Guidelines for Lowering Blood Pressure and Screening for Prostate Cancer

Guidelines for Lowering Blood Pressure and Screening for Prostate Cancer

Our experts reveal top ways you can stay healthy, including when to get tested for cancer risk.

Q: My doc says that if I don’t bring my blood pressure down I am going to have to take anti-hypertensive medications. I hate taking pills, so what should I do? —William T., Gloucester, MA

A: Getting your BP to normal is a key factor in avoiding a stroke or heart attack, let alone impotence. Even if your doc suggests medications (they are effective), we’re guessing lifestyle changes were also recommended. A 16-week study presented at the American Heart Association's Joint Hypertension 2018 Scientific Sessions offers evidence that upgrading your daily habits can make a big difference pretty quickly in your cardiovascular health.

Researchers from the University of North Carolina worked with people who were overweight and had blood pressure in the 130-160/80-99 range. For four months, the participants exercised three times weekly (150 minutes total) and followed the DASH (Dietary Approach to Stop Hypertension) diet. DASH basics are:

  • Six to eight servings a day of whole grains: brown rice, whole-wheat pasta, whole-grain bread (1 serving=1/2c rice, pasta, 1 slice bread )
  • Four to five daily servings of fruits (1 serving=1/2 apple, 1 orange or 8 strawberries)
  • Four to five servings of vegetables daily (1 serving=1/2c cooked green or orange veggies or 1c leafy greens)
  • Two to three servings of low- or no-fat dairy (1 serving=1c low-fat milk or yogurt) 
  • Six ounces daily of lean meats like skinless poultry, salmon and ocean trout
  • Four to five servings of almonds, walnuts, kidney beans, peas, lentils weekly (1 serving=1/2c to 1/3c)
  • Use healthy oils, like EVOO, and avoid saturated and trans fats, minimize alcohol and drink plenty of coffee (check out more details on the DASH diet at

The results: Study participants lost around 19 pounds, reduced systolic BP (top number) by 16 points and diastolic (lower number) by 10! Ask your doctor if you can try that approach first. Remember, if you want to avoid a stroke, you want your BP below 125/85.

Q: My dad is 75 and his recent PSA test indicates he has prostate cancer. He’s been to several doctors and they have different opinions about how to treat it. What guidelines should we pay attention to? —Glen J., Knoxville, TN

A: The answer to your question depends on what other diagnostic tests he’s had and how the cancer has advanced. Each case is unique: That’s true for the more than 180,000 men in the US who will be diagnosed with prostate cancer this year, and the more than 40,000 who will die of the disease. But here’s a basic overview.

The traditional tests for prostate cancer have been a digital rectal exam and the PSA (prostate specific antigen) blood test. But the PSA screening results in an astoundingly high number of false positives, which can lead to overdiagnosis, overtreatment, and unnecessary risks for incontinence and impotence.

Additionally, even if a diagnosis from a PSA test is correct, when prostate cancer is detected in men older than 70, it’s often very slow moving. Watchful waiting along with active monitoring is generally the smart move—especially when bolstered by smart lifestyle choices such as stress management, smart nutrition, physical activity and avoiding toxins, including tobacco. If, eventually, the cancer progresses, an MRI and a prostate biopsy provide information needed (a Gleason score) to make your best treatment decision.

A recent study from the University of North Carolina estimates that treating prostate cancer in men 70 and older has cost Medicare $1.2 billion over the last three years. And $451 million of that was spent on treatments for men with a Gleason score of 6, which the researchers believe should be, “considered to be low-grade disease and best managed using active surveillance rather than aggressive treatment.”

So if and when your dad gets a Gleason score, then it will be time to talk with his prostate specialist about the balance of benefits versus possible harms of the many treatment options that are now available.

Medically reviewed in January 2020.

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