Prevent Hypertension Before it Starts

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Hypertension, or high blood pressure, is considered an “insidious disease” because it doesn’t come with any obvious symptoms.  For most adults, there’s no one definite cause of hypertension, but things like stress, physical inactivity, eating a lot of salt, using tobacco, and drinking a lot of alcohol can all increase your risk.¹ Many people don’t know they have it until it starts to cause complications,² such as damage to the blood vessels, stroke, heart attack, vision loss, memory problems or kidney failure.^1–3 Adults over the age of 50 have a 90% risk of developing hypertension⁴ but until you start getting complications, the only way to know whether you have it is to get your blood pressure checked.  When you do, your doctor will tell you your blood pressure as one number “over” another number.  The first number is your systolic pressure, or the pressure your blood puts on your arteries when your heart is contracting.  The second number is your diastolic pressure, or the pressure your blood puts on your arteries when your heart is relaxed.³

A healthy blood pressure is considered to be 120/80 millimeters of mercury (mmHg), but some researchers believe the risk of complications increases beginning at a blood pressure of 115/75 mmHg, well before 140/90 mmHg when hypertension would be diagnosed.⁴ This means it’s crucial to get your blood pressure checked regularly and take a few precautions in your diet and lifestyle to prevent hypertension in the first place.

Achieve or Maintain a Healthy Weight

Many studies show that weight loss lowers blood pressure.  Ideally your body mass index should be at or below 25, but weight loss will improve your blood pressure even before you reach your goal weight.  Losing about 11 pounds can lead to a reduction of about 4.4/3.6 mmHg.⁴ If you’d like to lose weight, talk to a registered dietitian to learn some strategies to reduce your calorie intake that you’ll be able to maintain for the long term.

Stay Active

The American Heart Association recommends that people do some type of aerobic exercise for at least 30 minutes every day to keep their blood pressure low.  Aerobic exercises include power walking, jogging or running, dancing, cycling, swimming, and anything else that gets your heart rate up.  In general, the more intensely you exercise, the better.  Some studies also suggest that resistance exercise, such as weight lifting, can also improve your blood pressure.⁵ Since both aerobic and resistance exercises are also known to help you maintain weight loss, reduce your risk for diabetes, and maintain your muscle mass and balance as you get older, lowering your blood pressure is just one more reason to get active every day!

Choose Nutrient-Dense Foods

The DASH (Dietary Approaches to Stop Hypertension) Diet was developed specifically to help people keep a healthy blood pressure.  Other healthy-eating plans, such as the Mediterranean diet, the OmniHeart diet, and the vegetarian diet, are also known to improve blood pressure.  In general, you should aim for 8-10 servings of fruits and vegetables and 2-3 servings of low-fat dairy each day.  These food groups are high in potassium; people who consume about 4.7 grams of potassium each day tend to have lower blood pressures.⁴

Fruits, vegetables, and whole grains are also good sources of fiber, which is associated with reduced blood pressure.  Although your recommended daily intake of fiber is 25-30 grams, most Americans do not meet this recommendation.  Studies have shown that increasing your fiber intake by 14 grams per day can lead to modest improvements in blood pressure.⁴

 Drink Alcohol in Moderation

Studies have shown that the more alcohol you drink, the higher your blood pressure will get, especially if you have more than two drinks per day.  This will happen regardless of your weight, age, and other dietary factors; however, reducing your alcohol intake will lead to improved blood pressure.  At the most, men should have no more than two alcoholic drinks per day and women should have no more than one.⁴ One drink is considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.  All of these provide about 14 grams of pure alcohol.⁶

Limit Added Salt and Sugar

It’s pretty well known that eating a lot of sodium can increase your blood pressure.  Studies have shown that blood pressure rises as sodium intake does.  To combat this, people should limit themselves to no more than 2300 milligrams of sodium each day, and people who are over the age of 50 or African American should have no more than 1500 milligrams every day.  Using herbs and spices to flavor your foods and limiting the amount of processed foods you eat will help you keep your sodium intake within these recommendations.⁴

At the same time, studies suggest that eating added sugar will increase your blood pressure four times as much as sodium.  Researchers believe that eating a lot of sugar causes hypertension by promoting inflammation, insulin resistance, and obesity.  The blood sugar spike after eating sugar causes water to move out of the cells and into the blood vessels, raising blood pressure.  It doesn’t take long for a high-sugar diet to impact blood pressure.  After just a few months, people who ate a high-sugar diet had blood pressures that were an average of 7.6/6.1 mmHg higher than those who ate a low-sugar diet.⁷ To combat this, satisfy your sweet tooth with fruits rather than candy or desserts high in added sugar.  Also check the ingredients list on foods such as bread, canned sauces, yogurt, and cereal to make sure that some type of sugar hasn’t been added.

While these recommendations are important for a healthy blood pressure, following them will also help you maintain your weight, reduce your risk for Type 2 Diabetes, and stay healthy while you age. Stay active, choose a variety of fruits, vegetables, lean protein, and whole grains, limit alcohol, sodium, and sugar intake, and speak with a registered dietitian if you’d like more personalized recommendations!

References:

1.         High blood pressure (hypertension) Causes. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/causes/con-20019580. Accessed March 1, 2017.

2.         Hypertension. Tutorials - Pathology Subjects. http://library.med.utah.edu/WebPath/TUTORIAL/HYPERTEN/HYPERTEN.html. Accessed February 15, 2017.

3.         5 things you should know about high blood pressure - Nutrition Action. http://www.nutritionaction.com/daily/heart-and-disease-cat/5-things-you-should-know-about-high-blood-pressure/?mqsc=E3871758&utm_source=WhatCountsEmail&utm_medium=Nutrition_Action_Daily_TipsNutrition%20Action%20Daily&utm_campaign=2017.02.13%20Heart%20and%20Disease. Accessed February 14, 2017.

4.         Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary Approaches to Prevent and Treat Hypertension. Hypertension. 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6.

5.         Brook RD, Appel LJ, Rubenfire M, et al. Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure. Hypertension. 2013;61(6):1360-1383. doi:10.1161/HYP.0b013e318293645f.

6.         What Is A Standard Drink? | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink. Accessed March 1, 2017.

7.         DiNicolantonio JJ, O’Keefe JH. Hypertension Due to Toxic White Crystals in the Diet: Should We Blame Salt or Sugar? Prog Cardiovasc Dis. 2016;59(3):219-225. doi:10.1016/j.pcad.2016.07.004.