The combination of weight loss, exercise, reduced salt intake, and a healthy diet can dramatically lower blood pressure, according to an article in the April 23rd issue of The Journal of the American Medical Association.

A total of 810 adults (average age, 50 years, 62 percent female, 34 percent African-American) who were overweight and sedentary were randomized into 1 of 3 treatment arms: The first group had 1 counseling session on lowering blood pressure, whereas the second had 18 sessions over 6 months that covered increased exercise, weight loss, and a lower salt diet. The third group received 18 sessions over 6 months that included all of the information given to the second group, as well as counseling on the Dietary Approaches to Stop Hypertension diet, which emphasizes fruits, vegetables and low-fat dairy products. It includes whole grains, poultry, and fish, and it is reduced in fats, red meat, sweets, and sugar-containing beverages.

Participants in the second and third groups (the people who received multiple counseling sessions) tracked their physical activity and diet through the 6-month study period.

Participants in the third group, who received the most information, lowered their systolic blood pressure by 11 mmHg and diastolic pressure by 6.4 mmHg. The number of people with uncontrolled hypertension dropped from 37 percent to just 12 percent. The percentage of participants with optimal blood pressure (defined as systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg) increased from 0 to 35.

In addition, members of this group lost an average of 13 pounds, improved their fitness, reduced their salt intake, ate 3 additional servings of fruits and vegetables each day, increased their dietary calcium, and lowered their intake of total fat and saturated fat.

In comparison with the 1-session group, the participants in the third group doubled their reduction in blood pressure and were significantly less likely to need antihypertensive medication at the end of the 6-month study period.

"Our study shows that people can simultaneously make multiple lifestyle changes that lower their blood pressure and improve their health," said lead author Lawrence J. Appel, M.D., M.P.H. "The key issue now is helping people maintain these changes so they don't revert back to less healthy behaviors."