Q My wife has been taking drugs for high blood pressure for six years, and suffers distressing side-effects from whichever type she is prescribed. She is convinced the drugs have no beneficial effect whatsoever, as her blood pressure goes up and down at random while she’s on them. What else can she do? - LB, Worthing, West Sussex

A High blood pressure and hypertension are not necessarily the same condition, although most people use the terms interchangeably. High blood pressure rises and falls with a person’s level of anxiety, whereas hypertension is when blood pressure is constantly high, usually as a result of diet, being overweight, cigarette smoking or hereditary factors. In short, high blood pressure is often a lifestyle condition.

People who are easily stressed and suffer mood swings are at greater risk of heart disease, often brought about by raised blood pressure. One study, carried out by the Medical College of Georgia, found that those practising Transcendental Meditation (TM) had lower blood pressure than 'very healthy' people because it keeps their blood vessels open and unconstricted, thus avoiding raised pressure (Psychosom Med, 1999; 61: 525-31).

If you already meditate, or do not have high levels of stress, the next most important factor is diet. It is well established that a high-salt diet can raise blood pressure, but not so many realise that salt is found in most fast foods and snacks, so taking the time to eat proper food could have a doubly beneficial effect. The Dietary Approaches to Stop Hypertension (DASH) trial reported that a diet rich in fruit, vegetables and low-fat dairy, coupled with a low salt intake, could prevent and reduce high blood pressure, and was as effective as any drug in some people (J Am Diet Assoc, 1999; 8 [Suppl]: S35-9).

The American Heart Association Nutrition Committee broadly agrees with the DASH results, but believes a dietary solution is more complex. It suggests that foods high in potassium, such as bananas, dates, potatoes and raisins, are especially good for the heart.

Other lifestyle changes include daily moderate exercise such as brisk walking, reducing alcohol to moderate levels or at least to the 14 units a week recommended for women, and gradually losing any excess weight. Avoid cigarettes as they constrict the blood vessels which, in turn, will raise blood pressure.

There are various herbal extracts that claim to lower blood pressure, and many of them are advertised via the Internet. One such remedy, proven to work in over 20 European studies, is hawthorn, commonly used to reduce blood pressure in Germany.

Other herbal supplements to consider include garlic, which has proven abilities to reduce blood pressure (Planta Med, 1994; 60: 417-20), and Ginkgo biloba, although this should never be taken in conjunction with a blood-thinner such as warfarin, as it is itself a natural anticoagulant (Drugs, 2001; 61: 2163-75).