Aging Diets Exercise Heart Disease

What is Normal Blood Pressure?

            The American Heart Association (AHA) estimates that 46% of the adult U.S. population has some form of Cardiovascular Disease (CVD).  In part, this estimate is the result of redefining high blood pressure as a reading of 130/80 mmHg, a lower threshold than the previous standard of 140/90 mmHg.

            This new standard is because high blood pressure is implicated in a wide range of diseases. Cardiovascular disease and high blood pressure in particular is a leading global cause of death that claims more lives than all forms of cancer combined.  And yet, Cardiovascular Disease (CVD) is one of the most easily prevented diseases in most people.

            The AHA report points out that most Cardiovascular Disease (CVD) is attributable to dietary habits, smoking, high Body Mass Index (BMI), high total cholesterol, high fasting plasma glucose and low levels of physical activity.   In essence, our lifestyle is at the heart of most heart disease.

            Interestingly, smoking has been trending down in recent years and exercise has been trending up. What hasn’t improved is the average age and diet.  While age is usually considered a significant factor it doesn’t have to be for those following appropriate lifestyle guidelines.  In populations that follow a plant-based whole food diet, blood pressure rises far less as people age.  In some primitive cultures, people age with no significant increase in blood pressure.

            In most cases, the reason blood pressure rises is that the heart has to pump harder to overcome resistance from arteries that have accumulated plaque and lost their flexibility.  The higher pressure increases heart workload and unhealthy tissue growth (atheroma) within the walls of arteries. At higher blood pressure, the heart muscle tends to thicken, enlarge, and become weaker over time.  Eventually, this leads to strokes, heart attacks, aneurysms, or kidney failure.  Even moderately elevated blood pressure is a reason for concern since it may lead to a shortened life. At a blood pressure 50% or more above average, a person may expect to live no more than a few years.

           While the national trend that shows cardiovascular disease on the rise is unwelcomed news, there is an abundance of good news from doctors that practice lifestyle medicine.  Studies show that the major contributor to cardiovascular disease is a diet that, when changed, can in many cases even reverse heart disease.  In cases where heart disease has progressed too far, certain procedures or drugs may be needed as a complement to diet changes.  Most importantly, genetics is not destiny except for a small percentage of people.  In other words, just because your siblings or parents suffered from heart disease, it doesn’t mean that you will have the same issues unless you follow their lifestyle. For those that try lifestyle change and fail to get satisfactory results, the reason most fail to achieve enough reduction in heart disease to stop medications is that the changes they make are not sufficient.  Eating one extra fruit or vegetable a day is not sufficient.  In contrast, a 40% reduction in LDL (i.e., comparable to statins) is typical for patients adhering to a plant-based whole food diet that’s complemented with moderate exercise.

            In controlled trials, measurable improvements have been observed in as few as 24 days after making appropriate lifestyle changes.  Other measures may take a year or longer.  In contrast with traditional medical procedures, controlled trials of diet showed 2.5 times fewer cardiac events after five years.

            Another compelling reason for lifestyle change is that medications do not address the root cause of the problem.  The result is that medications help but may not contribute to overall well being. In contrast, the lifestyle changes that improve cardiovascular health also lead to an overall increase in the joy of living.  For all patients, my goal is progress over perfection. For a person unable to make sufficient lifestyle changes, medications are always available.

            The advantages of lifestyle change can be quite dramatic.  In several cases, patients waiting for heart transplants showed so much improvement they no longer needed the procedure. While these cases are anecdotal, improvements this significant are unlikely to be due to chance.  Fortunately, the evidence keeps accumulating.  In a demonstration project of over 300 patients eligible for vascular surgery, almost 80% were able to safely avoid surgery by making comprehensive lifestyle changes.

            Given that cardiovascular disease is the reason most will face radical surgical procedures later in life, have a low quality of life, and die prematurely, it makes sense to consider lifestyle changes well before a cardiac event catches you by surprise. For those that experience a sudden cardiac arrest, very few live to get a second chance at a good quality of life.

            For myself, I’m not taking any unnecessary chances.  That is why I pack my beans, greens, and vegetables for lunch and work in a three mile daily walk.  On a good day, it adds up to 10,000 steps.  If you happen to be shy of 10,000 steps a day, then join me Saturday morning.

            Nancy Neighbors, MD

Buffalo Cauliflower with Ranch Dressing

(From the archives at


            Preheat the oven to 425ºF. Line one or two large baking sheets with a silicone mat or parchment paper and set aside.

            In a large bowl, combine the flour, nutritional yeast, garlic powder, and Savory Spice Blend. Stream in ½ cup of water and whisk until smooth. Add the cauliflower to the batter, turning to coat each piece. Arrange the battered cauliflower on the prepared baking sheets. (Do not let them touch.) Bake for 15 minutes, turning halfway through.

            Pour the Healthy Hot Sauce in a large bowl. When the cauliflower is done, remove it from the oven and gently toss it in the hot sauce. Return the cauliflower pieces to the baking sheet. Bake for 20 to 25 minutes longer, or until they become crispy. Allow to cool for 10 minutes before serving with a side of Ranch Dressing.

            For complete information about this recipe, visit the archives at

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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