Nov 20, 2017
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Controlling blood pressure

High blood pressure (or hypertension) is when your blood pressure, the force of the blood flowing through your blood vessels, is consistently too high.  High blood pressure is dangerous because it makes the heart work too hard, and the high force of the blood flow can harm arteries and organs. High blood pressure often has no warning signs or symptoms.  It is usually called the “silent killer” for a reason.  If uncontrolled, it can lead to heart and kidney disease, stroke, and blindness. (1, 2)

About 85 million Americans — one out of every three adults over age 20 — have high blood pressure (2). The best way to know if you have high blood pressure it is to have your blood pressure checked.  Note: A diagnosis of high blood pressure must be confirmed with a medical professional. A doctor should also evaluate any unusually low blood pressure readings.  Normal blood pressure for most populations is 120/80 mm Hg. (2)

Get to know the risk factors:  age, gender, and race.  Lifestyle choices can increase your risk, i.e. being sedentary, unhealthy diet choices, obesity, alcohol consumption, smoking, increased stress.  Certain diseases can cause hypertension, like pregnancy, sleep apnea, certain heart defects, and kidney disorders. (1)

How to treat high blood pressure?  Check your blood pressure at home and track it because it may be different at home than at the doctor’s office (1).  Take your medication if you are prescribed it, and take it the way your doctor says (1).  Start slowly incorporating lifestyle changes to improve your blood pressure.   If overweight, strive to lose 5 pounds, weight loss has been shown to reduce hypertension when Body Mass Index is greater than 25 (1,2,3).  Increase your physical activity gradually and have goal of 40 minutes of moderate to vigorous physical activity 3-4 times per week (1,2).  Limit alcohol: drink no more than 1-2 drinks a day (1,2).  For an overall eating plan, consider the DASH diet, which stands for “Dietary Approaches to Stop Hypertension.”(1,2) You can reduce your blood pressure by eating foods that are low in saturated fat, total fat, and cholesterol, and high in fruits, vegetables, and low-fat dairy foods. The DASH eating plan includes whole grains, poultry, fish, and nuts, and has low amounts of fats, red meats, sweets, and sugared beverages (1,2,3). It is also high in potassium, calcium, and magnesium, as well as protein and fiber. Eating foods lower in salt and sodium also can reduce blood pressure (1,2,3).

Scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) conducted two key studies.  The first DASH study compared three eating plans: a plan that includes foods similar to what many Americans regularly eat; a plan that includes foods similar to what many Americans regularly eat plus more fruits and vegetables; and the DASH eating plan.  Participants who followed both the plan that included more fruits and vegetables and the DASH eating plan had reduced blood pressure. But the DASH eating plan had the greatest effect.  The second DASH study looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume.  Participants were randomly assigned to one of the two eating plans and then followed for a month at each of the three sodium levels:  3,300mg per day (typical American diet), 2,300 milligrams per day, and about 1,500 milligrams per day.  Results showed that reducing dietary sodium lowered blood pressure for both eating plans. At each sodium level, blood pressure was lower on the DASH eating plan than on the other eating plan. The greatest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,500 milligrams per day. (2)

The DASH diet generally includes about 2,000 calories a day. If you’re trying to lose weight, you may need to eat fewer calories. You may also need to adjust your serving goals based on your individual circumstances — something your health care team can help you decide. (2)

For a 2,000 calorie meal plan, DASH diet recommends (2,3):

6-8 servings/day of grains, focusing on whole grains

4-5 servings/day of vegetables

4-5 servings/day of fruit

2-3 servings/day of dairy, recommend low-fat choices

6 ounces or less/day- lean meat, poultry, fish

4-5 servings/week of nuts, seeds, legumes

2-3 servings/day of fats or oils

5 servings or less/week of sweets

The primary foods on the DASH diet are fresh and not processed, naturally eliminating most added salt naturally.  Additional ways to lower one’s consumption of sodium are (1,2,3):

  • Buy fresh, plain frozen, or canned “with no salt added” vegetables.
  • Use fresh poultry, fish, and lean meat, rather than canned or processed types.
  • Use herbs, spices, and salt-free seasoning blends in cooking and at the table.
  • Cut back on frozen dinners, pizza, packaged mixes, canned soups or broths, and salad dressings—these often have a lot of sodium.
  • Rinse canned foods, such as tuna, to remove some sodium.
  • When available, buy low- or reduced-sodium or no-salt-added versions of foods.

Use herbs, spices, garlic, and onions, to make your food flavorful without salt and sodium. There’s no reason why eating less sodium should make your food any less delicious.  One teaspoon of table salt has 2,325 mg of sodium (3). When you read food labels, you may be surprised at just how much sodium some processed foods contain.  Remember that sea salt, kosher salt, or pickling salt, are all the same, “NaCl” or sodium chloride, without iodine added.  Alternatively, some “salt substitutes” like Morton Salt Substitute, NoSalt, and Nu-Salt, contain potassium chloride, and it is not recommended for some people to have this increased source of potassium without physician approval.  Check out https://recipes.heart.org for recipes that are heart healthy, and variety of cooking methods, or https://www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf for DASH diet meal plans and recipes. (1, 2)

References:

  1. American Heart Association: Get the Facts About High Blood Pressure. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/GettheFactsAboutHighBloodPressure.  Accessed 10/22/17
  2. National Institutes of Health: Your Guide to Lowering Your Blood Pressure With DASH: DASH Eating Plan.  https://www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf.  Accessed 10/22/17
  3. DASH diet: Healthy eating to lower your blood pressure.

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456?pg=1.  Accessed 10/22/17

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