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What is the role of diet in high blood pressure?

For many people with high blood pressure, dietary modifications are a central part of treatment. Diet may also prevent the disorder in some people who are genetically predisposed to develop it. The relationship of diet and high blood pressure is an indirect one, however. What you eat probably will not, by itself, result in hypertension. By the same token, no particular diet will cure high blood pressure once it has developed.

Among the nutritional factors that are clearly related to hypertension are:

Sodium intake. About 20 to 30 percent of people with hypertension (particularly blacks) are salt sensitive, which means that their kidneys conserve excess sodium (the main ingredient in salt) rather than excreting it. Elevated levels of sodium cause the body to retain fluid as well, increasing the blood volume and driving up blood pressure. Most doctors advise all their hypertensive patients — even those who do not appear to be salt sensitive — to restrict their sodium intake. Although sodium restriction alone may not control blood pressure, it can enhance the effectiveness of other therapies.

Obesity. More than half of those with high blood pressure are obese. A number of these people can bring their blood pressure under control simply by losing weight. Those who need medication to reduce their blood pressure may be able to get by on lower doses if they lose some weight. Excess weight also increases the risk of Type 2 diabetes, which adds to the risk of hypertension.

Alcohol consumption. Habitual drinkers are prone to develop high blood pressure, although the reason for the relationship between alcohol and hypertension is unclear. People with hypertension should drink in moderation if at all.

Potassium consumption.
Diets that are low in potassium may act in concert with other factors leading to high blood pressure. Conversely, eating plenty of potassium-rich fruits and vegetables appears to lower the risk of stroke in people with hypertension.

Calcium consumption. High blood pressure also appears to be more common among people whose diets are low in calcium, although its role in blood pressure is unclear.

When should I use diet for high blood pressure?

Dietary prevention of high blood pressure should be a lifelong endeavor. Doctors now recommend that children whose parents have hypertension begin to restrict their salt intake at an early age. Likewise, if you have mildly elevated blood pressure (90 to 100 mm/HG on your diastolic reading, which is the second number in a blood-pressure measurement), you can probably lower it with dietary and other life-style modifications.

Who provides diets for high blood pressure?
Your doctor may have diet information or may refer you to a registered dietitian. There also are a number of low-salt, low-calorie cookbooks for people with hypertension.

What should I expect of a diet for high blood pressure?

If you are overweight, expect to

reduce the total number of calories you consume daily. This does not mean starvation, but it does require altering your eating patterns for life.

The key to weight reduction is to cut back on all fats, particularly the saturated kind (butter, palm or coconut oils, animal fats, or any fat that is solid at room temperature). In the typical American diet, about 37 percent of calories come from fats. A diet for high blood pressure should gradually reduce this amount to less than 30 percent, with saturated fats making up no more than 10 percent of total daily calories. This means using low-fat dairy products, reducing meat intake, and avoiding many commercial baked goods.

You will also need to reduce sodium intake and eliminate or reduce alcohol consumption. Caffeine appears to raise blood pressure in some people, so cut back on coffee, tea, and soft drinks.

What should be expected of me?

Changing dietary habits is difficult; don't attempt to make a radical switch overnight. Instead, make gradual changes. Count calories, and keep a list of everything you eat to help you see where to modify your diet. Cut back on salt by eliminating it when you cook and substituting other flavorings. Check labels of prepared foods for those that are low in sodium. Forgive yourself if you succumb to temptation, and keep trying.

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