The causes are most often some combination of clogged “pipes” and excessive salt in the diet. Lifestyle changes, such as appropriate diet and exercise, are among the most effective treatment strategies for high blood pressure. Relaxation, meditation, and otherwise “taking it easy” are not effective solutions, as valuable as such strategies may be for your psychological well-being.
It goes without saying that when you don’t sleep well, you don’t feel well, and your body just doesn’t work well. In fact, research has shown for decades that a strong link between insomnia and hypertension exists. Reevaluating your daytime decisions or nighttime routines leading up to bedtime can help you find what works best for you in getting a good night’s rest.
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Taking a few moments to concentrate on breathing deeply can be a great help. Meditation and yoga are other great activities to reduce stress. We recommend Yoga Burn, by Zoe Bray Cotton for an amazing at-home yoga workout.  In the long term, creating a routine that including one or more of these stress reduction techniques will be important to keep your blood pressure down in normal levels. [2]
In addition to these methods being effective, other lifestyle changes and diet adjustments may also be useful in lower blood pressure. One study explains that losing weight can have a significant positive impact on patients that have been diagnosed with hypertension. Even small reductions in bodyweight amongst those individuals who are both obese and hypertensive can yield life-saving benefits. Dietary changes can also help. In particular, the patient should aim to lower their daily intake of sodium, which causes an elevation in blood pressure. The patient should also focus on obtaining more calcium, potassium and other minerals that are useful in balancing blood pressure levels. Fiber, fruits and a lot of vegetables should also be an essential part of the patient’s daily diet.

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Too much booze is known to raise blood pressure. But having just a little bit could do the opposite. Light to moderate drinking (defined as one drink or fewer per day) is associated with a lower risk for hypertension in women, according to research from Boston’s Brigham and Women’s Hospital. Moderate drinking could play a role in heart disease prevention too, studies show.
3) Coconut water. Rich in potassium, electrolytes, and other important nutrients, coconut water has been shown to help significantly lower blood pressure levels in most of the people that drink it. A recent study published in the West Indian Medical Journal found that drinking coconut water helped 71 percent of participants achieve a significant reduction in systolic pressure, and 29 percent of participants achieve a significant reduction in diastolic pressure. The results were even more amplified when participants drank both coconut water and mauby, a tropical drink made from buckthorn tree bark.
8. Take less stress: If you want to stay healthy, take less stress. Every individual faces some kind of difficulty in their life. What matters is the attitude you have towards these difficulties. If you constantly take stress or tension, you are likely to have blood pressure problems. Being chronically stressed puts your body in constant fight-or-flight mode. This could lead to faster heart rate and constricted blood vessels. Listen to good music, do yoga, meditate. These are some effective ways to control your stress and also keep your blood pressure under control.
Some years ago I was put on medication for elevated blood pressure, as my mother before me. I took my medication and checked my values “religiously”… All of a sudden last October I developed malignant hypertension. I was hospitalized 3 times in 3 days with values over 220, then the hospital sent me to a nephrologist. He started running tests which were all normal. The hospital put me on Clonidine but the nephrologist did not add anything while running tests. In November I had to be hospitalized again. That time the ER doctor said they were not going to release me back to the same situation and added Amlodipine Besylate. My blood pressure has been normal with one brief spike since. Problem now are medication side effects: edema of feet and legs, hearing loss from fluid retention, bloating and constipation and generally not feeling well. I had always worked full time but finally retired this March. I am very disappointed to think that after working so hard for so may years I am going to feel like this in retirement due to side effects. I have talked to my nephrologist, especially a few weeks ago when I developed hearing loss from fluid retention and found that all the side effects are cumulative. He sent me an email saying we will stop the Clonidine and Amlodipine with no adjustments or anything in their place!! My pharmacist has tried to be helpful but can’t change anything. He says Amlodipine is one of the worst meds for side effects and many patients have to stop it for something else. The nephrologist does not seem to have done any research on side effects in order to suggest alternative medications, or to offer adjustments. He seems kind and listens, but offers nothing. In fact all of my medications for this condition were prescribed at the hospital. We have few geriatric doctors in this area, and no geriatric cardiologists. My regular cardiologist who just prescribed my standard meds cancelled my appointment when I developed the spikes. I already knew he was not up to challenges…I see an adult congenital cardiologist every so often even though he tells me I don’t need him as my congenital repair and heart are fine. There are not a lot of nephrologists here, but I think there is a better one in the same group so I doubt he will see me. I am really in a dilemma because I certainly cannot risk spikes, but would hope to feel better and not risk side effects such as fluid retention causing worse problems. It has also elevated my blood glucose which I watch and control through diet and exercise. The medication had my blood pressure running as low as the low 80s over low 50s, obviously too low, which is when the edema developed and I was lethargic. Now values are good. I have found little information on malignant hypertension and had never heard of it. I will greatly appreciate any suggestions. Thank you! PS I do not have a primary care doctor because so many here will not take Medicare and the “good” ones are not taking new patients or retiring. I have been looking for some time. My neurologist even had me send records to his good friend, an internal medicine specialist and they called and said he couldn’t help me….I had endocarditis at age 5 and have some medical PTSD. Sorry to write a novel, but I am thrilled there may be some help for me!
Coconut water: A great beverage on hot days, coconut water is rich in minerals and nutrients. It contains many electrolytes essential for the body, such as potassium, and has been shown to significantly lower blood pressure in most people who drink it. A study published in West Indian Medical Journal found that drinking coconut water helped 71 percent of participants achieve a significant reduction in systolic blood pressure, and 29 percent of participants achieves a significant reduction in diastolic blood pressure
3. Implement strategies to lower inflammation. Several cross-sectional and longitudinal studies connect high blood pressure with chronic inflammation, a driving force for nearly every disease on the planet. Lowering inflammation starts with what you put on your fork. Focus on anti-inflammatory foods like wild-caught seafood (rich in omega-3 fatty acids), freshly ground flax and chia seeds, spices like turmeric, and plenty of colorful plant foods. Good sleep, stress management, exercise, and the right nutrients can also help lower inflammation.

It sounds to me like the cardiologist is in the process of trying to figure out what is the right dose of BP meds for her at this time, given the current state of her heart. Re the nurse’s recommendation, you may want to call back and make sure they realize that your mother’s SBP is only around 110, even off all BP meds. Ask them what they think her goal BP should be.
Glad you’ve found the information here helpful. Sounds like you are being very thoughtful and proactive about maintaining your health. Wonderful that your Medicare plan is covering an exercise program with a trainer! It’s true that as one gets older, being more deliberate and purposeful about exercise and strength work becomes more important. good luck and take care! 

Your mother’s situation does sound worrisome, as you are describing falls and also some concerns with thinking. Her age of 96 is pretty old, so clinical research studies don’t provide much guidance on what is optimal blood pressure. Unless she has compelling medical reasons to aim for a SBP of 120, most geriatricians would probably reduce her BP meds and try to aim for a SBP in the 130s or 140s. So you may want to ask your mother’s doctor to discuss with you what is a suitable BP goal for her, and whether a reduction in BP meds might be reasonable.
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