Dietary & Lifestyle Changes for Hypertension
Hypertension, or high blood pressure, is a common health condition that can increase the risk of heart disease, stroke, and other health problems. Diagnosis and management of high blood pressure are essential for preventing chronic disease and reducing the risk of cardiovascular disease.
Nearly half of American adults have hypertension. It is estimated that 46% of adults with high blood pressure are unaware they have it, and only 21% of adults have their hypertension under control.
Nutrition plays an important role in managing hypertension. Here are some tips for a healthy diet for hypertension:
1. Reduce sodium intake: Sodium can raise blood pressure, so it is important to limit sodium intake. The American Heart Association recommends no more than 2,300 milligrams of sodium per day for most adults. However, if you have hypertension, you may need to further limit your sodium intake to 1,500 milligrams per day.
2. Increase potassium intake: Potassium can help lower blood pressure by counteracting the effects of sodium. Good sources of potassium include fruits, vegetables, and low-fat dairy products.
3. Fiber is key: Eat at least 25 to 30 grams/day. Fiber can help regulate blood pressure by reducing the amount of sodium in the body, promoting healthy blood flow, and reducing inflammation. Soluble fiber has been shown to be particularly effective in reducing blood pressure levels. Foods high in soluble fiber include oats, beans, lentils, and some fruits and vegetables.
4. Eat a diet rich in fruits and vegetables: Fruits and vegetables are rich in vitamins, minerals, and antioxidants that can help lower blood pressure. Aim for at least five servings of fruits and vegetables per day.
5. Choose whole grains: Whole grains are a good source of fiber, which can help lower blood pressure. Choose whole-grain bread, pasta, and cereal.
6. Limit alcohol intake: Drinking too much alcohol can raise blood pressure. If you choose to drink alcohol, do so in moderation. The American Heart Association recommends no more than one drink per day for women and no more than two drinks per day for men.
7. Reduce intake of saturated and trans fats: These fats can raise cholesterol levels and increase the risk of heart disease. Choose lean protein sources, such as plant protein, tofu, skinless chicken, and fish. Limit red meat and full-fat dairy products.
8. Monitor portion sizes: Eating too much can lead to weight gain, which can increase blood pressure. Use a food scale or measuring cups to monitor portion sizes.
9. Maintain a healthy gut & oral microbiome: Intestinal dysbiosis (imbalance between good and bad gut bacteria) is associated with the translocation of gut microbes into vascular tissues, resulting in systemic inflammation, lipid and blood sugar dysregulation, atherosclerosis, hypertension, and a generally increased risk of cardiovascular disease.
Additionally, nitric oxide, a natural vasodilator, requires a healthy balance in oral flora for sufficient endogenous production. Research suggests that nitric oxide deficiency is the first step in hypertension pathogenesis.
Dietary patterns that are beneficial in the treatment of hypertension:
1. The Dietary Approaches to Stop Hypertension (DASH) diet is a dietary pattern high in vegetables, fruits, low-fat dairy, whole grains, poultry, fish, and nuts. By emphasizing these foods, it is inherently rich in potassium, magnesium, calcium, protein, and fiber and low in saturated fat, refined sugars, and sodium.
2. The Mediterranean diet is a dietary pattern that emphasizes the consumption of fruits, vegetables, whole grains, legumes, nuts, fish, and olive oil. It is associated with numerous health benefits, including a reduced risk of hypertension. The beneficial effects of the Mediterranean diet on blood pressure may be due to the high content of polyunsaturated and monounsaturated fatty acids, fiber, and antioxidants in the foods that are part of the diet. These nutrients are thought to help reduce inflammation, improve endothelial function, and promote vasodilation, all of which can contribute to lower blood pressure levels.
3. A whole-foods, plant-based dietary pattern (“vegan”) can lead to lower blood pressure readings and a reduced risk of developing hypertension. This is likely because a vegan diet is typically lower in saturated and trans fats, which are found in animal products and can contribute to high blood pressure. Additionally, a vegan diet tends to be higher in plant-based foods, such as fruits, vegetables, and whole grains, which are rich in nutrients and antioxidants that can help protect against hypertension.
Remember, making dietary changes alone may not be enough to manage hypertension. It is important to also exercise regularly, manage stress, and follow any medication regimen prescribed by your healthcare provider.
Here are some lifestyle changes that can help reduce blood pressure:
1. Exercise regularly: Regular exercise can help lower blood pressure by strengthening the heart and reducing stress on the blood vessels. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
2. Maintain a healthy weight: Being overweight or obese can increase blood pressure, so maintaining a healthy weight through a balanced diet and exercise can help reduce blood pressure. For every 1 kg of weight lost, blood pressure decreases 1 mmHg.
3. Quit smoking: Smoking can damage blood vessels and increase blood pressure, so quitting smoking can help lower blood pressure and reduce the risk of heart disease.
4. Manage stress: Chronic stress can increase blood pressure, so finding ways to manage stress such as meditation, yoga, or deep breathing exercises can be helpful.
5. Prioritize good quality sleep: There is a relationship between sleep and hypertension. Chronic sleep deprivation or poor sleep quality can increase the risk of developing hypertension, and hypertension can also disrupt sleep.
Research has shown that getting less than 6 hours of sleep per night can increase the risk of developing hypertension. This is because during sleep, the body repairs and rejuvenates itself, including the blood vessels. Without enough sleep, blood vessels can become less flexible and more prone to damage, which can lead to high blood pressure over time.
Additionally, sleep apnea, a condition in which a person's breathing repeatedly stops and starts during sleep, can also increase the risk of hypertension. This is because the disruptions in breathing can cause changes in blood pressure, and the reduced oxygen supply to the body during sleep apnea can also have negative effects on the cardiovascular system.
On the other hand, hypertension can also disrupt sleep. People with hypertension may experience more sleep disturbances, such as snoring, sleep apnea, and insomnia. They may also wake up frequently during the night or have trouble falling asleep.
6. Check your meds: Drug-induced hypertension is a significant contributor to secondary hypertension; common offenders include the following:
Nonsteroidal anti-inflammatory drugs and acetaminophen
Sodium-containing antacids
Stimulant medications used to treat ADD/ADHD
Antidepressants
Atypical antipsychotics
Decongestants containing phenylephrine or pseudoephedrine
Appetite suppressants
Systemic corticosteroids
Estrogens (including oral contraceptives) and androgens
Nicotine
Herbal supplements: St. John's wort, Yohimbe, licorice, and ephedra
It's important to note that while some nutritional supplements may be helpful in managing hypertension (high blood pressure), they should not be used as a substitute for prescribed medications and lifestyle changes. Always consult with your healthcare professional before adding any supplements to your routine.
Here are some nutritional supplements that may be beneficial for hypertension:
1. AMLA (Indian gooseberry)
2. Omega-3 fatty acids
3. L-arginine
4. Vitamin C
5. Cocoa Flavonoids
6. Beetroot juice
7. Melatonin
8. Coenzyme Q10 (CoQ10)
9. Magnesium
10. Potassium
11. Garlic (Allicin)
12. Berberine
13. Soluble fiber