Blood Pressure Optimization Protocol

Hypertension affects 45% of US adults, leading cause of stroke, MI, CKD. "Silent killer" - no symptoms until damage done. Lifestyle modifications can lower BP 10-20+ mmHg without medication. DASH diet specifically designed and proven for BP - high potassium, magnesium, calcium from food. Sodium restriction has variable effect (salt-sensitive vs resistant) but worth trying <1500-2300mg. Weight loss has large effect - every kg lost lowers BP ~1 mmHg. Exercise lowers BP through multiple mechanisms (improved endothelial function, reduced sympathetic tone, weight loss). Supplements: CoQ10 has strongest evidence (meta-analyses 11-17 mmHg SBP reduction). Hibiscus tea surprisingly effective (multiple trials). Aged garlic extract (not raw garlic) has studies. Beet root provides dietary nitrate→nitric oxide (vasodilation). Magnesium modest effect but safe. Potassium crucial - counteracts sodium, lowers BP. Sleep apnea causes resistant hypertension - treating with CPAP can normalize BP. Stress management (meditation) lowers BP through autonomic nervous system. Many can reduce or eliminate BP meds with lifestyle - work with cardiologist to taper. Target <120/80 now per ACC/AHA guidelines (used to be <140/90). Medication needed if lifestyle insufficient and BP persistently elevated - uncontrolled BP causes organ damage.