High Blood Pressure and the DASH Diet
Susan P. Cohen, MA, RDN
High blood pressure, also known as hypertension, is called the “silent epidemic.” That’s because so many people have it. But because it rarely shows any warning signs or symptoms, it’s easy to miss if you’re not looking out for it. According to the CDC (Centers for Disease Control and Prevention), almost half of the adults in the US have hypertension and most don’t have it under control. High blood pressure can be very dangerous because it increases your risk for a heart attack, stroke, kidney disease, and blindness. This is why regular blood pressure screening and incorporating a healthy diet and lifestyle are so important.
The foods you eat affect so many aspects of your health and it’s never too late to start enjoying a more “heart-healthy” diet. In fact, there is one diet that’s been specially designed to help with high blood pressure. That’s called the DASH diet: Dietary Approaches to Stop Hypertension. And research says it works.
What is blood pressure?
Blood pressure is how much pressure your heart needs to use to keep blood flowing through your vessels. You can think of it as water flowing through a flexible tube versus flowing through a stiff, hard, narrow pipe. Imagine the amount of pressure you would need to push the water through the hose versus the pipe. That’s how blood pressure works. The more force that’s needed, the more pressure it puts on your vessels, and the more damage it can do to the pump and the vessels. This is especially true when high blood pressure persists over many years.
A normal blood pressure reading is 120/80 mm Hg. The first number (in this case, 120 mm Hg) is the systolic pressure in your vessels as your heart beats. The second number (in this case, 80 mm Hg) is the diastolic pressure in your vessels between beats. If your blood pressure is slightly higher than these numbers, that’s considered “elevated.” However, if your blood pressure gets above 130/80 mm Hg, you may be diagnosed with hypertension.
High blood pressure usually develops over many years. It can happen as a result of diabetes or obesity, or not getting enough physical activity. It can also sometimes happen during pregnancy. The good news is that there are ways you can manage high blood pressure and lower your risk for heart disease (angina, heart attack, heart failure), stroke, kidney disease, and vision loss.
Healthy lifestyle for healthy blood pressure
There are several healthy lifestyle habits that can lower your risk for high blood pressure. The first is to not smoke because smoking is associated with many issues including heart issues.
Another lifestyle habit for healthy blood pressure (and your overall health) is to get at least 150 minutes of physical activity every week. That can be done with as little as 30 minutes per day, 5 days per week.
Managing stress in a positive way is another strategy to help maintain healthy blood pressure.
Sodium and your blood pressure
Your blood pressure is impacted by your nutrition. There are several nutrients that can increase or decrease your blood pressure, depending on how much you consume. The nutrients associated with lower blood pressure include the minerals potassium, magnesium, and calcium, along with fiber and protein. The most infamous nutrient linked to increased blood pressure is sodium.
According to the American Heart Association, in general, the more sodium you consume, the higher your blood pressure. Sodium is one part of the salt compound, sodium chloride. One of the biggest sources of sodium in the diet is not from your kitchen salt shaker, but the sodium hidden in processed and packaged foods.
A recent study enrolled 20,995 participants with a history of stroke or high blood pressure to see if using a lower-sodium salt substitute would reduce their risk of stroke, heart incidents, and death. Half of the participants continued to use regular salt over several years, while half of them agreed to use the salt substitute (75% sodium chloride and 25% potassium chloride). After almost most five years, the participants who consumed the lower-sodium salt had fewer strokes, heart incidents, and deaths. Their risks were reduced by 12-14% which is substantial when there are millions of people at high risk from hypertension.
The DASH diet
There is a dietary pattern and food recommendations that have been put together specifically for hypertension. The DASH diet has been deemed one of the best overall diets by U.S. News and is ranked among the top diets in the categories of heart-healthy, healthy eating, diabetes, easy-to-follow, and overall diets. Harvard Health also rated the DASH diet and says, “research supports the use of the DASH diet as a healthy eating pattern that may help to lower blood pressure, and prevent or reduce the risk of cardiovascular diseases, diabetes, kidney disease, and gout.” Some studies show that the blood pressure-lowering effect of the DASH diet can be similar to that of people taking medication for hypertension.
The DASH diet is full of heart-healthy foods with blood-pressure-lowering nutrients. The recommendations for a 2,000 calorie per day intake include:
● whole grains (6-8 servings/day)
● fruits (4-5 servings/day)
● vegetables (4-5 servings/day)
● low-fat dairy (2-3 servings/day)
● meat, poultry, or fish (no more than two 3 oz servings/day)
● fats and oils (2-3 servings/day)
● nuts, seeds, or beans (4-5 servings/week)
● sweets and sugar-sweetened beverages (no more than 5 servings/week)
The DASH diet limits very few foods and nutrients such as sodium, saturated and trans fats, red meat, and sweets (including sugar-sweetened beverages).
As mentioned, the health benefits of eating a DASH diet are vast and include many of the most common diseases impacting adults.
One thing to keep in mind when transitioning to a higher-fiber diet with more whole grains, fruits, and vegetables is to do this slowly in order to reduce your risk of experiencing gas and bloating. This can easily be accomplished by increasing these plant-based foods by one or two per week until you’re eating the recommended amounts.
Final thoughts
If you have high blood pressure or simply want to start a healthier diet to reduce your risk for a whole host of diseases, then the DASH diet may be for you. The DASH diet is rich in foods that are highly nutritious and can help you enjoy a longer life free of stroke, heart disease, kidney disease, blindness, diabetes, and gout. The DASH diet is considered one of the easiest diets to follow and includes simple nutritional improvements like enjoying more whole grains, fruits, and vegetables.
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References
American Heart Association. (2016, October 31). Managing high blood pressure with a heart-healthy diet. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet
Centers for Disease Control and Prevention. (2021, May 18). High Blood Pressure Symptoms and Causes. https://www.cdc.gov/bloodpressure/about.htm
Centers for Disease Control and Prevention. (2021, September 27). High blood pressure: Facts about hypertension. https://www.cdc.gov/bloodpressure/facts.htm
Harvard Public Health. (n.d.). Diet review: DASH. https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/dash-diet/
Mandrola, J. M. and Neal, B. (2021). Will the Positive Findings From the SSaSS Trial on Salt Substitution Silence the Salt Skeptics? Medscape. https://www.medscape.com/viewarticle/957510#vp_1
National Heart, Lung, and Blood Institute. (n.d.). DASH Eating plan. https://www.nhlbi.nih.gov/health-topics/dash-eating-plan
Neal, B., Wu, Y., Feng, X., Zhang, R., Zhang, Y., Shi, J., Zhang, J., Tian, M., Huang, L., Li, Z., Yu, Y., Zhao, Y., Zhou, B., Sun, J., Liu, Y., Yin, X., Hao, Z., Yu, J., Li, K. C., Zhang, X., … Elliott, P. (2021). Effect of Salt Substitution on Cardiovascular Events and Death. The New England journal of medicine, 385(12), 1067–1077. https://doi.org/10.1056/NEJMoa2105675
https://www.nejm.org/doi/10.1056/NEJMoa2105675
U.S. News. (n.d.). Best diets 2021. https://health.usnews.com/best-diet
U.S. News. (n.d.). DASH diet. https://health.usnews.com/best-diet/dash-diet