ZOE Science & Nutrition
4 lifestyle changes that lower high blood pressure | Dr Sanjay Gupta
29 Jan 2026
Chapter 1: What is the main topic discussed in this episode?
Welcome to ZOE Science and Nutrition, where world-leading scientists explain how their research can improve your health. Can you name a health condition that has no symptoms, but is the single greatest risk factor for death globally? No?
Chapter 2: What is blood pressure and why is it important?
Here's another clue. 30% of adults in the world have it, and it causes dementia, heart disease, and stroke. Any guesses? The answer is high blood pressure, known to doctors as the silent killer. However, while high blood pressure is serious, today's guest explains there are steps you can take right now that can make a huge difference.
Today, I'm joined by Dr. Sanjay Gupta, one of the UK's leading cardiologists based at York Teaching Hospital. He's a passionate believer that lifestyle changes are the most powerful way to improve your blood pressure. In this episode, Sanjay shares evidence-based, sustainable lifestyle changes that can significantly reduce blood pressure and support overall health and well-being.
By the end, you'll have all the tools you need to keep your blood pressure in check. Sanjay, thank you for joining me today. Thank you for having me. And Sarah, thank you for being here. Pleasure. So, Sanjay, we have a tradition here at Zoe where we always start with a quick fire round of questions from our listeners. And we have these very strict rules.
You can give us a yes or a no, or if you have to, a one-sentence answer. You willing to give it a go? Yeah. All right. Can long-term high blood pressure lead to dementia? Yes, absolutely.
Is low blood pressure always better than high?
No. Can simple lifestyle changes lower your blood pressure significantly?
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Chapter 3: How does lifestyle affect blood pressure levels?
Yes.
Does alcohol help lower your blood pressure if you're stressed?
It may do. Can your gut microbiome influence blood pressure? Absolutely. And finally, what's the most common misunderstanding about blood pressure?
The idea that blood pressure is a disease. For many people, blood pressure, I believe, is a scream.
Chapter 4: How does stress impact blood pressure?
The body is screaming out and saying, I'm unhappy. And if we take the scream and make it a disease, then you end up treating the blood pressure but not addressing the root cause of the scream. And in some ways, you do that patient a disservice.
I've definitely heard of high blood pressure, and I know that it's one of those things that lots of us are told by our doctors that we should worry about. But I can't be the only person who doesn't really understand what it means, why my blood pressure rises, and what it means for my health.
So luckily, we have one of the UK's leading cardiologists to help us finally understand what it's all about. And we're joined by Professor Sarah Berry, who I discovered actually spent many years running clinical trials in humans looking at the impact of food on blood pressure. So I think we're in for a treat. Can we just start at the beginning, Sanjay?
What is blood pressure? Okay, to understand blood pressure, we have to understand pressure.
Chapter 5: What are the common misconceptions about blood pressure?
And pressure is physiologically a formula which is force over area. You exert some force over an area, and that equates to pressure. If you increase the force, you increase the pressure provided the area remains the same.
Chapter 6: What lifestyle changes can help lower blood pressure?
Or if you reduce the area and the force is the same, the pressure goes up. So blood pressure is the pressure exerted by blood on the area of our blood vessels. So the force is dictated by the heart rate and how much blood is coming out of the heart because the heart is pumping the blood into these blood vessels. And the area is dictated by the radius of our arterioles, our blood vessels.
So blood pressure will vary based on heart rate, how much blood is coming out of the heart, and also the surface area of our arterioles. So it is a constantly changing dynamic variable. It is not something which is static all the time, and this is a common misconception amongst the general public. And blood pressure will go up physiologically depending on what you're doing.
So if you're moving, your heart rate will go up, your blood pressure will go up. If you are stressed, your blood pressure will go up. If you've had too much salt, your blood pressure will go up. If you're producing stress hormones, they cause our blood vessels to constrict. So your area has gotten less and the blood pressure will go up. That is not a disease.
That is just a response to the body in response to the things that that person is doing. Why is blood pressure important? Well, I'd liken it to a little bit like when you're trying to water your plants. you have to have a certain amount of pressure in your hosepipe to get the water to that plant. If you don't have enough of a pressure, the plant doesn't get the water and dies.
If you have too much pressure, you damage the plant. And this is exactly how blood pressure works. It has to be within a certain range. If it's too low, then the patient's organs don't get the blood. and those organs suffer. And if it's too high, you damage those organs by damaging the blood vessels. And that is why blood pressure is important.
So you don't want it to be too low and you don't want it to be too high because you risk damaging the blood vessels. And therefore, those blood vessels then heal by clotting off, which means less blood gets to those organs.
And so like during my day, if my heart rate goes up because I'm running to catch the bus, are you saying that literally because my heart rate has gone up, then suddenly my blood pressure goes up almost sort of in proportion to my heart rate?
Absolutely. And you can see this very starkly when you're watching Olympians, for example, weightlifters. when they're lifting all this weight above their head, you can see their blood vessels sticking out and their eyes ready to pop out, you know? And we don't see anything bad happen to them. We say, well, this is because they are exerting this amount of effort.
It is in direct response to what they're doing. So the point is that our body and our body's blood vessels have the ability over a period of time to cope with certain pressures based on environmental factors, et cetera. The problem arises... When, over a period of time, our blood vessels start losing their elasticity.
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Chapter 7: What role does diet play in managing blood pressure?
It is what that number is doing to that patient, which is very much aligned with what you guys do, individualized medicine. High blood pressure is blood pressure that does that patient harm. It's not a number. But if a 90-year-old comes to me with a blood pressure of 150 over 90, I wouldn't automatically rush in and say, oh, here, you know, you must take a tablet, etc.
In fact, doing that will just raise that person's blood pressure further. So I would say, hey, look, you know, you're here. You are 90 years old. The more important thing in your case... is quality of life, not, oh, I'll give you a tablet and suddenly guarantee that you'll live till 95.
But this is what is happening these days because we've become so protocolized, we're so guideline-centered, we're not patient-centered anymore. In my practice, what I am interested in is taking that in the context of that patient and then working out how you bring those numbers down in as natural a way as possible
And if medications are needed, so be it, but not at the cost of that person's quality of life. That is, I think, really important.
And you refer to those numbers as a scream for help. And people do like to put their numbers in the context of what the average is or when they should seek advice. So whilst I know it is very individualized, is there a number that you could give to listeners to say, look, this is what it ideally should be before you see it as a scream for help?
Well, if you go by the guidance, 140 over 90 is sort of the kind of value. If it's sustained and it's elevated beyond that on repeated measurements, then it's probably what is considered high. Of course, different places have different criteria. So if you go to the Americans, they have lower values, you know.
And what is very interesting and quite absurd about the whole thing is if you have a bunch of American doctors there and you have a bunch of European doctors and you say, what is high blood pressure? The two groups give different values. The Americans will say it's 130 and the Europeans will say 140. And I say, well, OK, well, why don't you just give your
hypertensive patients in America, one-way ticket to Europe, and you've cured their condition. That is ridiculous. That is how absurd the world has become. You know, this is our fixation on numbers. That is, to my mind, not the way to practice good individualized medicine. You want to see that person And you want to address them holistically rather than just targeting one set of numbers.
And interestingly, those sets of numbers and those guidelines change every so often anyway.
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Chapter 8: What is the connection between gut health and blood pressure?
No, I'm saying the first thing is don't worry about it because worrying is only going to increase your blood pressure. Worrying doesn't stop anyone dying or anything. Worrying just erodes your quality of life. So don't worry about it. But I think it is important that you are empowered to understand that your blood pressure may be a manifestation of a whole host of different things.
And just going and getting a pill to lower it is not the answer. So I'm not saying ignore it. I'm saying it is important to take into account what that blood pressure is trying to tell you. I think
it is really important for patients to educate themselves because actually we've become so protocolized, so guideline bound, that now even doctors who are doing this have only been taught, well, the blood pressure is this value, you've just got to hit it with tablets, hard, hard, hard. And so I'm very much for patients understanding that it is nuanced.
I am very much for patients saying, okay, my blood pressure is high enough How is it measured? Is it just a one-off? Is it a crude measurement? Is it sustained? Has it been done in a better way? Has it been measured? Because blood pressure, you know, when you go to your doctor's office and have your blood pressure checked, that's a very artificial environment.
The heart rate's going to be up, you're going to be stressed, etc., etc., etc. If on the basis of that you are told that you have this diagnosis that you have to then carry around as a label for the rest of your life, well, I think I have an issue with that. I think what we need is patients to realize that that's a very crude reading.
You want a better way before you are labeled with something like that to measure it. And then I think you have to have a detailed evaluation of whether that number is actually harming you. And if you have all that information, then you are in a better position to make lifestyle choices and even start treatment and then have your measurements repeated in the same way.
Not, oh, I had a very sophisticated 24-hour blood pressure monitor first, and then I went to my doctor and he did a hand reading and he said it's not coming down. Well, you have to compare apples with apples. So I think that... We should never ignore something. I think worrying about it doesn't sort the problem out.
But I do think that we are in an era, especially with the internet, where patients are keen for more information and they're keen to feel more empowered about taking charge of these things.
This is a really important point we see in our own research, and this is in a research setting which is slightly similar to the doctor setting, that there's a huge change upon repeat visits in blood pressure readings.
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