Exercise. Some patients will cringe at the suggestion of exercise, because they envision a chronic cardio scenario like a mouse on a running wheel. Spread the good news: exercise of all kinds—endurance, dynamic resistance, HIIT, isometric resistance—has the potential to reduce blood pressure (38). Whatever exercise your patients will actually do on a regular basis is the best recipe for success. In patients with extreme hypertension, be cautious with exercises that may further increase blood pressure to an unsafe zone (39).

Sleep. Short and poor-quality sleep are both associated with raised blood pressure (40). On the other side of the spectrum, excessively long sleep may also be harmful. One study found increased blood pressure in those who got fewer than five hours of sleep per night and in those who averaged more than nine hours of sleep per night, when compared with people who slept around seven hours (41). I suspect that it’s not the long sleep itself that is the problem, but that some underlying condition is both increasing sleep requirement and raising blood pressure.
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