How to eat if you have high blood pressure

Source: The Swiss Association for Nutrition (SAN)
May 25, 2000 (Reviewed: December 8, 2002)

Introduction

In more than 90% of people with hypertension, there is no obvious organic cause for the increase in pressure. This is the most common form of high blood pressure and is called essential or primary hypertension. The rare secondary form of hypertension is caused by diseases and blood flow disorders of the kidneys, and sometimes also by certain cardiovascular or hormone disorders. High blood pressure is a "silent" risk, because the person concerned only rarely feels any symptoms. If symptoms do occur, they may manifest themselves in the form of headache, visual disturbances, dizziness, tiredness or a buzzing in the ears.

High blood pressure is a leading risk factor for the development of stroke, coronary heart disease (angina pectoris, myocardial infarction), obstructive arterial diseases of the legs, heart failure, visual disturbances, and kidney failure.

Hypertension must be treated medically if it is severe or even moderately severe. If the hypertension is quite mild, a return to normal values can sometimes be achieved by changes in lifestyle - in particular, stopping smoking and exercising regularly - and diet. However, in most cases, an antihypertensive medicine must be taken indefinitely. (For more on this, see "Risk of Stopping High Blood Pressure Medication".

Change of diet

Salt: Too much salt in the food increases blood pressure, especially in salt-sensitive people. Restriction of salt intake to about 6 g (~2.4 g sodium) per day is therefore an important way of lowering the blood pressure in some persons. By and large, high-salt foods such as salted meat and sausage products, salted snacks, crisps, salted nuts etc. should be avoided. In the preparation of meals, sparing use should be made of salt, and adding salt at the table is unnecessary. It is often overlooked that other condiments that people often use in their food, including stock cubes, have a high salt content. It is better (and tastier) to add fresh or dried herbs and spices to your food.

Fruit and vegetables contain not only the fibre that promotes digestion, but also a plentiful supply of minerals and vitamins. In high blood pressure, particular attention should be paid to ensuring an adequate intake of potassium, magnesium and calcium. Epidemiological studies on nutrition show that just increasing the potassium intake can markedly lower blood pressure, because potassium and calcium seem to counteract sodium (a component of salt) in the development of high blood pressure.

Milk and dairy products are a major source of calcium. An optimum calcium supply is believed to reduce the risk of hypertension.

Fats and oils: Overall fat consumption and fatty acid levels have been found to have only a minimal direct influence on high blood pressure. But hypertension is frequently associated with other risk factors of atherosclerosis, e.g. with increased cholesterol. For this reason, total fat intake should be reduced until it accounts for not more than 30% of the daily energy intake (this is at least 10% less than the fat content of most people). Vegetable fats and oils with a high proportion of unsaturated fatty acids (e.g. olive oil, rapeseed oil, sunflower oil, corn oil or wheat germ oil) are to be preferred.

Further recommendations

Certain lifestyle habits increase the risk of developing high blood pressure. If several of these contributory factors co-exist, the risk increases drastically. Therefore:

• Lose any excess weight (change your eating habits, increase exercise)
• Restrict alcohol consumption (not more than 1-2 glasses wine or beer a day)
• Stop smoking
• Avoid stress
• Take more physical exercise

Dietary recommendations for people with high blood pressure

Many factors affect our dietary behaviour: individual needs and desires, our day-to-day condition, the social environment, the food currently on offer, advertising etc. The following recommendations ensure a balanced and varied diet that provides an adequate intake of energy, nutrients and protective substances and thus a healthy approach to nutrition. The figures quoted are intended for the "average person", i.e. for adults who engage in normal physical activities and thus have an average energy and nutrient requirement. The figures would vary for other groups (such as children and adolescents, top athletes, pregnant women etc.). The quantities and portions given are likewise average values; they cannot be adhered to precisely every day. Those passages which appear in italics are particularly important for persons with a tendency towards high blood pressure.

Fats and oils:
Use 2 teaspoonfuls (10 g) of high-quality vegetable oil, such as olive oil, rapeseed oil, sunflower oil, thistle oil, or corn oil per day, unheated, e.g. for salad dressings.
Use not more than 2 teaspoonfuls (10 g) of cooking fat or oil per day, e.g. peanut oil or olive oil, for the preparation of meals.
Do not eat more than 2 teaspoonfuls (10 g) of spreading butter or margarine per day on bread.
Do not eat more than one high-fat meal per day, such as deep-fried or breaded food, cheese dishes, fried potato, sausage, cream sauce, puff pastry, cakes, chocolate, etc.

Sweets and snacks:
Eat sweets in moderation - they often contain hidden fat. Do not eat more than one small dessert daily (1 chocolate bar, 1 Danish pastry, one portion of ice cream). Avoid salted nuts, crisps and salted snacks.

Meat, fish, eggs and pulses:
Do not eat more than one portion of meat 2 - 4 times a week (1 portion = 80 - 120 g); more is unnecessary.
Cut down heavily on the consumption of salted meat (ham, sausage, bacon, etc.).
Do not eat offal (liver, kidneys, tripe, sweetbreads) more than once a month (1 portion = 80 - 120 g).
Plan to eat 1 - 2 portions of fish a week (1 portion = 100 - 120 g).
Eat 1 - 3 eggs a week, including processed eggs e.g. in cakes and pastries, soufflés or cream desserts.
Pulses, pulse products: eat 1 - 2 portions of lentils, chickpeas, kidney beans (1 portion = 40 - 60 g, dry weight) and tofu (1 portion = 100 - 120 g) per week.

Milk and dairy products:
Consume 2 - 3 portions of dairy products a day (1 portion = 2 dl milk or 1 cup of yogurt or 30 g of hard cheese or 60 g of soft cheese).

Cereal products and potatoes:
Eat at least 3 portions of carbohydrate-rich foods per day (e.g. bread, potatoes, rice, cereal, pasta, etc.), preferably wholemeal products. The size of the portion depends on the degree of physical activity the person engages in.

Fruit:
Eat 3 portions of fruit per day (1 portion = 1 apple, 1 banana, 3 plums or a dish of berries), ideally raw.

Vegetables:
Eat 4 portions of vegetable per day, at least one of them raw, e.g. as a dip or a mixed salad (1 portion = 100 g raw or 150 - 200 g cooked vegetable, 50 g lettuce or 100 g mixed salad).

Beverages and alcoholic drinks:
Drink at least 1.5 litres (6 cups or glasses) of liquid per day, preferably unsweetened and alcohol-free beverages.
Low-sodium mineral water is especially suitable.
Alcohol: Do not drink more than 1-2 glasses wine or beer per day.

High blood pressure - chief points to note

1. Restrict salt intake
2. Lose any excess weight
3. Avoid excessive consumption of alcohol (max. 1-2 glasses of wine or beer per day)
4. Eat more fruit and vegetables, wholemeal products and milk products
5. Take more physical exercise
6. Stop smoking
7. Take prescribed medications unfailingly

Please take a moment to give us your comments. For questions about Health matters you may check our "Questions & Answers" Portal and Service.