and Fact Sheet No. 9.318 Food and Series|Health by L. Bellows and R. Moore* What is Hypertension? • Secondary Hypertension— Quick Facts Hypertension, also known as high blood Hypertension that arises as a result of • Hypertension, or high blood pressure, affects one in three adults in the another disease, most often associated pressure, is called the “silent United States, while only half are treated with the endocrine system (the body’s for this condition. An additional 25% of gland system, responsible for secreting killer” because it can go adults have blood pressure readings that are hormones). Secondary hypertension undetected for years. considered pre-hypertensive, placing them may be resolve with treatment of the underlying condition. • Hypertension is associated at risk for hypertension and cardiovascular with a high intake and disease. Hypertension can occur at any age, excess body fat. and the risk rises as one continues to age. Hypertension Management Blood pressure is the force exerted on and Prevention • Maintaining a artery walls from blood flowing through the can prevent or manage Hypertension can be controlled through body. A blood pressure reading provides hypertension in many lifestyle changes and prescriptive medication. two measures, systolic pressure and diastolic individuals. pressure, which are expressed as millimeters While medications to treat hypertension are of mercury (mm Hg). Systolic pressure is available, research has shown that modest • For healthy individuals, the measured as the heart pumps. Diastolic lifestyle and dietary changes can help treat Dietary Recommendations pressure is measured between beats, as blood and often delay or prevent high blood suggest consuming no more pressure. flows back into the heart. than 2,300 milligrams of In addition to healthy weight High blood pressure, or hypertension, has sodium per day, while those no symptoms, and is often called the “silent maintenance, avoiding tobacco, and limiting alcohol intake (no more than 2 drinks per with certain risk factors should killer” because it can go undetected for years consume no more than 1,500 until a fatal heart attack or stroke occurs. day for men, and 1 drink per day for women), milligrams of sodium per day. Untreated hypertension causes damage to moderate physical activity for 30-45 minutes blood vessels over time. This can lead to on most days is also recommended. • Healthy potassium, other health complications such as stroke, magnesium, and calcium Hypertension Diet Plan- Five Dietary kidney failure, impaired vision, heart attack, Recommendations intakes have important, or . Blood pressure levels should protective roles in the risk for 1. DASH dietary pattern—The DASH be closely monitored and checked regularly. high blood pressure. Table 1 shows how to classify blood pressure (Dietary Approaches to Stop Hypertension) readings. dietary pattern is recommended by the • The DASH dietary pattern American Heart Association, and the (Dietary Approaches to Types of Hypertension National Cancer Institute. The DASH diet is Stop Hypertension) is • Essential Hypertension or Primary an overall eating plan that focuses on eating highly recommended for Hypertension—Hypertension of an twice the average daily amount of fruits, hypertension prevention and vegetables, complex carbohydrates and unknown cause, which may be the result management. of a combination of poor lifestyle choices low-fat dairy products (Table 2). The DASH and genetics. Lifestyle factors that may dietary pattern is lower in fat, saturated play a role include poor diet (high fat, cholesterol, and sodium, and higher in sodium, low fruit and vegetable intake), potassium, magnesium, and calcium than the typical American diet. The high levels tobacco use, limited physical activity, © Colorado State University of potassium, magnesium, and calcium in stress, and overweight/. Extension. 11/98. Revised 2/13. the DASH diet are thought to be at least partially responsible for its results. Under www.ext.colostate.edu * L. Bellows, Colorado State University Extension food and the DASH 2 low sodium diet, people with nutrition specialist and assistant professor; and R. Moore, graduate student, food science and . 2/2013 Stage 1 hypertension were able to lower An increased intake of calcium and their blood pressure as much or more than magnesium may have blood pressure Summary any anti-hypertensive medication had been lowering benefits, especially if achieved Hypertension has no symptoms, and through the DASH dietary pattern. able to decrease it. For more information over half of those with this condition on the DASH diet, see fact sheet DASHing However, research is not yet conclusive are not currently treated. to Lower Blood Pressure. and there are no specific recommendations 2. Regulation of caloric intake—A for calcium and magnesium at this time. Untreated hypertension may lead reduction in daily caloric intake is Instead, general recommendations suggest to many health problems, including associated with a significant decrease meeting the Adequate Intake (AI) for damage to blood vessels that may in systolic and diastolic blood pressure calcium and the Recommended Dietary lead to heart failure. levels. Following the DASH diet (see Allowance (RDA) for magnesium, through recommendation #1) may help one regulate food sources instead of supplements It is possible to control high blood daily calorie consumption, and may have (Table 3). pressure through a healthy diet and a greater effect in reducing blood pressure 5. Dietary fat—Current lifestyle that includes physical activity, than following a low-fat diet alone. Along recommendations for dietary fat include avoiding tobacco, and limiting alcohol with drug therapy, weight reduction should decreasing intake of saturated fat and trans consumption. be a primary goal. Weight maintenance fat as well as overall intake of dietary fat. may reduce the time and number of drugs These recommendations are geared towards An important dietary recommendation necessary to control blood pressure. healthy weight maintenance. Although for prevention or management of 3. Low sodium diet—A decrease research concerning the effects of omega-3 hypertension is following the DASH in sodium (a major component of salt) fatty acids has not shown any beneficial dietary pattern. is associated with a decrease in blood effect towards lowering blood pressure, it is pressure. The current Dietary Guidelines still an essential fat to incorporate into one's Additional recommendations include recommend consuming no more than diet. For more information on how dietary following a low sodium diet, regulating 2,300 milligrams of sodium per day. Special fat and cholesterol affect the diet, see fact caloric intake, reducing dietary fat, recommendations for those with high sheet Dietary Fat and Cholesterol. increasing potassium, calcium, and blood pressure, who are African American, magnesium through a diet rich in fruits middle aged, or elderly, are advised to References and vegetables. consume no more than 1,500 milligrams of sodium per day. Following the DASH Advanced Nutrition: Macronutrients, dietary pattern, as well as consuming less Micronutrients, and Metabolism (2009). than 1,500 milligrams of sodium per day, CRC Press, Taylor & Francis Group. has been shown to lower and maintain a Biochemical, Physiological, Molecular normal blood pressure. Aspects of Human Nutrition (2006). Those looking to reduce salt Saunders, Elsevier Inc. consumption should choose minimally Duyff, ADA . American Dietetic processed foods, examine food labels Association: Complete Food and for sodium content, and use alternative Nutrition Guide. Hoboken: John Wiley seasonings to flavor foods. For more & Sons, Inc., 2006. information on how sodium affects the diet, Mahan, L. K., Escott-Stump, S., Raymond, see fact sheet Sodium in the Diet. J. L., & Krause, M. V. (2012). Krause's 4. Potassium, calcium, and food & the nutrition care process. St. magnesium—Potassium works with Louis, Mo: Elsevier/Saunders. sodium to regulate the body’s water U.S. Department of Agriculture and balance. Research shows that a high U.S. Department of Health and potassium-to-sodium ratio is associated Human Services. Dietary Guidelines with a greater likelihood that normal for Americans, 2010. 7th Edition, blood pressure will be maintained. The Washington, DC: U.S. Government recommended intake of potassium for Printing Office, December 2010. adults is 4.7 grams/day. However, evidence does not suggest that those with high blood pressure should take potassium supplements. Instead, potassium rich foods such as leafy green vegetables, root vegetables like potatoes and , and fruit, should be eaten everyday (Table 3). For more information on how potassium affects the diet, see fact sheetPotassium and the Diet. Table 1. Blood Pressure Readings—Know Your Numbers. Systolic (mm HG)a Diastolic (mm HG)a Normal <120 and <80 Prehypertension 120 - 139 or 80 - 89 Hypertension Stage 1c 140 - 159 or 90 - 99 Stage 2d ≥160 or ≥100 Based on two readings taken 5 minutes apart with a confirmation reading in the contralateral arm. a mm HG – How high the pressure of blood would raise a column of mercury. b Prehypertension – At risk for developing hypertension and . c Stage 1 – The most common level seen in adults, this group is most likely to have a heart attack or stroke. d Stage 2 – A serious form of hypertension that requires immediate treatment.

Table 2. The DASH (Dietary Approaches to Stop Hypertension) Dietary Pattern. Food Group Daily Servings Important Components for Lowering Blood Pressure Whole grains and grain products 7 - 8 Carbohydrates and fiber Vegetables 4 - 5 Potassium, magnesium and fiber Fruits 4 - 5 Potassium, magnesium and fiber Low-fat or fat free milk or milk products 2 - 3 Calcium, protein, potassium and magnesium Lean meats, poultry and fish 2 or less Protein and magnesium Nuts, seeds and beans 4 - 5 a week Magnesium, potassium, protein and fiber Source: “DASH Diet Eating Plan” www.dashdiet.org. Table 3: Follow the DASH dietary pattern. Choose a variety of foods that are low in sodium and dietary fat, and high in potassium and calcium. Food Group Levels (high or low) found in food groups Dietary Fat Sodium (Na) Potassium (K) Calcium (Ca) (>200 mg considered (> 50 mg considered a high source) a high source)

Dairy: Cheese, milk, and High (low fat options High High (low sources include High yogurt. Nearly all dairy contains include non-fat dairy some types of cheese). high amounts of calcium and product such as milk, potassium. This food group also cheese, and yogurt). contains high amounts of sodium and dietary fat.

Meat: Eggs, fish, red meat, pork, High (low fat options Low (high sources include High (low sources include Low (high sources include and poultry. These products vary include skinless chicken, canned meats, , eggs, and bacon). salmon). widely in fat, sodium, and mineral fish, eggs, and lean cuts , and any salt-cured content. of beef). meats).

Fruit: Apples, avocado, bananas, Low Low High Low (high sources include strawberries, oranges, peaches, oranges). and watermelon. All raw fruits are naturally low in sodium, and contain high amounts of potassium.

Grain Products: Whole-wheat Low (high sources include Low (high sources include Low Low bread, oatmeal, macaroni, and pre-packaged baked bread, and pre-packaged rice. Most grains are low in dietary items). baked items). fat, potassium, and calcium. Some may contain high amounts of sodium, especially when more than one serving is consumed.

Legumes and Nuts: Almonds, High in healthy mono and Low (high sources include High (low sources include Low (high sources include black beans, garbanzo beans, poly unsaturated fatty canned and salted). and peanut butter). almonds, black beans, and tofu, peanut butter, pistachios, acids (low fat foods in garbanzo beans). and walnuts. This group contains this group include black high amounts of dietary fat in the beans, garbanzo beans, form of healthy mono and poly and tofu). unsaturated fatty acids. Many foods in this group are also rich in potassium and calcium.

Vegetables: Broccoli, carrots, Low Low (high sources include High High (low sources include corn, mushrooms, potatoes, and canned). mushrooms, corn, . Most raw vegetables are potatoes, and tomato). naturally low in fat and sodium, and high in potassium and calcium.

Desserts: Pastries, cookies, High High Low Low muffins, pie, and cake. Most baked goods are high in sodium and fat, and low in potassium and calcium. This group should be consumed in moderation.

Condiments, Fats, and Oils: Low (high sources include High Low (high sources include Low Ketchup, pickles, mayonnaise, mayonnaise, butter, pickles). barbeque sauce, butter, and salad margarine, and salad dressing. This group is mostly dressing). high in fat and sodium, and nutrient poor.

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