#249 Drugs versus Diet for High Blood Pressure: Which is Best?

Drugs versus Diet for High Blood Pressure: Which is Best?

No one wants to take drugs for high blood pressure.  A new study shows that one specific diet may lower blood pressure more than drugs.  In this article, I’m going to deconstruct this new diet for high blood pressure and teach you what you need to do to lower your blood pressure naturally.

My Blood Pressure Struggles

I know what it is like to have high blood pressure.  At one time, my blood pressure used to run 150/90.  As readers know, a blood pressure of 150/90 is far higher than the new blood pressure guidelines which recommend treating blood pressures higher than 130/80.

Like most other doctors, I turned to a pill.  Except, rather than have my doctor prescribe a pill, I did it myself.

At first, I tried a beta-blocker.  However, beta-blockers made me tired.

Then I tried lisinopril.  But lisinopril gave me a cough.

Finally, I ended up on losartan.  Losartan kept my numbers down until I found a natural solution.

Today, my blood pressure runs 110/70 without medications.  I now know that drugs are not the answer for most people with high blood pressure.

If you can treat high blood pressure quickly enough with lifestyle changes, then you can avoid a lifetime of medications.  The key is to act fast before your heart and arteries are permanently damaged, and high blood pressure becomes unavoidable.

The Drugs versus Diet for High Blood Pressure Study

While this wasn’t specifically a drug versus diet study design, this study showed that a new diet can completely blow away any drug for high blood pressure.  Personally, I will refer to this diet as the DASH Plus Diet.  I have added the “plus,” because this new diet has tweaked the well-established DASH Diet in a way that even the researchers of this study didn’t understand.

In this study, researchers from Harvard and Johns Hopkins University recruited 412 people suffering from high blood pressure.  The average age was just 48 which highlights the fact that high blood pressure is so common even in young people today.

These 40-year-olds were then randomized to the Standard American Diet (SAD), DASH Diet, or the DASH Plus Diet.  For the Standard American Diet (SAD) people, these folks were instructed to eat like the typical Americans.  In other words, have all the sugar, processed foods, and fast foods you want to eat.

For the DASH Diet people, they were instructed to limit their grains to intact grains and eat large amounts of fruit, vegetables, and legumes.  Any meat consumed in this group had to be lean chicken or fish.

The DASH Plus people followed the DASH Diet approach and dialed their sodium way back.  As readers well know, the only way to eat an ultra low salt diet is to be incredibly strict about eliminating any foods that come in a bag, can, or box.  Basically, 100% of all processed foods have to be removed to eat ultra low sodium.

What Did The Drugs versus Diet for High Blood Pressure Study Show?

The results of this drugs versus diet for high blood pressure study completely blew away any preconceived notion of what the right diet can do.  The dramatic results of this study likely explain why this study was published in the most prestigious cardiology medical journal on this planet.

Would you believe me if I told you that the DASH Plus Diet reduced blood pressure by 21 points when compared to the Standard American Diet (SAD) in those people who started out with a systolic blood pressure of more than 150?

Considering that the average blood pressure drug only drops blood pressure by 8 points, these results are anything but spectacular.  The right diet is the equivalent of almost three high blood pressure drugs!

For those readers with a blood pressure not quite as high as 150, don’t worry that this type of diet will lower your blood pressure too much.  Not one of the 412 people in this study got in trouble from too low of a blood pressure.

One key point to remember in this study was that the average age was 48.  The people in this study were young enough that dietary changes alone could be curative.

The only way to avoid a lifetime of high blood pressure pills is to start eating healthy before permanent damage occurs.  Once the arteries become hardened with plaque build up, it is hard for diet alone to fix the problem.

However, even if you are in your 60s, 70s, or 80s, eating right may be the difference between taking one versus three or four high blood pressure drugs.  Thus, everyone, regardless of your age, is much better off eating real foods!

What These Harvard and Hopkins Researchers Missed

Like 99% of other physicians, these Harvard and Johns Hopkins researchers were too focussed on reducing sodium.  They attributed all of the benefits to lowering salt intake.

While salt may contribute to high blood pressure in some people, this isn’t a universal truth.  In fact, for people who sweat a lot from high endurance exercise (think marathon runners or triathletes), an ultra low salt diet might be dangerous.

Of course, I would never advocate for industrially processed foods to boost salt intake.  Instead, for my ultra endurance athlete readers, I would suggest salting the real food you prepare at home if your doctor is in agreement.

When it comes to industrially processed foods, these Harvard and Hopkins researchers failed to account for the fact that eliminating processed foods also eliminates most sugars and unhealthy oils from your diet.  Indeed, studies show that reducing sugar may lower blood pressure far more than salt could ever dream of.  Perhaps it is time for the medical community to accept that sugar may be far more dangerous to cardiovascular health than salt.

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  1. I have followed your work from the very beginning when I read about you in a newspaper article in the Deseret News a couple of years ago. I have read and loved your book and really enjoy the weekly newsletters! I believe totally in a plant based diet and how it can affect your health. I went on BP medications about 5 years ago when I was in a stressful job. I have tried hard to follow your guidelines and feel I have achieved about 80 to 85% Not perfect but so much better than before. My doctor is not a fan of me going off medications. When I asked her and told her a little bit about what I was doing, she felt that I was too old to try and that my arteries are too stiff. I am 67-years-old. I take 25 my Hydrocholorthiazide and 25 mg of Losartan each day. She finally said well go ahead and try not taking the Losartan. I did, and I was monitoring my BP. I had BP on medication of 120/70 but without it rose to 138/75. I went back on my medication and felt very sad that I could not get off the medication. I really do want to get off of medication. Should I realize that it might not work for me? Should I get a different doctor? Is it okay to have a BP at that range and keep working on diet. I do exercise every day. Thanks so much for your GREAT work!!

    • Hi Jan,

      Thank you so much for reaching out! Don’t give up…Yes, 138/75 is too high but it doesn’t mean all is lost. You can definitely keep working with your current doctor.

      Perhaps you should track your blood pressure a little more closely. Are there certain situations, foods, etc. that seem to drive it up?

      Also, you could consider consulting with a functional medicine/integrative medicine physician. Perhaps there is an underlying cause of your high blood pressure that has not yet been addressed…

      Hope this helps!


  2. Dr. Day this is your old friend Don Morgan (Carbwatchers), sure wish I could get you on the Ketogenic band wagon. It’s being recognized finally as a wonderful tool in the fight against type 2 diabetes. I love your book and the message you give. Thanks Don

    • Hi Don,

      Thank you so much for reaching out!

      The ketogenic diet, if done properly, can be a great tool for people suffering from diabetes, obesity, or many neurologic conditions.

      Warm regards,


    • Hi Pamela,

      Fruit is an important part of a healthy diet. However, not all fruit is created equally. Those higher on the glycemic index, like many tropical fruits, pack an excessive sugar load which may not be optimal for people with blood sugar or weight challenges.

      My favorite fruit are berries. The sugar load is low, fiber is high, and there is very compelling scientific data supporting their use.

      Hope this helps!


  3. Thank you for your newsletter. I am a big fan and also forward info to family and friends. My question is can you further define no sugar intake. Is Stevia okay, would wine and alcohol be on the list of things to remove from your diet to achieve no sugar intake?

    • Hi Pamela,

      Great question. Alcohol definitely is a sugar. Stevia, while not a “sugar” per se, appears to be the safest of all the nonnutritive sweeteners. What we don’t really understand is what is the effect of Stevia to our gut microbiome.

      While a no sugar diet is certainly commendable, it isn’t required for health. The problem with sugar really comes down to the dose. Not everyone is created the same so the key is to find out what works for you and then stick with it.

      Hope this helps!


  4. I can get my BP down through deep breathing and relaxation more than anything else. For instance last night it was 116/64. However, it does tend to vary and will be high in the a.m. The cardiologist does not have me on meds because it doesn’t read high when he takes it. I am trying to look at my potassium intake vs sodium. My question is should I look at this for each meal or the total of each throughout the day? For instance, will a high potassium intake during the day undue the effects of a high sodium dinner if the potassium was 2-3x the amount of sodium for dinner or does it need to be in or close to that meal time? If anyone could clear this up for me I would be grateful. I am 68 yrs old.

    • Hi Ann,

      Thanks for reaching out!

      That is great that you can lower your blood pressure through mindfulness!

      As everyone responds to potassium/sodium differently, the only way to find an answer to your question is to do your own experiment. Track your sodium and potassium intake, as well as your blood pressure, through the day to better understand the relationship to your blood pressure.

      Two great apps to track your sodium and potassium intake are Healthwatch 360 and Cronometer. Both apps have a free version.

      Hope this helps!


  5. I went on a plant based diet and will NEVER go back to eating otherwise. Not only do I feel like a million bucks, but had the added benefit of losing 15 lbs. and lowering my blood pressure to 117/60. I’m 63 years “young”!!

  6. I have begun subscribing to Dr John Day’s newsletter and I am so inspired by what he writes. I am recommending him to my friends and want them to follow his health guidelines. I am so happy that I have discovered him – I have always led a healthy life but it’s even better now. A big big thankyou Dr Day!

  7. I have the same question Chris (below) has. Only I am a 71 year old female. I’ve been on BP medicine for decades and just wonder if it is too late for me to try. I have not had stents or other procedures yet. Thanks!

    • Hi Francie,

      It is never to late to try. Even if your BP can’t be reversed, there are so many other positive benefits!!!


  8. HI Dr Day, my name is Chris Wiedemer, Rochester NY. I am a huge fan of your weekly emails, have bought and read your book, the Longevity Plan and strive to live a life free of heart disease. I was diagnosed with it, 5 years ago, needed two stents, and have been working hard to keep my blood pressure in check thru proper nutrition, and daily exercise like you describe this week. My question is this: is it too late for a 61 year old with heart disease to reverse it, with a plant based diet, daily exercise but eventually without any drugs? My cardiologist does not recommend it but i am determined to get drug free someday and wonder is it possible? thank you for any feedback!

    • Hi Chris,

      Thank you so much for reaching out!

      I am inspired by your determination! My suggestion would be to continue to live as healthy as you possible can. In addition to following your cardiologist’s advice, keep a detailed blood pressure log and share it with him/her. When your cardiologist sees the data you collect, he/she may just change her mind.

      Hope this helps!