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If Your Doctor Orders a Diet to Lower Your High Blood Pressure

Holly Alley, MS, RD, LD
Nutrition Specialist,
Department of Food and Nutrition

If you have high blood pressure, your doctor may prescribe a special diet for you. The following information is provided to help you with that diet. To lower blood pressure, you'll need to eat a diet low in sodium, fat and saturated fat. And you'll need to keep your weight down. The following information is provided to help you with that diet.

WHAT IS HIGH BLOOD PRESSURE?

Blood pressure is the force of blood as it moves through the blood vessels. If blood cannot flow easily through the vessels, the force on the vessel wall is increased. If the force is too high, you have high blood pressure. Another name for high blood pressure is hypertension. High blood pressure is a serious disease that cannot be cured, but can be controlled. If left uncontrolled, high blood pressure increases your risk of heart disease, stroke, kidney problems, and blindness. It is often called the silent killer because it has no symptoms. It doesn't hurt, and it usually doesn't make a person feel sick, dizzy or nervous. The only way to know if you have high blood pressure is to have your blood pressure checked by a health professional.

Having your blood pressure measured is quick and painless. It is done by placing a cuff around your arm and measuring the force of blood against the inflated cuff. Your blood pressure is recorded in two numbers. Your systolic pressure is the first recorded number (or the number on top) and is the pressure in the blood vessel when the heart is pumping. Your diastolic pressure is the second (or bottom) number and is the pressure in the blood vessel when the heart is resting between beats. If your blood pressure reading is consistently 140/90 mm Hg (millimeters mercury) or higher, or if either number is higher, you have high blood pressure.

Uncontrolled High Blood Pressure can lead to:

• heart failure
  

• heart attack
  

• stroke
  

• blindness
  

• kidney failure
  

HOW IS IT TREATED?

High blood pressure may be lowered in a variety of ways. Your doctor may recommend weight loss if you are overweight, exercise and a special diet. The diet is probably low in sodium, fat, and saturated fat. It may also be high in potassium. Drugs to lower blood pressure may also be prescribed. The drugs work with diet, exercise and weight loss. Drugs do not replace the need to watch your diet and exercise habits.

Some people have side effects from the drugs they take. If you do, talk to your doctor about it. Some side effects can be minimized by taking the drug with food, taking a smaller dose more times during the day, or by changing the type of drug.

ABOUT THE DIET

A major part of the treatment of high blood pressure is diet. If you are overweight, you may be able to lower your blood pressure by losing weight. The best way to lose weight is to eat fewer calories and exercise regularly. (However, before you begin an exercise program, be sure to get your doctor's recommendation for the type and amount of exercise best for you). Since fat provides more calories than any other nutrient, one of the best ways to lose weight is to eat less fat.

Eating a diet low in fat, especially saturated fat, may also help you lower your blood pressure. Only 30% of your total calories should come from fat with less than 10% of total calories from saturated fat. Ask your dietitian to help you figure how much fat you can eat based on the number of calories your doctor has prescribed for you. Here is a chart to show how many grams of fat are equal to 30% of total calories and how many grams of saturated fat would equal 10% of total calories for different calorie levels:

The main nutrient linked to high blood pressure is sodium. Decreasing sodium in the diet helps some people lower their high blood pressure. About 20% of Americans are thought to be "sodium-sensitive." That means that they have an inherited tendency to get high blood pressure when they eat a diet high in sodium. And they can lower their blood pressure by eating a low-sodium diet. Unfortunately, we don't always know who is sodium-sensitive. If all people would eat a diet low in sodium, there would probably be fewer people with high blood pressure.

Not everyone can lower their blood pressure to normal by eating a low-sodium diet. Antihypertensive drugs may be necessary. But even if you take drugs to lower your blood pressure, you need to eat a diet low in sodium. This helps the drugs work more effectively.

Salt is probably the biggest source of sodium in your diet. Salt is 40% sodium. One teaspoon of salt contains 2000 mg of sodium. Your body needs some sodium from your diet, at least 500 mg a day, but most people get much more than they need. Try to limit the amount of sodium in your diet to less than 2000 mg a day, unless your doctor prescribes a different amount.

Here is a guide to help you keep the sodium in your diet to less than 2000 mg per day:

MILD SODIUM RESTRICTED DIET - 2000 MG. SODIUM
(Also low in fat and saturated)

This diet follows a normal dietary pattern with the daily sodium intake limited to about 2000 milligrams. No salt is served with meals. Very salty foods are omitted. This diet limits foods such as processed cheese, cured or smoked meats, pickles, olives and sauerkraut. Other foods are restricted in amounts because of high natural sodium content.

The average sodium content is listed for each food type. It is the total amount of sodium expected if the minimum recommended number of servings is eaten from the allowed list. Some people may eat more than the minimum number of servings listed. Their average sodium intake would then be more.

Here is a sample 2100 calorie sample menu that contains less than 2000 mg sodium. This diet is only 24% fat and 6% saturated fat. It contains over 3000 mg potassium and over 1300 mg calcium.

Breakfast:

1 1/2 cups toasted oat cereal (or other lower sodium cereal)
1 cup skim milk
1 banana
1/2 cup orange juice
1 cup coffee with 1 teaspoon sugar

Lunch:

tuna sandwich with:
2 ounces salt-free water-packed tuna, drained
2 slices whole wheat bread
tomato and cucumber slices
1 cup julienne carrot and zucchini strips
1 cup chow mein noodles (a low-sodium alternative to chips)
ice tea
4 graham crackers

Supper:

1 serving homemade lasagna (made with 2 ounces ricotta cheese, 1/2 cup low-sodium tomato sauce, 2 ounces ground beef,drained, 1 cup lasagna noodles, 1 tablespoon parmesan cheese, seasoned with oregano, pepper, parsley, basil, garlic, and onion)
2 slices French bread toasted with 1 teaspoon margarine and garlic powder (not garlic salt)
1/2 cup greens, cooked in low-sodium bouillon
1 cup tossed salad
1 tablespoon vinegar and olive oil dressing (pepper, herbs and other no-sodium seasonings may be added)
ice water

Snack:

1 cup frozen fruit yogurt

IN ADDITION TO SODIUM...

In addition to restricting sodium, you may need to get extra potassium in your diet, depending on the kind of drug you are taking to control your high blood pressure. These foods are high in potassium, yet low in sodium:

• banana
  

• cantaloupe
  

• grapefruit
  

• oranges
  

• watermelon
  

• potatoes
  

• broccoli
  

• brussel sprouts
  

• greens
  

• carrots
  

• peaches
  

• tomatoes
  

Low calcium diets have also been linked to high blood pressure. Some people may be "calcium sensitive." That means that if they don't get enough calcium, they are more likely to have high blood pressure. Be sure to get plenty of calcium in your diet. The Recommended Dietary Allowance for calcium for adults 25 years old and over is 800 mg per day. Many adults can drink 2 cups of regular milk to help them get the calcium they need without going over their sodium limit. If your doctor has prescribed a diet that allows less than 2000 mg sodium, you may need to use low-sodium dairy products. Rich calcium sources include skim, 1%, and low-fat milk, low-sodium cheeses, and low-fat yogurt.

EXERCISE HELPS TOO

Regular exercise, in addition to helping with weight loss can also help lower blood pressure. Try to exercise for 20 minutes or more, at least three times a week. Be sure to check with your doctor before starting an exercise program.

CAUTION - ALCOHOL

Drinking alcoholic beverages in excess of one or two drinks a day may increase your blood pressure. Alcohol may also increase your risk of having a stroke if you have high blood pressure. Talk to your doctor about the safety of drinking alcoholic beverages.

Sources:

Boyle, MA and Whitney, EN, 1987. Nutrition and Hypertension, Nutrition Clinics, 2:1-17, George F. Stickley Co. Philadelphia, PA.

Martin, JE, Dubbert, MD, and Cushman, WC, 1990. Controlled Trial of Aerobic Exercise in Hypertension, Circulation 81:1560-1567

American Heart Association, 1982. Facts About Potassium

Georgia Dietetic Association, 1987. Diet Manual, Section 6:1-17

Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, The University of Georgia College of Agriculture and the U.S. Department of Agriculture cooperating.

Reprinted with permission from the University of Georgia.
Alley, H. (1992). If Your Doctor Orders a Diet to Lower Your High Blood Pressure. Athens, GA: University of Georgia, Cooperative Extension Service.

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