Friday, February 28, 2014


I have always been an advocate of life style modification in the management of non-communicable diseases. Drugs should always be an adjunct to life style modification, which is cheaper in the long run, safer and has more sustained effect. Pushing pills may be necessary for a while, but lifestyle must sustain us.
Anyway, I came across an interesting piece of work ( simple work ), coming out of Osaka Japan. The lead author is Dr Yoko Yokoyama from the Cerebral and Cardiovascular Center, in Osaka Japan. The paper is entitled simply " Vegetarian Diet and blood pressure".  This paper was published in the Feb 24th issue of Journal of the American Medical Association.
The authors looked through 250 clinical research papers, selected 6 randomised clinical trials and 32 observational studies on this topic of vegetarian diet and BP. These involved thousands of patients.

Blood pressure reductions with vegetarian diets, compared with omnivorous diets 
Study type                                     Systolic, mm Hg                Diastolic, mm Hg               p
Pooled clinical trials                                     -4.8                                  -2.2               <0 .001="" o:p="">
Pooled observational studies                        -6.9                                  -4.7               <0 .001="" b="">

They found that vegetarian dieted lowers BP in all the studies, more so with data from observational studies, and less so with the six randomised controlled trials, as shown in the table above. Looks like green leafy veges are good for health with less calories and less salt when compared to meat and preserved food. The fact that veges also has more potassium salt and less sodium salt must also make a difference.
Having known this fact, I suppose public health leaders must see if advocating a greener diet will help prevent hypertension. That fact must be established as I am certain that it will prevent many stroke deaths and disability.


Winston Yap said...

Doctor, I am in my early seventies and quite healthy and my only problem is some high blood pressure for which I am taking 50mg of Normaten atenolol daily.
My BP reading is usually 130/80.
Can I reduce this to 25mg or even go off atenolol entirely?

hmatter said...

Hi Winston, I am rather adversed to give personal advice without examining a patient.Whatever you hear me say, please do discuss with your own doctor.
Whether or not you can come ff your current medication depends very much on 1, whether you have any target organ damage? and 2. Your BP control over 30 days or so. A one off normal BP is not adequate to make a decision. Most of my patients are on a self home monitoring program, so they are educated taught about HBP and its dangers, and to take their own BP 2-3 times a day, about 2-3 days a week.Usually we reduce the dose by half over a few weeks and then decide. Whatever happens, please take no added salt in diet, plenty of green veges and at least 5 servings of fruits daily. No preserve meat or food. Regular exercise helps.
If you follow the above explanation, please discuss with your own GP, before stopping.
Thanks for asking.