Current best practice lowering blood pressure cholesterol?

[the-photographer]

Hi everyone, I am looking for advice on lowering blood pressure and cholesterol.

I've read lots of NICE, NHS and other webpage;

Reduce salt
Reduced processed meat
Reduce alcohol
Increase fibre/vegetables/fruit
Identity good cholesterol food stuffs
Increase exercise

Basically, switch to a Mediterranean diet, however I've read the low carb high fat diet thread below with interest and would like to know if I am missing anything?

My last cholesterol test was 5.8 with a target of 4 (statins prescribed) and natural PB is around 150 if not medicated.

Thanks

[MurderousCrow]

the-photographer said:

Hi everyone, I am looking for advice on lowering blood pressure and cholesterol.

I've read lots of NICE, NHS and other webpage;

Reduce salt
Reduced processed meat
Reduce alcohol
Increase fibre/vegetables/fruit
Identity good cholesterol food stuffs
Increase exercise

Basically, switch to a Mediterranean diet, however I've read the low carb high fat diet thread below with interest and would like to know if I am missing anything?

My last cholesterol test was 5.8 with a target of 4 (statins prescribed) and natural PB is around 150 if not medicated.

Thanks

All this advice is perfectly sound; you are on the right lines. The physiological conditions leading to chronically elevated blood pressure do not arise overnight, and neither will they disappear overnight. Genuine lifestyle change is essential.

Exercise:

This point seems never to be emphasised enough: consistent and progressive exercise (taking a rounded approach to aerobic training and strength development) is the single biggest thing you can do to reduce not only your blood pressure, but more importantly your **all-cause** risk of mortality. It really is a magic bullet.

Diet:

The first and most important factor in a healthy diet is simply quantity. If you're at all overweight, you should address fat loss as a priority.

Ensure a reasonable amount of protein at each meal. Focus on whole food sources of such - meat, fish (esp. oily fish), dairy, eggs, beans.

Don't sweat too much about dietary fat intake, but take a sensible approach. Dietary fat is not as strongly linked to blood cholesterol as once thought, and is a useful source of fuel, as well as being required for normal hormonal function. Healthy sources of fat (unsaturated fats) include olive oil, avocado, oily fish. Less-healthy but still useful sources of fats (saturated fats) include meat, dairy etc. And try to avoid trans fats, found in biscuits, pastries, margarines and creamers.

It's also vital not to increase your overall calorie intake, and this is easily done with fats as they are energy-dense, so also:

Cut sugars and refined carbohydrates (white pasta, white bread, spuds etc.) down to a minimal level. You don't need to cut them out, and if you're training frequently you arguably shouldn't, but a healthy diet generally ends up quite low-carb by default. Finally, eat lots and lots of fibre, particularly from green vegetables and salad leaves.

As you've already mentioned, all the above ends up looking like a Mediterranean diet.

Other stuff:

You haven't mentioned stress reduction. It's a big deal in regard to BP, and again in all-cause mortality. Find a method of healthy stress relief that works for you (yoga could work very well).

Smoking - an obvious no-no.

Hope that's helpful.

Edited by MurderousCrow on Tuesday 10th April 13:45

[Kenny Powers]

Keep in mind that if you start a carbohydrate restricted diet, you’ll likely also be reducing your salt intake, so don’t focus on low carb AND low salt.

[TwistingMyMelon]

The MC post and NHS website tell you what you need to know

Doing a stty diet that is listed on the internet isn't going to cut it imo.

[the-photographer]

Thanks for the detailed post MurderousCrow.

Luckily weight isn't a problem for me (61Kg/31"waist).

Can, I safely swap to wholemeal pasta/bread or doesn't this impact the carb count? Also, what type of exercise is best? Cardiac or muscle/strength?

If anyone has links to the latest scientific food based research, please post, there is lots of magic bullet pages about how to reduce.

[MurderousCrow]

the-photographer said:

Can, I safely swap to wholemeal pasta/bread or doesn't this impact the carb count? Also, what type of exercise is best? Cardiac or muscle/strength?

If anyone has links to the latest scientific food based research, please post, there is lots of magic bullet pages about how to reduce.

Replacing highly-refined carbs with less-refined carbs makes a lot of sense. However. I've no idea what your diet looks like, but would suggest that most people consume far too much carbohydrate in various forms, relative to their caloric needs and an often highly sedentary lifestyle.

A healthy Mediterranean diet broadly translates to getting most of your daily calories from proteins and healthy fats, the balance to be made up with (less refined) carbohydrates. That's a very broad brush way of putting it, but it works for purposes of explanation.

Exercise recommendations: begin a basic strength program as per Starting Strength, Stronglifts 5x5 etc. Perhaps get some coaching to ensure you lift well and avoid injury. Do frequent light cardio (vary the effort day by day according to how you feel - if you're consistent with it you *will* improve over time). Program some progressive and organised mobility work e.g. yoga, pilates.

ETA: the above is the current best evidence. Maybe not the latest, but certainly the evidence with the strongest base. And, on the evidence point, it's absolutely established that consistent and progressive exercise is the single biggest lifestyle alteration that can be made. Diet is important but exercise arguably importanter.

Edited by MurderousCrow on Tuesday 10th April 16:38

[ReverendCounter]

OP, if you don't mind me asking, how long have you been on statins and have you noticed any side effects?

The reason for asking is, another PHer briefly mentioned an immediate side effect of joint pain and one or two others. Incidentally have you given any thought to stents by any chance/were they offered?

[BoRED S2upid]

5.8 isn’t high certainly not statin high I presume they have taken everything else into account blood pressure, weight, age, smoker, drinker etc..

[the-photographer]

ReverendCounter said:

OP, if you don't mind me asking, how long have you been on statins and have you noticed any side effects?

The reason for asking is, another PHer briefly mentioned an immediate side effect of joint pain and one or two others. Incidentally have you given any thought to stents by any chance/were they offered?

I cannot objectively answer because of all the other drugs;

- statins
- beta blocker
- ACE (PB)
- Anti platelet
- Asprin

I think the biggest impact is the beta blocker, the notes say they can cause joint pain.

Yes, I have two stents, one under emergency conditions and one as a precaution.

To try and eliminate any more installed hardware and I reviewing diet/exercise.

[Piha]

Get a dog.

More exercise taken due to the dogs waste disposal requirements.
It's been proven that dog owners have lower B.P.

[the-photographer]

BoRED S2upid said:

5.8 isn’t high certainly not statin high I presume they have taken everything else into account blood pressure, weight, age, smoker, drinker etc..

Understood, I had a GP health check about six months ago, where they put the basic variables into a web based risk calculator, mine was 5%

Fast forward six months and after a trip to A&E, statins now seem a good idea.

[the-photographer]

Piha said:

Get a dog.

More exercise taken due to the dogs waste disposal requirements.
It's been proven that dog owners have lower B.P.

Interesting, given a choice between the gym and a dog, i will choose the greater evil of the gym

[BoRED S2upid]

the-photographer said:

BoRED S2upid said:

5.8 isn’t high certainly not statin high I presume they have taken everything else into account blood pressure, weight, age, smoker, drinker etc..

Understood, I had a GP health check about six months ago, where they put the basic variables into a web based risk calculator, mine was 5%

Fast forward six months and after a trip to A&E, statins now seem a good idea.

Ah well that’s probably just as well.

Oatmeal is very good.

[Robertj21a]

My doctor's view is slightly different to that outlined above but only in that, in his view, diet is the most important issue - exercise is also essential, but would have to be the secondary issue.
I guess it must be down to the individual and their circumstances, but it's worth remembering that we are all different and shouldn't assume 'One size fits all'.

[Nimby]

the-photographer said:

...where they put the basic variables into a web based risk calculator ....

My GP uses https://qrisk.org/three/index.php.

[anonymous-user]

Piha said:

Get a dog.

More exercise taken due to the dogs waste disposal requirements.
It's been proven that dog owners have lower B.P.

You're not wrong. Walking our dog every day has done wonders for my arthritic knees too

[the-photographer]

Nimby said:

the-photographer said:

...where they put the basic variables into a web based risk calculator ....

My GP uses https://qrisk.org/three/index.php.

I put my historical data in and it calculates 5%

[smn159]

MurderousCrow said:

Exercise:

This point seems never to be emphasised enough: consistent and progressive exercise (taking a rounded approach to aerobic training and strength development) is the single biggest thing you can do to reduce not only your blood pressure, but more importantly your **all-cause** risk of mortality. It really is a magic bullet.

I started exercising after a routine heath check revealed high cholesterol and borderline high blood pressure a couple of years back. First through Couch to 5k, then Parkrun, then I got the bug and joined a local running club and now run 4 or 5 times a week and am running my first marathon in a couple of weeks.

Cholesterol and BP have dropped significantly though, back to 'normal' levels now.

[the-photographer]

Thanks, its good have a direct reference that exercise works.

[grumbledoak]

OP, it isn't the total cholesterol figure that matters. A few decades ago, just after the effects of statins were discovered, cholesterol was being demonized and dietary fat was being blamed for the cholesterol. It turns out both are untrue, but the experts only slowly back away from their errors lest they be seen to be wrong.

Cholesterol is vital for your health. It isn't soluble in water so it gets distributed in the blood by lipoproteins. The "lipid profile", or a crude approximation of it in the form of a ratio, is a marker for how your body is doing transporting the cholesterol about. Very crudely, the cycle is: triglycerides are produced in the liver, into the blood, start dropping cholesterol off where needed, and in the process becoming VLDL, then LDL, then HDL and finally back to the liver for disposal. So HDL is considered the "good" cholesterol, though that is a an poor analogy - high HDL indicates a healthy cycle. High triglycerides or high LDL or low HDL indicate an unhealthy cycle.

And here we come to diet - it is actually dietary carbohydrate that causes triglyceride production to soar, leading in turn to higher VLDL and LDL, and lower HDL. And you can control your lipid profile through diet - low carb, high fat will do exactly that.

As a male post heart attack you are in the group that benefits from statins (it's only them, last I read). But it might still be interesting to get a proper blood test done; giving you all the numbers, then remove all alcohol, sugar, and white carbs, then get another blood test done in three months.