Sometimes, it isn’t just patients who gloss over lifestyle changes — it’s doctors as well.Freeman points to a 2017 study that he co-authored in which 90 percent of the more than 900 cardiologists surveyed reported that they’d received no or minimal nutrition education during their training.
“It’s important to remind all the healthcare people out there that we need to arm ourselves with every tool in the arsenal,” he said. “That includes medications and procedures of course, but we really need to learn more about lifestyle medicine, and a lot of those gaps that are created during our training, we really need to spend time filling so that we have the tools available to treat diseases better — and more cheaply, for that matter.”
It’s simple, but it takes work
For people who want to lower their blood pressure, it isn’t easy to hear that they need to change their diet and get more physical activity.
But when it comes to blood pressure and cardiovascular health, there really aren’t any shortcuts.
While virtually all patients will see promising results just a few weeks after incorporating lifestyle changes, they’ll need to continue the regimen in order to maintain good health.
Freeman says that for patients who have mildly elevated blood pressure, he’ll recommend a multi-week program of lifestyle changes. Generally, blood pressure levels normalize in this time.
For patients who have more significant blood pressure issues, he’ll prescribe medications along with an intensive focus on lifestyle modifications.
While patients who follow this plan might initially miss eating their favorite foods, he says the results tend to speak for themselves.
“Every so often I’ll get a call from a patient who says they’re feeling miserable and it turns out they’ve implemented the lifestyle modification and their blood pressure has dropped so much that we have to get rid of the medicine, which is great,” he says.
When it comes to aiding cardiovascular health and bringing blood pressure down, Freeman says, there are four tenets to follow in terms of lifestyle change.
The first two are following a predominantly plant-based, whole food, unprocessed diet combined with getting at least 30 minutes of moderately vigorous, restless exercise per day.
“This does not mean I want them exercising so hard that they pass out, but I want them to be challenged, even if it means taking a break if they have to,” he said. “For some people, that may mean nothing more than a gentle walk with periodic breaks, but as the weeks go on they need to challenge themselves to get rid of those breaks, little by little.”
The third facet is stress relief techniques such as yoga, introspection, and other mindfulness exercises.
“The last part, believe it or not, and this is based on Dean Ornish’s work, is actually connections, support, and love,” explained Freeman. “We know that people that have the most connections, support, and love have the best cardiovascular outcomes.”
“When you combine all four of those — eating plants, exercising more, stressing less, and loving more — health outcomes improve in lots of categories, including blood pressure and coronary disease. So that’s really what I try to get patients to do.”