufficient to lower systolic blood pressure by 12 mm Hg and diastolic pressure by 8 mm Hg in subjects with stage 1 and stage 2 hypertension.

Calming techniques, such as deep breathing exercises, may help manage hypertension.

Finally, although the JNC recommendations stress the importance of lifestyle changes to prevent hypertension by creating a “prehypertension” category, they left intact the threshold for prescribing medication to lower blood pressure. The 2003 guidelines, like the 1997 guidelines before them, recommend medications only for individuals whose blood pressure is 140/90 or above. With mounting evidence that even slight reductions in blood pressure can result in fewer cardiovascular deaths, these guidelines are likely to come under scrutiny in the future as well.