How to achieve a healthy weight to lower your blood pressure
Being overweight and having high blood pressure are independent risk factors for cardiovascular disease. However, both are regarded as major modifiable risk factors of cardiovascular disease.
Lifestyle changes to reduce your weight and improve your blood pressure can significantly reduce your risk of cardiovascular disease.
As being overweight increases the strain on your heart, losing weight can help to reduce this strain, as your heart doesn't have to work as hard to pump blood around your body.
Weight loss can also help to lower your risk of heart failure, a heart attack, and strokes.
Understanding BMI
Body mass index (BMI) is a measurement used to assess whether your weight is healthy for your height. The BMI calculation divides your weight in kilograms (kg) by your height in metres squared (m2).
- Ideal weight: For most adults, this is a BMI in the range of 18.5 to 24.99 kg/m2
- Overweight range: A BMI between 25 and 29.99 kg/m2
- Obese range: A BMI of 30 kg/m2 or over.
Using the NHS BMI calculator can help you to assess a healthy weight for your height.
Your ethnicity can affect your risk of disease. These are the latest National Institute for Health and Care Excellence (NICE) guidelines and use of BMI classifications:
Green |
Amber |
Red |
|
South Asian |
18.5–22.9 kg/m2 |
< 18.5 kg/m2 or 23–27.49 kg/m2 |
≥ 27.5 kg/m2 |
Black African or African-Caribbean |
18.5–22.9 kg/m2 |
< 18.5 kg/m2 or 23–27.49 kg/m2 |
≥ 27.5 kg/m2 |
Chinese |
18.5–22.9 kg/m2 |
< 18.5 kg/m2 or 23–27.49 kg/m2 |
≥ 27.5 kg/m2 |
Other Asian |
18.5–22.9 kg/m2 |
< 18.5 kg/m2 or 23–27.49 kg/m2 |
≥ 27.5 kg/m2 |
Middle Eastern |
18.5–22.9 kg/m2 |
< 18.5 kg/m2 or 23–27.49 kg/m2 |
≥ 27.5 kg/m2 |
White Caucasian |
18.5–24.9 kg/m2 |
< 18.5 kg/m2 or 25–29.99 kg/m2 |
≥ 30 kg/m2 |
Other ethnicities not defined above |
18.5–24.9 kg/m2 |
< 18.5 kg/m2 or 25–29.99 kg/m2 |
≥ 30 kg/m2 |
Excess stomach fat as a risk factor
Excess stomach fat is also deemed an important predictor of high blood pressure and cardiovascular disease. Even with a healthy BMI, you may be at an increased risk of disease if your waist size is elevated above the recommended ranges, because excess stomach fat is a key risk factor for elevated blood pressure, diabetes, and other cardiovascular diseases.
Recent guidance from NICE encourages those with a BMI below 35 kg/m2 to achieve a waist circumference that is less than half of their height. In other words, if your height is 170 cm, your waist circumference should be less than 85 cm. This is called your waist-to-height ratio.
Measuring your waist-to-height ratio is an easy way to assess your health risks at home. All you need to do is:
1. Stand up and wrap a tape measure around your waist
2. Measure the circumference at your belly button while breathing out, making sure the measuring tape is horizontal and the tape is snug around your waist (but not compressing the skin)
3. Your waist circumference measurements (in centimetres) should be half of your height (in centimetres). If the number is greater than half your height, then healthy weight loss can help reduce your risk of cardiovascular disease.
Healthy weight loss
Knowing your BMI can give you an idea of a healthy weight for you. It can sometimes seem like an overwhelming task to achieve, but research has shown that a modest weight loss of 5–10% of your starting weight is effective at lowering blood pressure.
In fact, blood pressure can normalise before reaching your ideal weight. So starting your weight loss journey today can help you to reduce your blood pressure along the way, in pursuit of your ideal weight. This means an individual starting with a weight of 95kg can see meaningful reductions in their blood pressure at a weight of 86–90 kg.
Although benefits to your blood pressure can occur before you achieve your ideal weight, it's recommended to pursue this ideal weight as this can have further benefits to your blood pressure and risk of cardiovascular disease, diabetes, and cancer. Reducing your weight can also improve your quality of life and emotional wellbeing.
It’s important to note that slow and gradual weight loss is more likely to be sustained and lead to better blood pressure control over time.
How to achieve an energy deficit
To lose weight, you need to achieve a calorie deficit whereby you expend more calories than you consume in a 24-hour period. There are a lot of ‘fad’ diets (diet plans promoting results without sufficient evidence) in the media that can make weight loss confusing.
Weight loss should be achieved through a healthy, balanced diet that doesn’t require eliminating or severely restricting any food group. The most effective way to lose weight is through a combination of diet and exercise, as this can create a calorie deficit by reducing energy intake and increasing energy expenditure.
This can sound daunting, but small changes to your daily routine can help to increase your energy expenditure and reduce your energy intake.
Exercise tips
It’s recommended that adults engage in 30 minutes of moderate exercise, 5 days a week. Just a single bout of aerobic exercise, including walking, can reduce your blood pressure. This is known as post-exercise hypotension and can last for several hours.
As little as a 2mmHg reduction in blood pressure can reduce your risk of coronary artery disease and stroke mortality – so every bout of exercise counts! Engaging in aerobic exercise regularly over time can have a sustained reduction on both waking and sleeping blood pressure, having a significant effect in reducing your risk of cardiovascular disease.
Structured exercise is a great way to increase your energy expenditure, however, it’s not the only way. Increasing your day-to-day movement and reducing your sedentary behaviour can significantly increase the calorie you burn throughout the day. Here are some ideas of how to go about it:
- Walk or cycle rather than drive to your destination
- Get off the bus/tube a stop earlier and walk the remainder of the way
- Increase time spent doing housework such as hoovering, cleaning, and gardening
- Take the stairs instead of the escalator or lift
- Get active with family and friends by meeting for a walk or outdoor games
- Take a walk in your lunch break.
Healthy eating tips
- Try to avoid emotional eating: This includes eating when you're bored, stressed or anxious. Try and distract yourself by doing something else such as reading a book, going for a walk, doing housework, or calling/meeting a friend.
- Reduce high fat and high sugar foods: These are often high in calories and saturated fat, which can lead to weight gain and impair your cholesterol profile.
- Increase fibre: Fibre helps to regulate your appetite, keeping you fuller for longer and reducing the temptation to snack or overeat at your next meal. Increasing your intake of fruit, vegetables and wholegrain carbohydrates can be a good way to increase your fibre intake.
- Increase protein: Protein has a higher satiety effect than carbohydrates and fat, helping you to feel fuller for longer. Making sure you have a protein source in your meals can help you to reduce your portion sizes.
- Reduce alcohol: Alcohol is generally high in calories, particularly beer, cider, and wine. These calories offer no nutritional benefit and can increase your risk of disease.
- Use the traffic light system on food labels and avoid those that are red: Food labels are a great way to choose low fat and low sugar options, which can help to reduce your calorie intake.
In summary
Reducing your weight is a great way to help you to lower your blood pressure and reduce your risk of cardiovascular disease.
Achieving your ideal BMI will help you to improve your health, but meaningful reductions in your blood pressure can happen before reaching this ideal weight with a 5–10% reduction in bodyweight.
Focus on reducing your waist circumference to less than half of your height.
A single bout of aerobic exercise can help to lower your blood pressure for several hours. Regular aerobic exercise can help to sustain this reduction.
Implementing simple strategies to increase your energy expenditure and reduce your energy intake, and sticking to these changes over time, can lead to weight loss.
References
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Neter, J.E., Stam, B.E., Kok, F.J., Grobbee, D.E. and Geleijnse, J.M., 2003. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension, 42(5), pp.878–884.
NICE (2022) Recommendations: Obesity: Identification, Assessment and Management: Guidance, NICE. Available here (Accessed: March 14, 2023).
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Zhu, Z., Yan, W., Yu, Q., Wu, P., Bigambo, F.M. and Chen, J., 2022. Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2022.
Last updated Thursday 5 October 2023
First published on Thursday 4 May 2023