How to lower your blood pressure by use of the DASH diet

Dear Ask The Doctor: I am 21 years old and have had on and off high blood pressure for a few of years now. At its highest, my blood pressure is usually around 145/90. I haven't really noticed a pattern for when it may be high or normal. My doctor recently prescribed me the lowest dose of Ramipril, but I am hesitant to take it because of the side effects and because I don't want to be on medicine for the rest of my life. I feel like there are other options we could try, such as seeing a nutritionist, etc. I also workout 4-5 times a week and have cut down on sodium. Am I wrong to want a second opinion about being on blood pressure medicine as a person in her early 20's? What are your thoughts?

Dear Hope: High blood pressure (BP) is usually diagnosed by a consistent elevation of BP readings, usually on three separate occasions greater than one week apart. There are many lifestyle measures that can be modified to lower blood pressure (BP). These include: Weight reduction with a target Body Mass Index of <25; reduced sodium intake <100mmol/day = 2.4g sodium; increased daily physical activity minimum of 30 minutes/day; limit alcohol intake <2 units/day for women and<3 units/d for men; smoking cessation; reduced saturated fat/cholesterol intake, adequate calcium and magnesium dietary intake and adequate intake of dietary potassium approx 90 mmol/d. The DASH diet (Dietary Approaches to Stop Hypertension) has been promoted by the National Heart, Lung and Blood Institute. The current target BP is <140/90 for the general population and if, after undertaking lifestyle modifications for a trial 3 month period, your BP remains high, I would recommend attending your family practitioner regarding optimal control measures. He may also perform a 24 hour ambulatory BP monitor, which will give a more accurate assessment of your blood pressure throughout the day.