Ashlee Williams, MD (Host): High blood pressure is often called the silent killer because many people don't know that they have it until a serious health problem develops. The good news is that everyday habits play a major role in keeping blood pressure under control. From the foods you eat and how much you move to stress, sleep, and hydration, small changes can make a meaningful difference in your heart health
Welcome to the Healthier You podcast. I'm Dr. Ashlee Williams. And today, I'm joined by Dr. Sudip Saha, a board-certified cardiologist here at Kaiser Permanente, to talk about what causes high blood pressure and the simple lifestyle habits that can help lower it without medication. Dr. Saha, thanks so much for being here today.
Sudip Saha, MD: Thanks so much for having me. I'm really excited to be here and talking to you
Ashlee Williams, MD (Host): Yes. It's such an exciting topic. So, we always like to start with the basics. What is high blood pressure?
Sudip Saha, MD: Blood pressure is something we measure using a medical instrument, blood pressure cuff. It measures the force of contraction of the heart against the vessels in your body. When blood pressure stays too high for long periods of time, it can actually have a negative effect on the heart. The heart can work too hard, and it can actually damage the blood vessels over time, which is why it's really critical to know your numbers, know your blood pressure numbers, to make sure they're in a normal range.
Host: Got it. So in primary care, we do lots of counseling. Can you discuss everyday habits that can increase your blood pressure?
Sudip Saha, MD: There's a lot of things that can affect your blood pressure. Simple things like your diet, your activity level, exercise. One thing that a lot of my patients don't really think about is actually other habits like sleep. We're asleep for up to a third of the day. So, having good sleep hygiene and sleeping enough per night and making sure you don't have other conditions like sleep apnea are really critical to blood pressure control and your overall health.
Eating a diet that's well-balanced, that focuses on low salt or sodium, being mindful of how much sodium you take in every day is going to really help drive some of those blood pressure numbers down, and hopefully to a normal range for most folks.
Getting regular aerobic exercise is a great way to, in terms of just overall health, be healthy, be fit, but also have a lower blood pressure reading as well. It can train your heart and train your blood vessels to react normally to the hormones that our body produces. Some of those hormones can be bad in times of stress.
So, another thing that can really affect your blood pressure is emotional or mental stress. We all deal with it in everyday life. It's really about how you cope with it, how you deal with it. And so, people that tend to have better blood pressure control are those that can cope with their stress in a more healthy way.
Other things like alcohol use or smoking and vaping can raise your blood pressure as well. So, it's really important to try to avoid some of those activities.
Host: Yes. It seems like there's many ways to help control our blood pressure. I think sleep and stress, you know, those are the things that's like easier said than done. Are there specific tips you can give or that you give your patients as a cardiologist, diet tips? So, what should someone be eating to help control their blood pressure?
Sudip Saha, MD: Yeah. There's a lot of different diets out there that you can use to try to live a healthy life. The one I typically will recommend to all my heart patients is the Mediterranean diet, which focuses on whole grains, fruits, vegetables, nuts, olive oil, fish, and shies away from things like processed foods, animal fats, inflammatory type foods. There's also the DASH diet, which you can read about online as well and through our Kaiser Permanente website, which also focuses specifically on lowering your risk for high blood pressure, hypertension
Host: And a lot of my patients actually get confused, because when I say, "Oh, you should try the DASH diet," they think of the spice that's Dash. But DASH stands for dietary approach to stopping hypertension. And it's actually an excellent way to help lower your blood pressure
Sudip Saha, MD: Exactly. So yeah, if you're at risk for high blood pressure or you have high blood pressure already and you're looking for ways to reduce it, not through medication, some people need medicines, but if you're looking for a way to reduce it without medications, the DASH diet's a great example. Really knowing how much salt sodium you take in per day is important.
What I typically like to say to my patients is, "See what you're doing now." Give an honest inventory of what you're eating the past one to two to three weeks. Write down what you're eating. Try to figure out how much salt sodium you're taking in." If you're eating out at restaurants a lot, they add a lot of salt sodium to the food so it tastes good. Try preparing your own food so you know what's going into them. One thing that my wife and I have noticed, we have three small kids, and as a cardiologist, I'm all about just reducing the salt sodium, especially for my parents that all have high blood pressure as well. So, she actually says every time we go out to eat, "I feel like it's way too much salt."
So, you'll actually notice that your taste, everything will sort of change over time. There's also some salt substitutes you can use to try to wean off some of the salt sodium. But really trying to be mindful of not ingesting too much salt sodium is really going to help with blood pressure control. Less than 2.2 grams or 2200 milligrams per day would be ideal.
But again, just start with an honest inventory of what you're doing now and try for some realistic reductions. Like in one month, "I want to try to reduce that by a 1000 milligrams per day, for example. I want to try to cook my own meals," for example. Just doing small simple steps over time will really help long term.
Host: And even when you're out at restaurants, you can mention to the waiter or waitress or server, "Hey, you know, I'm ordering this, but can you tell the chef, you know, low salt on my meals?"
Sudip Saha, MD: Yeah, I think there's a lot more awareness now in restaurants and menus. They'll actually put how many calories in their food. You can ask for a menu, even if it's not published, to see how much salt, fat, sugar, all that, is in the specific kind of foods and try to make better choices that way, as you mentioned, Ashley.
Host: Yes, I love the awareness. So, you spoke a little bit about stress and sleep. How much does that really impact your blood pressure?
Sudip Saha, MD: Yeah, I think it's all related. Mental stress, poor sleep habits will raise hormones in your body like adrenaline, cortisol. They have direct effects on your blood pressure. They'll constrict your blood vessels, and you'll have higher blood pressure.
It's really interesting, even simple techniques like doing deep breathing meditation. Do it for five minutes, check your blood pressure before and after. You'll probably notice a difference in your blood pressure reading in terms of it going down. So, I think things like healthy sleep habits, trying to sleep at a reasonable time, getting enough sleep per night, screening for things like sleep apnea, and doing whatever you can in your daily life, figuring out what things in your life cause you more mental, emotional stress and trying to deal with it in a more healthy way is going to be really key.
There's some things in life we can't change. But for the things we can, you know, trying to figure out what it is for you that can help you react to those situations in a more calm manner is going to be great.
Host: Got it. So most of the time, hypertension or high blood pressure is managed by a primary care doctor. Is there ever a time that you think someone should come see someone like you, a cardiologist, for their hypertension?
Sudip Saha, MD: We have great primary care doctors and pediatricians. I'm married to a pediatrician here. I think one great thing we do here in our organization is we really take blood pressure control really seriously, where even if you're an ophthalmology clinic, they're going to check your blood pressure. If it's elevated, they're going to get you in to see your doctor.
So, we'll recognize the high blood pressure. And then, there are certain instances and certain folks, especially very young people that may have other disorders other than primary hypertension, where we might treat them a little bit differently, might do other testing. The vast majority of people with high blood pressure really just need some of these non-medication-related interventions, retesting over time, checking home blood pressures. For some folks, you will need blood pressure medicine. So, either a cardiologist or an internist or pediatrician can start them if needed.
Host: I think one of my favorite things about Kaiser Permanente is our remote home blood pressure monitoring program, because some people do have elevated blood pressure coming in to see the doctor. It's called white coat hypertension, talking about stress. And so what's great is that we have this remote monitoring program where you're mailed a blood pressure cuff and you can download a program onto your phone that when you check your blood pressure at home, it comes right into your medical record, which is great about our integrated care model system.
Sudip Saha, MD: I think it's great data that we get. I mean, I'm a cardiologist, so I'm all about data and numbers, honestly. But I think it's one of the best tools that we have. And I agree, you know, we get the two or three or four times a year blood pressure reading in the office, and some people it might be elevated. They just ran up the steps, something happened. But getting those home numbers is really critical. Patients don't have to come in with long spreadsheets handwritten anymore. They can just check it on their cuff and it gets uploaded, and it's probably more accurate, you know, in some ways. So, I think it's a fantastic tool.
Host: Yes, I love the advancement in technology. Thank you so much, Dr. Saha. This was excellent information, and we learned a lot about pressure and ways we can manage it naturally. Here are the top takeaways.
One, lowering your blood pressure doesn't require dramatic changes. Small steps like walking after meals, staying hydrated, and getting better sleep can make a meaningful difference over time.
Two, reducing sodium in your diet is key, and adding potassium-rich foods like leafy green vegetables, beans, bananas, and sweet potatoes can also help with blood pressure control.
Three, managing stress through deep breathing, movement, laughter, and strong social connections can positively impact both your mental well-being and heart health.
Four, smoking, vaping, excess alcohol, poor sleep, and untreated sleep apnea can all contribute to high blood pressure, even in people who otherwise feel healthy.
And five, high blood pressure often has no symptoms. So, knowing your numbers and checking your blood pressure regularly is one of the best ways to protect your long-term health.
For expert insights, visit kp.org/doctor and explore more episodes of Healthier You wherever you get your podcasts. If you found this episode helpful, be sure to subscribe so you don't miss what's next, and leave a comment with topics you'd like for us to cover in future episodes. Thank you. And from all of us at Kaiser Permanente, be well
Welcome to the Healthier You podcast. I'm Dr. Ashlee Williams. And today, I'm joined by Dr. Sudip Saha, a board-certified cardiologist here at Kaiser Permanente, to talk about what causes high blood pressure and the simple lifestyle habits that can help lower it without medication. Dr. Saha, thanks so much for being here today.
Sudip Saha, MD: Thanks so much for having me. I'm really excited to be here and talking to you
Ashlee Williams, MD (Host): Yes. It's such an exciting topic. So, we always like to start with the basics. What is high blood pressure?
Sudip Saha, MD: Blood pressure is something we measure using a medical instrument, blood pressure cuff. It measures the force of contraction of the heart against the vessels in your body. When blood pressure stays too high for long periods of time, it can actually have a negative effect on the heart. The heart can work too hard, and it can actually damage the blood vessels over time, which is why it's really critical to know your numbers, know your blood pressure numbers, to make sure they're in a normal range.
Host: Got it. So in primary care, we do lots of counseling. Can you discuss everyday habits that can increase your blood pressure?
Sudip Saha, MD: There's a lot of things that can affect your blood pressure. Simple things like your diet, your activity level, exercise. One thing that a lot of my patients don't really think about is actually other habits like sleep. We're asleep for up to a third of the day. So, having good sleep hygiene and sleeping enough per night and making sure you don't have other conditions like sleep apnea are really critical to blood pressure control and your overall health.
Eating a diet that's well-balanced, that focuses on low salt or sodium, being mindful of how much sodium you take in every day is going to really help drive some of those blood pressure numbers down, and hopefully to a normal range for most folks.
Getting regular aerobic exercise is a great way to, in terms of just overall health, be healthy, be fit, but also have a lower blood pressure reading as well. It can train your heart and train your blood vessels to react normally to the hormones that our body produces. Some of those hormones can be bad in times of stress.
So, another thing that can really affect your blood pressure is emotional or mental stress. We all deal with it in everyday life. It's really about how you cope with it, how you deal with it. And so, people that tend to have better blood pressure control are those that can cope with their stress in a more healthy way.
Other things like alcohol use or smoking and vaping can raise your blood pressure as well. So, it's really important to try to avoid some of those activities.
Host: Yes. It seems like there's many ways to help control our blood pressure. I think sleep and stress, you know, those are the things that's like easier said than done. Are there specific tips you can give or that you give your patients as a cardiologist, diet tips? So, what should someone be eating to help control their blood pressure?
Sudip Saha, MD: Yeah. There's a lot of different diets out there that you can use to try to live a healthy life. The one I typically will recommend to all my heart patients is the Mediterranean diet, which focuses on whole grains, fruits, vegetables, nuts, olive oil, fish, and shies away from things like processed foods, animal fats, inflammatory type foods. There's also the DASH diet, which you can read about online as well and through our Kaiser Permanente website, which also focuses specifically on lowering your risk for high blood pressure, hypertension
Host: And a lot of my patients actually get confused, because when I say, "Oh, you should try the DASH diet," they think of the spice that's Dash. But DASH stands for dietary approach to stopping hypertension. And it's actually an excellent way to help lower your blood pressure
Sudip Saha, MD: Exactly. So yeah, if you're at risk for high blood pressure or you have high blood pressure already and you're looking for ways to reduce it, not through medication, some people need medicines, but if you're looking for a way to reduce it without medications, the DASH diet's a great example. Really knowing how much salt sodium you take in per day is important.
What I typically like to say to my patients is, "See what you're doing now." Give an honest inventory of what you're eating the past one to two to three weeks. Write down what you're eating. Try to figure out how much salt sodium you're taking in." If you're eating out at restaurants a lot, they add a lot of salt sodium to the food so it tastes good. Try preparing your own food so you know what's going into them. One thing that my wife and I have noticed, we have three small kids, and as a cardiologist, I'm all about just reducing the salt sodium, especially for my parents that all have high blood pressure as well. So, she actually says every time we go out to eat, "I feel like it's way too much salt."
So, you'll actually notice that your taste, everything will sort of change over time. There's also some salt substitutes you can use to try to wean off some of the salt sodium. But really trying to be mindful of not ingesting too much salt sodium is really going to help with blood pressure control. Less than 2.2 grams or 2200 milligrams per day would be ideal.
But again, just start with an honest inventory of what you're doing now and try for some realistic reductions. Like in one month, "I want to try to reduce that by a 1000 milligrams per day, for example. I want to try to cook my own meals," for example. Just doing small simple steps over time will really help long term.
Host: And even when you're out at restaurants, you can mention to the waiter or waitress or server, "Hey, you know, I'm ordering this, but can you tell the chef, you know, low salt on my meals?"
Sudip Saha, MD: Yeah, I think there's a lot more awareness now in restaurants and menus. They'll actually put how many calories in their food. You can ask for a menu, even if it's not published, to see how much salt, fat, sugar, all that, is in the specific kind of foods and try to make better choices that way, as you mentioned, Ashley.
Host: Yes, I love the awareness. So, you spoke a little bit about stress and sleep. How much does that really impact your blood pressure?
Sudip Saha, MD: Yeah, I think it's all related. Mental stress, poor sleep habits will raise hormones in your body like adrenaline, cortisol. They have direct effects on your blood pressure. They'll constrict your blood vessels, and you'll have higher blood pressure.
It's really interesting, even simple techniques like doing deep breathing meditation. Do it for five minutes, check your blood pressure before and after. You'll probably notice a difference in your blood pressure reading in terms of it going down. So, I think things like healthy sleep habits, trying to sleep at a reasonable time, getting enough sleep per night, screening for things like sleep apnea, and doing whatever you can in your daily life, figuring out what things in your life cause you more mental, emotional stress and trying to deal with it in a more healthy way is going to be really key.
There's some things in life we can't change. But for the things we can, you know, trying to figure out what it is for you that can help you react to those situations in a more calm manner is going to be great.
Host: Got it. So most of the time, hypertension or high blood pressure is managed by a primary care doctor. Is there ever a time that you think someone should come see someone like you, a cardiologist, for their hypertension?
Sudip Saha, MD: We have great primary care doctors and pediatricians. I'm married to a pediatrician here. I think one great thing we do here in our organization is we really take blood pressure control really seriously, where even if you're an ophthalmology clinic, they're going to check your blood pressure. If it's elevated, they're going to get you in to see your doctor.
So, we'll recognize the high blood pressure. And then, there are certain instances and certain folks, especially very young people that may have other disorders other than primary hypertension, where we might treat them a little bit differently, might do other testing. The vast majority of people with high blood pressure really just need some of these non-medication-related interventions, retesting over time, checking home blood pressures. For some folks, you will need blood pressure medicine. So, either a cardiologist or an internist or pediatrician can start them if needed.
Host: I think one of my favorite things about Kaiser Permanente is our remote home blood pressure monitoring program, because some people do have elevated blood pressure coming in to see the doctor. It's called white coat hypertension, talking about stress. And so what's great is that we have this remote monitoring program where you're mailed a blood pressure cuff and you can download a program onto your phone that when you check your blood pressure at home, it comes right into your medical record, which is great about our integrated care model system.
Sudip Saha, MD: I think it's great data that we get. I mean, I'm a cardiologist, so I'm all about data and numbers, honestly. But I think it's one of the best tools that we have. And I agree, you know, we get the two or three or four times a year blood pressure reading in the office, and some people it might be elevated. They just ran up the steps, something happened. But getting those home numbers is really critical. Patients don't have to come in with long spreadsheets handwritten anymore. They can just check it on their cuff and it gets uploaded, and it's probably more accurate, you know, in some ways. So, I think it's a fantastic tool.
Host: Yes, I love the advancement in technology. Thank you so much, Dr. Saha. This was excellent information, and we learned a lot about pressure and ways we can manage it naturally. Here are the top takeaways.
One, lowering your blood pressure doesn't require dramatic changes. Small steps like walking after meals, staying hydrated, and getting better sleep can make a meaningful difference over time.
Two, reducing sodium in your diet is key, and adding potassium-rich foods like leafy green vegetables, beans, bananas, and sweet potatoes can also help with blood pressure control.
Three, managing stress through deep breathing, movement, laughter, and strong social connections can positively impact both your mental well-being and heart health.
Four, smoking, vaping, excess alcohol, poor sleep, and untreated sleep apnea can all contribute to high blood pressure, even in people who otherwise feel healthy.
And five, high blood pressure often has no symptoms. So, knowing your numbers and checking your blood pressure regularly is one of the best ways to protect your long-term health.
For expert insights, visit kp.org/doctor and explore more episodes of Healthier You wherever you get your podcasts. If you found this episode helpful, be sure to subscribe so you don't miss what's next, and leave a comment with topics you'd like for us to cover in future episodes. Thank you. And from all of us at Kaiser Permanente, be well