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NMU – 216 Diet and Aerobic Exercise Successfully Against Resistant High Blood Pressure

Nutrition/Natural Medicine Update No 216 (September 29, 2021)

with Dr. James Meschino


Topic: Diet and Aerobic Exercise Successful Against Resistant High Blood Pressure

Source: Journal Circulation (September 2021)


A study published in the journal Circulation in September 2021 showed that a healthy eating program, weight loss, and improved aerobic fitness can significantly reduce blood pressure and improve heart health in people with resistant hypertension. Resistant Hypertension is defined as uncontrolled high blood pressure (130/80 mm Hg or higher), despite the use of three or more high blood pressure medications of different classes.  Although estimates vary, resistant hypertension likely affects about 5% of the general global population and may affect 20% to 30% of adults with high blood pressure. Resistant hypertension is a dangerous problem to contend with, as it is associated with end-organ damage (such as kidney failure) and a 50% greater risk of adverse cardiovascular events, including stroke, heart attack, and sudden death. Anything that can reduce blood pressure in these individuals should be taken seriously.

In June 2021, the American Heart Association advised that physical activity is the optimal first treatment choice for adults with mild to moderately elevated blood pressure and blood cholesterol who otherwise have low heart disease risk. The September 2021 study in the journal, Circulation, known as the “Treating Resistant Hypertension Using Lifestyle Modification to Promote Health (TRIUMPH),” was the first to evaluate the impact of lifestyle modifications in people with resistant hypertension. The four month-study involved 140 adults with resistant hypertension, whereby about half the participants were assigned The DASH eating plan, rich in fruits, vegetables, low-fat dairy products, with limited salt intake, which aligns with the American Heart Association’s nutrition recommendations. They also performed exercise training in a supervised cardiac rehabilitation setting three times per week. The second group received a single informational session from a health educator and written guidelines on exercise, weight loss, and nutritional goals to follow on their own. The average age of participants was 63 years old. Forty-eight percent were women; 59% were Black adults’ 31% had type 2 diabetes, and 21% had existing chronic kidney disease. The results showed that the participants in the supervised exercise program had about a 12-point drop in systolic blood pressure, compared to 7 points in the self-guided group. Participants in the supervised program also had greater improvements in other key indicators of heart health, suggesting that they had a lower risk of a heart event in the future.

One of the researchers, Dr. Blumenthal, commented, “Our findings showed lifestyle modifications among people with resistant hypertension can help them successfully lose weight and increase their physical activity, and as a result, lower blood pressure and potentially reduce their risk of heart attack or stroke.” He also noted that, “the success of the supervised program doesn’t mean people with resistant hypertension can stop taking their medications; however, it suggests that they may want to talk with their physicians about possibly reducing the dosages or altering their medications based upon their lowered blood pressure values.” Then he concluded, “the most important point is that it is not too late to lower blood pressure by making healthy lifestyle choices. Adopting a healthy lifestyle pays huge dividends, even for people whose blood pressure remains elevated despite being on three or more antihypertensive medications”, he commented. In my personal experience, many physicians fail to emphasize the meaningful therapeutic effects of targeted dietary and exercise protocols for patients with high blood pressure and resistant hypertension. Diet and exercise exert important medicinal effects on the body in both preventing high blood pressure and helping to treat high blood pressure, including helping those with dangerous resistant hypertension, once again illustrating that lifestyle medicine should be a key component of self-health care throughout your entire lifetime.

I have included the reference for this information in the text below.


1. James A. Blumenthal, Alan L. Hinderliter, Patrick J. Smith, Stephanie Mabe, Lana L. Watkins, Linda Craighead, Krista Ingle, Crystal Tyson, Pao-Hwa Lin, William E. Kraus, Lawrence Liao, Andrew Sherwood. Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial. Circulation, 2021;




Eat Smart, Live Well, Look Great,


Dr. Meschino

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