BLOOD PRESSURE

EAT PLENTY OF
• Fresh vegetables, fresh and dried fruits, legumes, and dairy products, for potassium.
• Recommended foods as part of the DASH diet

LIMIT
• Canned and other processed foods with added salt.
• Fatty foods.

AVOID
• Pickled and very salty foods
• Excessive alcohol and caffeine.

As blood circulated through the body, it exerts varying degrees of force on artery walls; doctors refer to this as blood pressure. Over 60 million North Americans have blood pressure that is too high, or hypertension. In its early stages, high blood pressure is symptomless, so many people don’t realize they have a potentially life-threatening disease. If the condition goes unchecked, high blood pressure damages the heart and blood vessels and can lead to a stroke, heart attack, and other serious consequences.
In about 5 percent of cases, there’s an underlying cause for high blood pressure; for example, a narrowed kidney artery, pregnancy, an adrenal gland disorder, or a drug side effect. Most often there is no identifiable cause; this is referred to as primary, or essential, hypertension.
Blood pressure rises when the arterioles, the body’s smallest arteries, narrow or constrict, requiring the heart to beat more forcefully in order to pump blood through them. Increased blood volume, often due to the body’s tendency to retain excessive salt and fluids, raises blood pressure; so do high levels of adrenaline and other hormones that constrict blood vessels.
Monitor underlying factors. With age, blood pressure rises somewhat, but no one fully understands precisely what leads to hypertension, although a combination of factors seems to be involved. Because it tends to run in families, an inherited susceptibility is suspected. Diabetes, obesity, and certain other disorders increase risk. Stress prompts a surge in adrenal hormones and a temporary rise in blood pressure; some researchers believe that constant stress may play a role in developing hypertension. Other contributors include smoking, excessive alcohol, and a sedentary lifestyle.
There is little doubt that keeping blood pressure at normal levels makes a difference in the quality and length of life. Cardiovascular disease death rates, which had been steadily declining since the 1960s, thanks largely to life-style changes and improvements in hypertension treatment, are now on the increase again.

DIET AND HYPERTENSION
Diet plays a role in both prevention and treatment of high blood pressure, experts now agree. Simple things can help keep your blood pressure in check.
Limit your salt intake. A high-salt diet also contributes to the condition in people who have a genetic tendency to retain sodium; in these individuals, restriction of salt beginning at an early age reduces the risk of developing hypertension. A portion of the population, including older people and people with diabetes, appears to be particularly sensitive to sodium and may benefit significantly from eating low-sodium foods. Experts disagree to how much salt is too much; many recommend no more than 2400mg of sodium each day for healthy individuals. The best way to reduce sodium intake is to avoid adding salt, and to avoid most processed foods, which are usually loaded with sodium. Check labels carefully look for the term “sodium” to find hidden salt. In addition to avoiding salty and pickled foods, use herbs and spices in cooking.
Keep your weight down. Being even slightly overweight contributes to hypertension; lowing excess weight is often all that is needed to return blood pressure to normal. Even a modest weight loss will cause a drop in blood pressure.
Eat less fat. A high-fat diet not only leads to weight gain but may also contribute to high blood pressure. Limit fat intake to 30 percent or less of total calories. With 10 percent or less coming from saturated animal fats. This means cutting back on butter and margarine; switching to low fat milk and other low fat dairy products; choosing lean cuts of meat; and shifting to low fat cooking methods, such as broiling instead of frying.
Reduce alcohol and caffeine consumption. Although a glass of wine or other alcoholic drink daily seems to reduce the chance of a heart attack, consuming more than this will negate any benefit and may increase the risk of hypertension. Too much caffeine can also raise blood pressure. Older adults with hypertension may be more sensitive to the effects of caffeine and should limit their intake.
Mind your minerals. Some nutrients may protect against high blood pressure. Potassium, an electrolyte that helps maintain the body’s balance of salt and fluids, helps ensure normal blood pressure. Potassium can be found in fruits and vegetables, dairy products, and legumes.
Some studies have linked calcium deficiency to hypertension; the diet should provide two to three servings of low fat milk products a day.
Get more garlic. Other research appears to validate the claims that garlic may lower blood pressure. The amount of garlic necessary to lower blood pressure, however, can cause other problems especially unpleasant breath and body odor. Although garlic is available in odorless pills, it is not known if these pills produce the same benefits as eating garlic fresh or lightly cooked. A further problem with garlic supplements is that the lack of government regulations means there is no assurance that the product in the bottle matches the contents on the label.

OTHER LIFESTYLE CHANGES
While a proper diet is instrumental in maintaining normal blood pressure, it should be combined with other lifestyle changes. One of the most important is regular aerobic exercise, which lowers blood pressure by conditioning the heart to work more efficiently. If you smoke, give up the habit. Nicotine raises blood pressure. Quitting can drop blood pressure by 10 points or more.
Use medications with caution. Over the counter cold, allergy, and diet pills can raise blood pressure. In some women, birth control pills, or estrogen replacement therapy can cause high blood pressure.
Reduce stress. Experts continue to debate the role of stress in hypertension. There is no doubt that stress temporarily raises blood pressure, and some experts think that it may have a long term effect. Meditation, yoga, biofeedback training, self-hypnosis, and other relaxation techniques may help lower blood pressure. Studies have found that people with pets have lower blood pressure than non-pet owners.

DRUG THERAPY
Doctors usually recommend 6 months of life-style changes to see if mild to moderate hypertension returns to normal levels. If not, drug therapy is often instituted. There are dozens pf antihypertensive drugs and doctors can usually find one or a combination that lowers blood pressure with minimal adverse side effects. The most widely used drugs are diuretics, which reduce salt and fluid volume by increasing the flow of urine. Some classes of drugs reduce the heart’s workload be helping to widen, or dilate, the arterioles to increase blood flow; others regulate nerve impulses to slow the pulse.
It is also important to treat disorders that contribute to high blood pressure; these include diabetes and elevated blood cholesterol, both of which compound the risk of developing heart problems. Dietary and other lifestyle changes that lower high blood pressure also help to control diabetes and blood cholesterol levels.

DID YOU KNOW? CALCIUM LEVELS MAY BE LINKED TO BLOOD PRESSURE Recent studies indicate that individuals with low levels of calcium are greater risk of high blood pressure. A diet that includes figs, cooking greens, broccoli, and dairy products, will raise levels of calcium. DRY-ROASTED SOY NUTS CAN REDUCE BLOOD PRESSURE These snacks don’t merely nudge your blood pressure down a tad. According to research presented to the American Heart Association in November 2003, eating a half-cup a day can drop your blood pressure readings as much as some prescription blood pressure medications.

CHECK IT OUT All adults over age 40 should have their blood pressure checked annually. But just one blood pressure measurement is insufficient to diagnose hypertension unless the reading is in the severe range. Some people also have “white coat” hypertension, in which their blood pressure rises when they are in a doctor’s office but is normal at other times. In order to properly diagnose hypertension, several measurements are needed—taken at different times and perhaps in different places.

UNDERSTANDING BLOOD PRESSURE MEASUREMENTS