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LMU 216 – Unleashing the Power of Lifestyle: The Triumph Over Resistant Hypertension

Diet and Aerobic Exercise Successful Against Resistant High Blood Pressure

Unleashing the Power of Lifestyle: The Triumph Over Resistant Hypertension

Source: Journal Circulation (September 2021)

Lifestyle Medicine Update (September 29, 2021)


A groundbreaking study published in Circulation in September 2021 highlights the significant impact of a holistic lifestyle approach in combatting resistant hypertension. Resistant hypertension, where blood pressure remains high despite medication, affects millions globally, posing serious health risks. The TRIUMPH study unveiled the potential of lifestyle modifications, including dietary improvements and supervised exercise programs, in significantly reducing blood pressure and enhancing cardiovascular health. Dr. James A. Blumenthal, one of the study’s researchers, emphasizes that a healthy lifestyle remains a potent weapon against hypertension.

Unlocking the Potential of Lifestyle Modifications to Defeat Resistant Hypertension

High blood pressure, the silent assassin of cardiovascular health, has met its match in a groundbreaking study published in September 2021 in the esteemed journal Circulation. This illuminating research reveals the potent impact of a holistic approach encompassing healthy eating, weight loss, and improved aerobic fitness on individuals grappling with resistant hypertension.

Resistant Hypertension: A Formidable Foe

In the realm of hypertension, a formidable adversary known as resistant hypertension emerges when blood pressure refuses to bow to conventional treatment. To qualify, one’s blood pressure must stubbornly remain at or above 130/80 mm Hg, despite the administration of three or more high blood pressure medications of diverse classes. Resistant hypertension, lurking in the shadows, affects an estimated 5% of the global population and casts a menacing shadow over 20% to 30% of adults grappling with high blood pressure. A sinister spectre, it is associated with dire consequences, including end-organ damage such as kidney failure and a harrowing 50% increased risk of catastrophic cardiovascular events, such as stroke, heart attack, and sudden death. In the face of this relentless foe, any glimmer of hope for reducing blood pressure commands our unwavering attention.

The Triumph of Lifestyle: A New Dawn

In June 2021, the American Heart Association championed a new paradigm in the fight against mild to moderately elevated blood pressure and blood cholesterol, particularly in individuals with low heart disease risk. It proclaimed that physical activity should take center stage as the primary therapeutic intervention. The unveiling of the “Treating Resistant Hypertension Using Lifestyle Modification to Promote Health (TRIUMPH)” study in September 2021 marked a historic turning point in the battle against resistant hypertension. This groundbreaking research delved into the transformative power of lifestyle modifications for those wrestling with this relentless condition.

The TRIUMPH Study: A Beacon of Hope

Conducted over four months, the TRIUMPH study engaged 140 adults grappling with resistant hypertension, embarking on a journey toward better health. Half of the participants embraced the Dietary Approaches to Stop Hypertension (DASH) eating plan, an oasis of fruits, vegetables, low-fat dairy products, and limited salt intake—a diet aligning seamlessly with the American Heart Association’s nutritional counsel. These brave souls also participated in supervised exercise training, a thrice-weekly ritual within the hallowed halls of cardiac rehabilitation.

The remaining half received a single informational session from a health educator, along with written guidelines on exercise, weight loss, and nutritional objectives to pursue independently. With an average age of 63, the participants comprised a diverse group, with 48% being women, 59% Black adults, 31% facing type 2 diabetes, and 21% already bearing the burden of chronic kidney disease.

The Triumph of Transformation

As the TRIUMPH study unfolded, the results spoke volumes. Participants in the supervised exercise program achieved a remarkable 12-point drop in systolic blood pressure, compared to the 7-point reduction seen in the self-guided group. Beyond this dramatic reduction in blood pressure, the supervised program heralded greater improvements in key indicators of heart health, painting a promising picture of a lower risk of future cardiovascular events.

The Voice of Insight

Dr. James A. Blumenthal, one of the study’s researchers, shared his insights, stating, “Our findings showed lifestyle modifications among people with resistant hypertension can help them successfully lose weight and increase their physical activity, and as a result, lower blood pressure and potentially reduce their risk of heart attack or stroke.” He emphasized that these successes did not warrant discontinuation of medications but rather a discussion with physicians about possible dosage reductions or medication adjustments in light of improved blood pressure values.

Dr. Blumenthal’s closing words resonate deeply: “The most important point is that it is not too late to lower blood pressure by making healthy lifestyle choices. Adopting a healthy lifestyle pays huge dividends, even for people whose blood pressure remains elevated despite being on three or more antihypertensive medications.” His remarks underscore the profound impact of targeted dietary and exercise protocols in the fight against high blood pressure and resistant hypertension.

In conclusion, the TRIUMPH study shines as a beacon of hope, demonstrating that lifestyle medicine stands as a pivotal component of self-health care throughout one’s lifetime. Its results remind us that even in the face of a relentless adversary like resistant hypertension, the power of a healthy lifestyle can be our triumphant ally.


  1. James A. Blumenthal, Alan L. Hinderliter, Patrick J. Smith, Stephanie Mabe, Lana L. Watkins, Linda Craighead, Krista Ingle, Crystal Tyson, Pao-Hwa Lin, William E. Kraus, Lawrence Liao, Andrew Sherwood. Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial. Circulation, 2021. [Read More](
  2. Healthy Lifestyle Can Lower Blood Pressure Even in Resistant Hypertension. ScienceDaily, September 27, 2021. [Read More](
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Dr. Meschino

Dr. James Meschino


Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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