I have been diagnosed with high blood pressure, and my doctor has placed me on medication. My blood pressure seems to be improving and better controlled. One of my neighbors had lunch with me recently and was concerned about my diet. Surely I can eat whatever I want to if I am on medications and the blood pressure is improved?
Your neighbor is well informed; medications alone are not the only aspect of high blood pressure treatment. It’s very important to apply lifestyle changes that include a healthful diet, maintaining ideal body weight, regular exercise, and no tobacco or alcohol.
High blood pressure is a common problem. Approximately 1 billion people worldwide have high blood pressure, and this number is projected to increase to almost 1.6 billion by the year 2025. This shows a relentless progression of this dangerous condition. High blood pressure is responsible worldwide for 7.6 million deaths from heart and vascular disease every year.
Blood pressure is produced by the interaction of the heart pumping blood through the blood vessels and the various phases of this process, as well as by the wonderfully created arteries and veins. There are two numbers that are used to record blood pressure: an upper number, or systolic reading, and a lower number, or diastolic reading. The systolic pressure is produced by the pumping action of the heart (ventricular contraction), which pushes blood into all the blood vessels of the body. This is a reflection of the work the heart does to sustain life. The diastolic pressure reflects the drop in pressure when the heart relaxes during diastole (rest phase) and fills again with blood in between each heartbeat. This pressure is dependent on the muscle structure, especially of the smaller arteries (arterioles or resistance vessels), which assist in the maintenance of blood flow.
It’s important to review and know the numbers that define normal blood pressure and when intervention is needed for rising blood pressure readings. There are four categories of numbers:
1. Normal—under 120/80
2. Prehypertension—systolic 120-139, or diastolic 80-89
3. Stage 1 hypertension—systolic 140-159, or diastolic 90-99
4. Stage 2 hypertension—systolic 160 or higher, or diastolic 100 or higher
It’s important to know your numbers because each category has recommendations for steps that need to be taken regarding treatment, starting with lifestyle changes for prehypertension and medications as needed.
High blood pressure is known as the “silent killer” because often there are no symptoms. Therefore it’s vital to know your numbers.
Diet and Hypertension
Your question about diet is pertinent and important. As noted earlier, high blood pressure is becoming more common. In populations of most industrialized countries, high blood pressure increases dramatically with age. Some groups, however, including strict vegetarians whose diet consists mainly of vegetable products and have a low salt (sodium) intake, show no increase in the incidence of high blood pressure with aging.
The association of improved outcomes of hypertension and diet have now been extensively studied. The dietary patterns that have been proven to lower blood pressure place emphasis on fruits and vegetables and low-fat dairy. In addition, they include whole grains, nuts, and unsaturated vegetable oils. The best results are obtained when the salt intake is limited as well (1.2 grams or 1,200 miligrams per day). In the classic studies dietary approaches to stop hypertension (DASH) included poultry and fish, although these can safely be eliminated. Sweets and sugar-containing beverages are discouraged.
Patients following the DASH and other similar diets have better control of blood pressure, and where medications are needed—as they often are—they are more effective and doses may even be lowered.
The take-home message is that medication alone is not adequate treatment for hypertension without lifestyle interventions, and dietary measures are very important in the overall approach.
Reference: New England Journal of Medicine, June 3, 2010, pp. 2102-2112.