Diet can have a big impact on your blood pressure. Following a heart-healthy diet can actively reduce your blood pressure, both in short term and long term. The American Heart Association (AHA) recommend following the DASH diet to help manage blood pressure.

DASH Diet

DASH stands for Dietary Approaches to Stop Hypertension. The diet is simple:

1) Eat more fruits, vegetables, and low-fat dairy foods
2) Cut down foods that are high in saturated fat, cholesterol and trans fat.
3) Eat more whole-grain foods, fish, poultry and nuts
4) Limit sodium, sweets, sugary drinks and red meat.

To start the DASH diet, follow these recommendations (based on 2,000 calories a day).

GRAINS: 7-8 daily servings
VEGETABLES: 4-5 daily servings
FRUITS: 4-5 daily servings
LOW-FAT/FAT-FREE DAIRY PRODUCTS: 2-3 daily servings
MEAT, POULTRY, FISH: 2 or less daily servings
NUTS, SEEDS: 4-5 servings per week
FATS, OILS: 2-3 daily servings
SWEETS: Try to limit to less than 5 servings per week
( 1 tablespoon sugar, jelly, or jam)

How Much Is a Serving?

When you’re trying to follow a healthy eating plan, it helps to know how much of certain kind of food is considered a ‘serving’.
One serving is:

– 1/2 cup cooked rice or pasta (GRAINS)
– 1 slice bread (GRAINS)
– 1 cup raw vegetables or fruits (VEGETABLES)
– 1/2 cup cooked veggies (VEGETABLES)
– 1/2 cup fresh fruit (FRUITS)
– 1/4 cup dried fruit (FRUITS)
– 6 ounces of fruit juice (FRUITS)
– 8 ounces of milk (DAIRY PRODUCTS)
– 1 cup yogurt (DAIRY PRODUCTS)
– 1 teaspoon of olive oil (or any other oil)
– 3 ounces cooked meat
– 2 tablespoon seeds
– 1 tablespoon sugar, jelly or jam (SWEETS)

Reducing Salt Intake

Salt has a tremendous effect on blood pressure, mediated by increased extracellular fluid volume and thickening of the arterial walls. This decreases the diameter of the arteries, thereby making it necessary for the heart to pump the blood under higher than normal pressure. Thereby, restricting the salt in one ‘s diet will reduce blood pressure.

The World Health Organization (WHO) recommend reducing intake to less than 5g a day can decrease the risk of hypertension and related health problems. Lowering salt intake can benefit people both with and without hypertension.

Reducing Alcohol Consumption

Moderate to excessive alcohol consumption can increase blood pressure.
In addition, many alcoholic drinks are high in sugar and calories. Drinking alcohol can contribute to overweight and obesity, which can increase the risk of hypertension.
According to American Heart Association (AHA), a maximum of two alcoholic drinks a day for men, and one for women is suggested. The following would count as one drink:

– 12 ounces of beer
– 4 ounces of wine
– 1.5 ounces of 80 proof spirits
– 1 ounces of 100 proof spirits

Reducing Sugar Intake

Sugar can increase your blood pressure in several ways.
Research shows that sugar and sugar-sweetened drinks contribute to weight gain in adults and children. Overweight and obesity predispose people to high blood pressure.
The AHA recommends the following daily added sugar limits:
– 6 teaspoons/ 25g for females
– 9 teaspoons/ 36g for males

Prevention and Management of Hypertension

1) Weight Reduction

Dietary interventions to lower body weight are often recommended for overweight people with mild hypertension. In people with hypertension, weight reducing diet has been shown to reduce blood pressure and body weight. There is evidence that showed a reduction of 1kg in weight relates to 1 mmHg reduction in systolic blood pressure.

2) Increasing Physical Activity

We should suggest patients to actively involved in exercising to help in controlling their hypertension. Exercise can improves blood circulation, contributes to weight control and eventually  lowers the risk of cardiovascular disease as well.
It is recommended that engage in:
– 150 minutes of moderate intensity, aerobic exercise every week
– 75 minutes of high intensity exercise every week.
Exercise at least 5 days per week with 30 mins each is recommended as exercising 30 minutes daily is associated with a reduction of 4 to 9 mm Hg. Examples of suitable activities are walking, jogging, cycling, or swimming.

3) Cessation of Smoking

The nicotine in cigarette smoke is a big part of the problem. It raises your blood pressure and heart rate, narrows your arteries and hardens their walls, and makes your blood more likely to clot. It stresses your heart and sets you up for a heart attack or stroke. While one is smoking, and the effect is sustained for 5-10 minutes after the cigarette is extinguished which means, a cigarette every 15 minutes would keep the blood pressure elevated.
Advise patient to stop smoking to reduce overall cardiovascular risk. Use of Nicorette nicotine gum is one of the options that can suggest to patient who wish to quit smoking.

4) Managing Stress

When stress is excessive and prolonged, it causes trouble in controlling blood pressure. Avoiding or learning to manage stress can help patients to control blood pressure better.
Exercise is a great way to manage stress. Other activities can also be helpful. These include:
– meditation
– deep breathing
– massage
– yoga
– tai chi
These are all proven stress-reducing techniques. Getting adequate sleep can also help reduce stress levels.

5) Developing a Healthy Diet

A heart-healthy diet is vital for helping to reduce high blood pressure. It’s also important for managing hypertension that is under control and reducing the risk of complications. These complications include heart disease, stroke, and heart attack. A heart-healthy diet are those mentioned above (DASH diet).

6) Compliance to Medication

Some antihypertensive medications will have bothersome side effects that leads to poor patient compliance. If a side effect occurs which is not life threatening, encourage the patient to continue the medication but contact the prescribing physician in order to obtain a more tolerable drug therapy. On the other hand, patients should be educated on the importance of adherence to drug therapy to promote better compliance. Patients should understand that the disease is chronic and that continuous therapy is necessary for the prevention of complications.

7) Regularly Checking Blood Pressure

Measuring your blood pressure is the only way to know whether you have high blood pressure. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it.

How To Use A Home Blood Pressure Monitor

1) Measure your blood pressure twice daily.
The first measurement should be in the morning before eating or taking any medications, and the second in the evening. Each time you measure, take two or three readings to make sure your results are accurate.

2) Be still.
When you’re ready to take your blood pressure, sit for five minutes in a comfortable position with your legs and ankles uncrossed and your back supported against a chair. Try to be calm and not think about stressful things. Don’t talk while taking your blood pressure.

3) Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement
Also, go to the toilet first. A full bladder can increase blood pressure slightly.

4) Make sure your arm is positioned properly. 
Always use the same arm when taking your blood pressure. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You might need to place a pillow or cushion under your arm to elevate it high enough.

5) Place the cuff on bare skin, not over clothing. 
Rolling up a sleeve until it tightens around your arm can result in an inaccurate reading, so you may need to slip your arm out of the sleeve.

6) Take a repeat reading. 
Wait for one to three minutes after the first reading, and then take another to check accuracy. If your monitor doesn’t automatically log blood pressure readings or heart rates, write them down.