One third of adult Americans have high Blood Pressure (Hypertension). Another third have pre-hypertension. Sounds strikingly like the stats on diabetes and pre-diabetes. High BP is a leading cause of cardiovascular disease (heart attack, stroke, kidney failure, heart failure) and a leading cause of death worldwide. Among adults 50 years old the lifetime risk of high BP is an astounding 90%.
Long before BP reaches hypertensive levels and requires (usually) lifelong drug treatment, the right diet can derail the hypertension express.
Weight loss: One third of Americans are obese, another third overweight. Starting to sound familiar? Weight loss reduces BP. A lot of weight loss reduces BP a lot. Aim for a Body Mass Index (BMI) less than 25. Height, weight, and BMI tables are on-line.
Reduced salt (sodium chloride) intake: Decrease salt intake, decrease your BP. Median sodium intake over the years has run from about 3,000 to 4,000 milligrams/day (mg/d) in children and adults. Doctors advise a maximum daily intake of 2300 mg but only 1,500 mg per day if over age 50, in blacks, who are more susceptible, and in people who have high BP, diabetes, or kidney disease. Watch out for processed foods which tend to be high in salt.
Increased potassium intake: Obtain from food, not pills. For people with normal kidney function 4.7 grams per day is reasonable. Potassium excretion by the kidneys is affected not only by kidney function but by many drugs and medical conditions. Cardiovascular diseases and drugs used in their treatment are in this category. There are on-line lists of the foods providing potassium, but do not go overboard on this without medical advice.
Moderation of alcohol intake: BP rises with more than two drinks per day (a drink is 12 oz beer, 5 oz wine, 1.5 oz hard liquor).
Diet: Vegetarian diets markedly lower BP. The DASH diet (Dietary Approach to Stop Hypertension) is high in fruits and vegetables and low-fat dairy, whole grains, fish, poultry, and nuts, low in saturated fat, sugar, red meat. It reduces BP.
There is conflicting evidence so far about other approaches: Fish oil, fiber, calcium, magnesium, different levels of carbohydrate consumption, different forms of fats, different amounts of protein, and Vitamin C.
The alternative is almost certain rising BP associated with aging, leading inevitably to drug treatment. In medicine there are a lot of annoying but true proverbs to confront: pay me now or pay me later, a stitch in time….., an ounce of prevention….. Enough.
Reported on in The Journal of Clinical Hypertension, July, 2009.
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