Drs. Oz & Roizen: By the Numbers

This month we answer your questions about blood pressure and cholesterol, key factors in overall health.

Q: My blood pressure has been a little high—130/80. I want to lower it with diet and exercise. What should I do?

A: Get your blood pressure down to 115/75, the level at which you’ll see the least aging. The ideal blood pressure is 115/76, established in 56 studies and 52 countries by studying more than 20 million people. It is the same in New Delhi and Tokyo as in Chicago.

High blood pressure (or hypertension), which has no symptoms, is the amount of force exerted by your blood on the walls of your arteries as it passes through. High blood pressure nicks your arteries, leading to plaques, which are deposits inside the vessels; they can be life-threatening because they block blood flow, break off as blood clots and create aneurysms.

High blood pressure is easily treatable with drugs or lifestyle changes, so everyone should have his or her BP measured. To get the most accurate health feedback, it’s best to check your blood pressure during your normal activities in the morning, during the day and at night. If your BP is high at any of those times, take steps to reduce it—and you’ll also reduce what we call your “RealAge,” how your body is actually aging (not by the calendar).

At 55 years of age, you are one year older in RealAge for every 5 units above the top ideal BP number and one year older for every 7 units above the ideal bottom number. So drop a 160/90 reading down to the ideal, and you make your RealAge about 11 years younger; from 130/80 to 115/75 would reduce your RealAge about four years. Here’s further motivation: High blood pressure magnifies aging and symptoms associated with diabetes; it also causes kidney failure, heart disease, stroke, memory loss, impotence, hormone-related conditions and skin wrinkles.

Commit to changes in diet and physical activity to get to 115/75. If they don’t reduce your blood pressure enough, then take one of the many BP-lowering medications. Drugs will provide benefits outweighing their potential side effects. Weight loss will reduce your blood pressure and your risk of cancer and musculoskeletal diseases such as colon cancer and hip osteoarthritis.

We recommend these foods and exercises for getting that ideal BP:

Follow our Rule of Five. Don’t eat foods that list any of these ingredients among the first five on the label:

1. and 2. Simple sugars and syrups. Among these are brown sugar, dextrose, corn sweetener, fructose (as in high-fructose corn syrup), glucose, corn syrup, honey, invert sugar, maltose, lactose, malt syrup, molasses, raw sugar and sucrose. Keep a little honey, maple sugar and table sugar in your pantry for recipes.

3. Saturated fats. They include most four-legged animal fats (including butter, lard and milk fat) and tropical oils (palm and coconut, for instance). These fats inflame arteries and increase “bad” LDL cholesterol, expand waistlines, raise blood pressure and increase the awful consequences of hypertension.

4. Trans fats. These are listed on product labels and are most likely to occur in partially hydrogenated fats, vegetable oil blends that are hydrogenated, and many margarines. (If you must have a buttery spread, use cholesterol-fighting products such as Promise and Benecol.)

5. Flours other than “100 percent whole grain” or “100 percent whole wheat.” Avoid anything labeled with “enriched” white flour, semolina, durum and other wheat flours that aren’t 100 percent whole wheat. Why? Your body absorbs processed/enriched flour quickly, rushing too much sugar into the blood, and the excess is stored as fat. This causes fluctuating blood-sugar levels, putting you at risk of diabetes and obesity.

Eat the right kinds of fats. Focus on lean proteins such as skinless turkey and chicken, and excellent sources of omega-3 fatty acids (which raise HDL cholesterol), including salmon, trout or unsalted nuts. We suggest six walnut halves 30 minutes before a meal to reduce your appetite.

The good news is you don’t need a dramatic weight loss from the start to improve your BP. If you lose just 10 percent of the weight you’ve gained since age 18—only 4 pounds if you’ve gained 40 pounds—you can take five years off your RealAge. By extension, that same 10 percent weight loss will usually decrease your blood pressure by 7 (top number) and 4 (bottom number).

Rearrange your plate and watch salt intake. Put fresh veggies, fruits and whole grains front and center; place lean protein and no-fat dairy on the side. Salt limitation is important only to individuals with hypertension who are salt-sensitive. If you avoid salt for three weeks and your BP goes down by 20/6 or more, you are salt-sensitive.

For the rest of hypertensives (99.5 percent of them), salt may matter, too—we doctors don’t know for sure yet. Try three weeks without added salt, and if your BP drops, consult your doctor, who may put you on a salt-restricted diet. By the way, the top 10 salt bombs are pizza, white bread, processed cheese, hot dogs, spaghetti with premade sauce, ham, ketchup, salty snacks, noodle soups, and macaroni and cheese.

Add these treats for BP-lowering power. Foods such as tomato products (make sure there’s no added salt or sugar), purple potatoes and raisins add extra kick to fighting off hypertension. Pumpkin seeds, cashews and walnuts keep blood pressure in check with stabilizing magnesium and good fats to limit arterial inflammation. Lastly, dark chocolate: Choose 70 percent cocoa or bittersweet chocolate and indulge in a half-ounce twice a day two to three times a week with berries, which contain health-boosting antioxidants. This is a sweet way to keep passages dilated and pressure low.

Get moving and lifting. Start with walking. Buy two pedometers, get a buddy, and work toward a few more steps every day. Go for 10,000 steps a day—no excuses.

After a month at 10,000 steps a day, add resistance training: 30 minutes of strength/resistance training a week. That’s once a week for 30 minutes or two 15-minute sessions or three 10-minute ones. Stronger muscles help you burn more calories and speed your metabolism.

Next add cardio three times a week for 20 minutes each time. In a week, you need 60 minutes of an activity that raises your heart rate to 80 percent of maximum (220 minus your calendar age for men; 208 minus 82 percent of your calendar age for women). You can choose from activities such as running, cycling, swimming, rowing or using an elliptical trainer.

And measure your BP frequently. Buy a cuff to use at home or use one at your pharmacy. If not consistently below 120/80, do whatever it takes (including meds) to get it there. Your BP is too important for you to procrastinate.

 

Q: I heard I should take one aspirin daily for artery health. At what age should I begin? And is that a regular aspirin or baby aspirin? Should my wife take one, too?

A: Guys over 35 and gals over 40 should follow their physicians’ recommendations regarding aspirin. Aspirin, which thins the blood, can trigger stomach and brain bleeding, but the benefits may outweigh the risks for some people.

Only if your doctor gives you the OK, this regimen can be followed to prevent or decrease the severity of nine cancers (including breast, colon, prostate, esophageal and brain), heart attacks, strokes, skin wrinkles and impotence. Take two baby aspirins daily—162 milligrams a day with half a glass of warm water before and after; the water decreases the side effects of aspirin.

 

Q: I’m 53. What are the acceptable ranges for my cholesterol (good and bad)?

A: The total cholesterol level may not matter—below 200 mg/dl (milligrams of cholesterol per deciliter of blood) is recommended—but what counts is keeping your LDL (low-density lipoprotein; think L for lousy) cholesterol level below 100 mg/dl. Keep your HDL (high-density lipoprotein; think H for healthy) at 50 mg/dl or above. A little alcohol, more exercise, healthy DHA omega-3 and omega-7 fats or even medication can help you hit the right numbers.

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