From the Guidelines
Maintaining a healthy BMI is crucial for managing hypertension, and weight loss in overweight or obese individuals can lower blood pressure by approximately 1 mmHg for every 1 kg of weight lost, as recommended by the 2020 international society of hypertension global hypertension practice guidelines 1. To achieve a healthy BMI, it is essential to adopt a balanced diet rich in whole grains, fruits, vegetables, polyunsaturated fats, and dairy products, while limiting sodium, processed foods, and alcohol.
- Key components of a healthy diet include:
- Eating a diet rich in whole grains, fruits, vegetables, polyunsaturated fats, and dairy products
- Reducing food high in sugar, saturated fat, and trans fats
- Increasing intake of vegetables high in nitrates, such as leafy vegetables and beetroot
- Consuming foods high in magnesium, calcium, and potassium, such as avocados, nuts, seeds, legumes, and tofu Regular physical activity is also vital, with a recommendation of at least 150 minutes of moderate exercise weekly, such as brisk walking, swimming, or cycling, as well as strength training on 2-3 days per week 1.
- Additional lifestyle modifications that can help manage hypertension include:
- Reducing salt intake
- Moderating alcohol consumption
- Quitting smoking
- Reducing stress and inducing mindfulness
- Getting regular aerobic and resistance exercise Weight loss helps reduce hypertension by decreasing blood volume, improving arterial flexibility, enhancing insulin sensitivity, and reducing inflammation and sympathetic nervous system activity. Even modest weight loss of 5-10% of body weight can yield significant blood pressure improvements, often reducing systolic pressure by 5-20 mmHg, as supported by previous studies 1. For sustainable results, it is recommended to focus on gradual lifestyle changes rather than rapid weight loss methods, and to aim for a calorie deficit of 500-1000 calories per day to lose 1-2 pounds weekly, while also monitoring and managing overall health and well-being 1.
From the Research
Relationship Between Low BMI and Hypertension
- A low Body Mass Index (BMI) is associated with a reduced risk of hypertension, as maintaining a healthy body weight is one of the key lifestyle modifications that can help lower blood pressure 2, 3, 4.
- Studies have shown that for every 1 kg/m2 reduction in BMI, there is a corresponding reduction in systolic blood pressure of approximately 1-2 mmHg 3.
- The mechanisms behind the positive impacts of low BMI on hypertension may involve reductions in visceral fat accumulation, insulin resistance, and improvements in vascular endothelial function, oxidative stress, inflammation, and autonomic function 2, 4.
Lifestyle Interventions for Hypertension
- Lifestyle interventions, including weight loss, healthy dietary patterns, regular physical exercise, and stress management, have been shown to be effective in preventing and treating hypertension 2, 3, 4.
- These interventions can help reduce blood pressure by modulating various physiological mechanisms, including the renin-angiotensin-aldosterone system, vascular endothelial function, and autonomic function 2, 4.
- A healthy dietary pattern that includes low sodium and high potassium intake, as well as regular physical activity, can help lower blood pressure and reduce the risk of cardiovascular disease 3.
Association Between BMI and Blood Pressure Control
- Studies have shown that higher BMI is associated with an increased risk of hypertension, but the association between BMI and blood pressure control is complex 5, 6.
- Adults with hypertension and normal BMI may be less likely to be aware they have hypertension and have controlled blood pressure compared to those with overweight or obesity 6.
- However, antihypertensive medication use and blood pressure control may vary by BMI category, with some studies suggesting that certain antihypertensive medications may be more effective in individuals with obesity 5.