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Preventing & Reversing Hypertension
Q&A with Doc Wilson, Ph.D.
 High blood pressure can lead to heart attacks, strokes, kidney failure and, in general, a much shortened life. Check out this “no medication” solution that will work for most people. This is a two-part series. This month the focus is on exercise; next month it is on nutritional components for reducing the risk of developing (or reversing) hypertension.
Q: My physician says that I am moderately hypertensive, and he wants to put me on two medications. Are there any non-medication ways to bring my blood pressure down to a safe, healthy level?
A: There are a number of things you can do that have high odds for success; however, be certain to check first with your physician because you could have a condition that requires the use of prescription drugs (either short-term or long-term). Although what I am about to reveal has a very high probability of success (statistically speaking), you might fall in the statistically “small probability” category of persons for whom drugs are absolutely necessary. Unless you are in that “small probability” group, your physician is likely to work with you – for example, giving you four to six months to get your blood pressure under control.
First, let’s examine some statistics for success.
- By strictly following a great nutritional plan (for example, the DASH Diet that is espoused by the National Institutes of Health), and doing nothing else, your odds of success will be a little over 80%. With just a few small modifications to the DASH Diet (in other words, superior nutrition), your odds will be even a tad greater.
- By regularly engaging in a run-of-the-mill exercise regimen (interpretation: doing only wuss-level workouts), and doing nothing else, your odds of success will be roughly 60%. In other words, low-level workouts will suffice to lower high blood pressure in about 60% of the population.
- On the other hand, if you follow not only a superior nutritional regimen, but also a superior exercise program, your odds of success will be greater than 90%!
Therefore, the real question becomes: What do you have to do to have a superior nutritional regimen and a superior exercise program? Let’s tackle these issues separately: exercise this month and nutrition next month.
Exercise
For our purposes and for optimum results, you will need to focus on two areas, developing and regularly practicing a) a sufficiently demanding strength exercise program, and b) a sufficiently demanding cardiovascular (that is, endurance) exercise program.
In both of these areas, you may need to allow a number of weeks or months to gradually work up to the “sufficiently demanding” level of exercise – at which point you will start to see the strongest results. The length of time it will take to reach the “sufficiently demanding” level will be determined by your overall health, recent conditioning, genetics, level of effort, consistency in following the program, etc.
For your strength building exercise program, choose 8 to 15 exercises that collectively target the large muscles of most of the areas of your body. Your exercises can be ones using free weights, using machines that each have a range of weights or resistances that you “dial in,” or you can select exercises that just use your body weight if they are sufficiently demanding.
Next, it is critical to determine the optimum weight, or level of resistance, for each exercise, as follows. (Note: This is a moderate workout, and is all that you need for optimum health.) For those exercises that use muscles in your chest, arms, and upper back, use a weight that allows you to do only 8 to 10 repetitions (“reps”) before your muscles poop out (the technical phrase is “reaching the point of muscle failure”). As you get stronger, you will increase the weight or resistance so that you remain in the 8 to 10 reps range. You will move the weight/resistance higher once you can do 11 or 12 reps to muscle failure. For each exercise that uses muscles in your legs, choose a weight or resistance with which you can only do 12 to 15 reps to the point of muscle failure, and then increase the weight when you can do 16 or 17 reps. For your core muscles (your lower back and abdominal muscles, as well as your “side” or oblique muscles), use a standard of 10 to 20 reps to muscle failure.
Assuming that you have no medical issues that would prevent you from following (or working up to) a full-fledged program, your cardio (endurance) exercise can start with a low level of training on a treadmill, a bike (stationary or for the road), an elliptical machine or walking/jogging/running. Once you can hold a “good” pace for at least 20 minutes without becoming excessively fatigued, then you may be ready to up the ante by moving to interval training. Two of the many benefits of interval training are that you can have a cardio program that is much shorter and much more endurance-enhancing (i.e., producing a higher level of “aerobic conditioning”) than the conventional cardio exercise that is practiced by most of the patrons in most gyms. My personal cardio workout is only 9 minutes (4 interval cycles), and I do it three times a week. The harder the level of exertion, the fewer “interval cycles” that you will need to do; so, as you progressively increase your conditioning level, you will be able to decrease your number of cycles, and the length of your cardio workout. At the beginning, you might do 6 to 8 relatively easy interval cycles, and work your way down to just 4 or 5 interval cycles once you are better conditioned and doing a demanding workout.
How do you practice interval training? With my clients, once they are relatively well- conditioned, I typically have them go for one minute at a low-level “recovery rate,” followed by a one minute two-phase “fast rate.” The “fast rate” portion consist of 40 seconds at a “moderately fast” pace, followed by a “very fast” or “all-out” pace for the last 20 seconds of the minute. Thus, the pattern is 1 minute slow, 40 seconds moderately fast, 20 seconds very fast, 1 minute slow, and so forth, until 4 or 5 interval cycles have been completed. An interval cycle consists of 1 minute fast (i.e., 40 seconds moderately fast, plus 20 seconds very fast), plus 1 minute slow, for a total of 2 minutes per cycle. I usually precede the interval cycles with 2 minutes of warm-up at the slow recovery pace, and end the cardio session with 2 minutes at the slow pace. You should get appreciably out of breath when you do the very fast or all-out pace, and you should feel it even more strongly by the time you execute your last interval cycle. Total time for 5 cycles = 13 minutes. With a very demanding program, and only 4 cycles, the total time is 11 minutes. You can do this 3 times a week, and on an every-other-day schedule.
For more information about personal training at CA, click here.
Always check with your physician before starting any exercise regimen or change in diet.
This column is intended to provide only general information that may be of interest to the public and is not intended to provide and should not be relied on for specific medical advice. Any questions regarding your personal health and medical issues should be directed to your physician.
About Doc Wilson
 Doc Wilson is a physiologist, biochemist, nutritionist and personal trainer who does personal training and nutritional counseling at the Columbia Association. He earned a Ph.D. in physiology and biochemistry from the University of Illinois at Urbana-Champaign. He also holds a Master of Arts in physiology from SUNY at Buffalo, and he conducted a post-doctoral fellowship in biochemistry and physical chemistry at Duke University. He is a past faculty member of the University of Maryland Schools of Medicine (Department of Medicine, Division of Nephrology) and Dentistry (Department of Physiology).
Wilson’s areas of specialization include weight loss and weight control, preventing and reversing type 2 diabetes, preventing and reversing high blood pressure and other cardiovascular diseases, and exercise and nutrition for optimum overall health. His first book, "Total Health in a Nutshell," is slated for publication this fall.
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