Hypertension (High Blood Pressure) and Diet

 High Blood Pressure, smoking and high cholesterol are the three main modifiable risk factors coronary heart disease and hypertension is the single largest risk factor for stroke.

What is High Blood Pressure?

High blood pressure occurs when the vessels through which your blood flows become too narrow, or the volume of the circulating blood is too high. Increased blood pressure increases the workload on the heart and can damage the lining of the blood vessels.

How can you Lower your Blood Pressure with Diet?

Weight Loss

Weight loss of 5-10% of body weight can reduce systolic pressure (SBP) and diastolic pressure (DBP) by 5mmHg. A sustained weight loss of 10kg is associated with a reduction in SBP of up to 20mmHg. A slow and sustainable approach to weight loss is best advised and can be helped with the support of Dietitian.

Alcohol

Evidence shows us that alcohol has a direct impact on increasing blood pressure.

Salt Intake

Salt is a major contributor to high blood pressure. Studies have shown that a reduction in salt intake from10g to 5g per day would be expected to decrease stroke risk by 23%. The World Health Organisation (WHO) recommend a target for salt intake at less than or equal to 5g per day.

DASH (Dietary Approaches to stop Hypertension)

The DASH diet is high in vegetables and fruit, low fat dairy products, wholegrain carbohydrates, nuts and seeds and is limited foods high in saturated fats and refined sugar. The DASH diet increases protein, fibre, calcium and magnesium and reduces saturated fat and sugar. There is significant evidence which show us that the DASH diet is effective in reducing blood pressure.

How can we Adopt the DASH diet?

1.     Salt

·       Adults should have no more than 5 grams of salt a day – about one teaspoon.

·       It is the sodium in salt that contributes to high blood pressure, and it is present in all types of salt including sea salt, flakes, crystals and flavoured salt-see the list below for alternative ways to flavour food when cooking. Putting work in a varied herbs and spices rack will be helpful here.

·       Avoid adding salt to food.

·       Limit ready meals and take aways.

·       Salt is used to preserve the shelf life of processed foods, so it is important to become familiar with reading food labels-see guide below.

Reading food labels

The salt content of a product is found on the food label under ‘nutritional content’.

Always look at the salt content per 100g of the product.

Sometimes, salt will appear on the product labels as 'sodium'. If this is the case, you must multiply the sodium value by 2.5 to get the salt content.

High/100g Medium/100g Low/ 100g

Salt 1.5g (or more) 1.3-1.5g 0.3g (or less)

Sodium 0.6g (or more) 0.1-1.6g 0.1g (or less)

Alternative Ways to Flavour Food

Herbs (e.g. parsley, basil, rosemary, bay leaf, mixed herbs) and spices (e.g. turmeric, cardamom, cayenne pepper, all spice etc), unsalted butter, black pepper, onion, garlic, chives, mustard, vinegars, fruit e.g. lemon/ apples/ oranges. Apple, cranberry and mint sauces. Tomato puree. Salt Free stock cubes

2. Increase Fibre Intake

Include more Fruit and Vegetables, Wholegrains, Nuts, Seeds and Pulses    

Fruit and Vegetables are rich in potassium, magnesium and fibre. Fibre helps to promote a healthy gut microbiome and improves overall digestion. It helps to promotes satiety which can reduce sugar cravings and manage appetite which helps with weight management. Aim for half of your plate to be vegetables at lunch and dinner as a guide.

Wholegrain foods like wholegrain breads, brown pasta/rice and oats are high in fibre, potassium and magnesium. See recipe for porridge bread on website for a low salt bread alternative.

Adding Beans, Peas and Lentils is a great way to boost fibre intake. See recipe on the website for lentil dahl and homemade hummus.

3. Omega 3

Omega 3 fats have anti-inflammatory properties which can help with cardiovascular health. There are three main types of omega-3s; DHA, EPA and ALA. DHA and EPA are found in oily fish such as salmon, sardines and mackerel. Aim to include oily fish 1-2 per week. ALA is found in flaxseed and walnuts. Consider adding flaxseed to cereal or yoghurt and walnuts can be easily included as a snack alongside a piece of fruit.

Dietary supplements such as calcium, magnesium and potassium are not recommended for reducing blood pressure, as consuming more than you need can be harmful. Talk to your doctor if you are thinking about taking a supplement.

What other lifestyle changes can lower blood pressure?

Improving cardiovascular fitness can help reduce blood pressure. Try to build more physical activity into your daily routine. If you are struggling to incorporate regular exercise to suit your current fitness levels, support from a physiotherapist may be helpful.

It is also important to consider the role of stress in managing your blood pressure. Feeling stressed for a period can raise blood pressure for a short time, which is normal. However, if this is prolonged over a longer time and causes behaviours linked to stress like overeating, eating too much salt, drinking too much alcohol and not being active enough can lead to long term high blood pressure.

Here are some of the supports available around stress management provided by the HSE.

https://www2.hse.ie/mental-health/issues/stress/

Note

Dietary changes for reducing blood pressure should be included as part of an agreed plan with your GP who may also advise the use of medications to manage blood pressure.