Blog post written by Dr Eugene Kongnyuy, author of No Pills, No Needles, launching 25th May.
10 years ago, I was diagnosed with high blood pressure (hypertension). As a physician and researcher, I decided to self-experiment. My aim was to find out what could successfully reverse my hypertension so that I could stop taking blood pressure (BP) medicine. I tried over 70 different things including salt restriction, meditation, stress management, different dietary regimens, weight loss, walking, etc. After 5 years of self-experimenting, none of the things worked for me and I felt disappointed.
In order to keep fit, I decided to run or jog for 1 hour every morning. Six months after I started this programme of 1 hour per day of regular exercise, I took my BP and it was very low. I stopped the BP medicine and the hypertension was gone.
One hour of regular moderate to high intensity exercise per day may be what you need to reverse your high blood pressure. Over the years, I have kept with 1 hour of exercise per day while tracking my BP and I have learned a lot more. Here are some of things that I have learned that can help you either prevent or reverse hypertension.
Exercise is the centrepiece for the prevention or reversal of high blood pressure. Experts recommend 150 to 300 of moderate exercise (or 75 to 150 minutes of vigorous intensity exercise) per week. This is what you need to prevent hypertension. In order to reverse hypertension, you would probably need a lot more. To reverse hypertension, I had to do 1 hour of moderate to vigorous exercise per day (or 420 minutes per week).
First, aerobic or ‘cardio’ exercises cause repetitive contraction of large muscle groups which in turn forces the heart to work hard and pump blood to the muscles. Regular ‘cardio’ workouts, such as jogging, brisk walking, running, cycling, swimming, yoga, dancing, football, golf, hiking and basketball, increase the heart rate and train the heart muscles. You need to train your heart muscles to pump blood more efficiently and this takes time. The longer the duration of each exercise, the better the results. Cardio training over several months causes a significant fall in blood pressure.
Second, exercise causes the endothelium (inner wall of blood vessels) in exercising muscles to produce nitric oxide and prostacyclin, both of which promote enhanced vasodilatation by relaxing the smooth muscle cells in the blood vessel walls.
Third, exercise blocks the renin-angiotensin-aldosterone system (RAAS), a hormone system that, when stimulated, raises blood pressure by increasing vascular resistance and causing sodium retention by the kidneys. This causes the blood vessels to widen and the kidneys to flush out sodium.
Fourth, exercise blocks the sympathetic nervous system (SNS). This causes the blood vessels to relax and widen, which in turn reduces the blood pressure. The SNS is one of the two main divisions of the autonomic nervous system (the other being the parasympathetic nervous system – PNS) that is responsible for our ‘fight or flight’ response among other things. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as heart rate, digestion, respiratory rate, pupillary response in the eyes, urination, and sexual arousal. The SNS activation causes BP to rise. Once activated, the system fires electrical signals that lead to the release of the hormone adrenaline by the adrenal gland. Exercise blocks the SNS and therefore lowers the BP.
Exercising plus being physically active throughout the day is more effective than exercise alone. I realised that each day when I came back from work, I did between 1000 to 2000 steps. I spent most of the day sitting. I decided to change my desk to a standing workstation. I remained standing while working, reading emails, writing, and I held standing meetings. The number of steps I did per day increased from 1000-2000 to 4000-5000 steps. I observed that my systolic BP was about 10 mm Hg lower during the day than it would otherwise be when I wasn’t physically active. I also find gardening, cooking and cleaning very helpful in keeping me physically active. There are many other ways to be physically active and each person can figure out what he or she can do to avoid a sedentary lifestyle.
Sweating lowers blood pressure by causing the dilation of blood vessels under the skin as well as loss of water and salt. I found that exercise that caused me to sweat was more effective in lowering my BP than exercise that didn’t. With sweat-inducing exercise, my systolic BP was about 10 to 20 mm Hg lower than exercise that didn’t cause me to sweat. Sweating is a natural method the body uses to control body temperature. When your body starts to heat up, whether because of exercise or outside temperature, it releases sweat from the more than 2-4 million eccrine glands spread out across your skin, pouring liquid through pores to lower body temperature. Sweating induces a ‘diuretic’ effect by causing increased loss of salt, including sodium, and this lowers blood pressure. For those who can afford it, having a sauna at home could be an easy way to get sweaty.
I found that my BP was generally lower in warm weather (such as summer or being in a hot country) than in cold weather (such as winter or a cold country) independent of sweating. Numerous studies have found a correlation between temperature and blood pressure, and have also generally shown higher blood pressure during winter. The explanation is that cold weather activates both the sympathetic nervous system and the renin–angiotensin-aldosterone system. Warm weather does the reverse as well as inducing sweating. Therefore, following the sun when booking holidays can therefore be a good way to manage your hypertension.
Weight is important if you want to say ‘goodbye’ to your antihypertensive pills. Studies have shown that by losing 5 kg (8.8 pounds), your systolic and diastolic blood pressure can drop by 4.5-3.2 mm Hg respectively. If you have mild high blood pressure, weight loss alone can be sufficient to control it. Weight loss improves blood pressure, although exercise has a greater impact. This is the reverse of what I found for type 2 diabetes. Diabetes is affected more by weight loss than by exercise. In my case, I estimate that my BP was treated 80% by exercise and 20% by weight loss and my diabetes 80% by weight loss and 20% by exercise.
In conclusion, by combining regular exercise with being physically active throughout the day, doing something what makes you sweat, keeping warm and losing some weight, you can prevent or reverse hypertension. In this article, I decided to focus on my experience. But it’s important to note that there are other ways which, although they didn’t work for me, could work for other people. These include salt restriction, healthy diet, quitting smoking, moderating alcohol intake and managing stress.
One of my self-experiments was to find out the effect of altitude on my BP. It’s well known that the higher you climb, the higher the BP. However, I found that the effect of exercise and sweating was so strong that it completely overrode any effect of altitude on my BP.
These are just a few of the lessons I have learnt self-experimenting which helped me reverse both hypertension and type 2 diabetes. After hesitating for several years, I finally decided to put my experience in writing because I felt it could help many people, or at least the methods I used could be applied by anyone to find out what works for them. I have written down all my lessons in a book No Pills, No Needles which is coming out in May 2021.
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 Nystoriak MA, Bhatnagar A. Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine 2018; 5: 135.
 Fortenberry K, Ricks J, Kovach FE. How much does weight loss affect hypertension? Journal of Family Practice 2013; 62(5): 258–259.