John A. Patterson MD, MSPH, FAAFP, ABIHM
August 10 2022

Wise food choices can help some people lower their blood pressure in just 2 weeks!

The American Heart Association defines normal blood pressure as less than 120 systolic (upper number) plus a diastolic (lower number) less than 80. Elevated blood pressure is defined as a systolic between 120-129 plus a diastolic less than 80. Stage 1 hypertension (high blood pressure) is defined as a systolic of 130-139 or a diastolic between 80-89. Stage 2 hypertension is defined as a systolic of 140 or higher or a diastolic of 90 or higher. Hypertensive crisis is an emergency and is defined as a systolic higher than 180 and/or a diastolic higher than 120. Hypertension is sometimes referred to as a silent killer because some people cannot tell their pressure is elevated, which can lead to delay or lack of treatment and potentially fatal stroke, kidney failure and heart failure.
Compared to the typical American diet, DASH (Dietary Approaches to Stop Hypertension) is lower in saturated fat, cholesterol, total fat, sweets, sugary beverages and red meats. It is higher in fruits, vegetables, fat-free or low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. Though the DASH Eating Plan is designed to treat or prevent hypertension, it also can help prevent or control obesity, diabetes, osteoporosis, cancer, heart disease and stroke.
DASH encourages foods low in sodium (salt) and high in nutrients that lower blood pressure- especially potassium, calcium and magnesium. The typical American diet contains about 4,000 milligrams of sodium daily (about 1½ teaspoon of salt). Reducing daily sodium intake to 2,300 milligrams (about 1 teaspoon of salt) can lower blood pressure. Limiting daily sodium to only 1,500 milligrams (about 2/3 teaspoon) can lower blood pressure even further and is advised in people who already have hypertension, diabetes or chronic kidney disease as well as African Americans and middle-aged and older adults. Sodium intake can be reduced by using sodium-free spices or flavorings in place of salt, not adding salt when cooking rice, pasta or hot cereal, rinsing canned foods to remove added salt and buying foods labeled “no salt added,” “sodium-free” and “low sodium”.
DASH emphasizes whole grains, fruits, vegetables, low-fat dairy products, fish, nuts, seeds and legumes. Whole grains have more fiber and nutrients than refined grains. When choosing bread, cereal, rice and pasta, select whole wheat, brown rice, whole (‘old-fashioned’) oats and look for ‘whole grain’ on the label.
Many vegetables provide fiber, vitamins, and blood pressure-lowering minerals such as potassium and magnesium. Serve steamed or lightly stir-fried vegetables over brown rice or whole-wheat noodles. Many fruits provide fiber, potassium and magnesium. Have fruit as a snack between meals and as a dessert after your meal.
Dairy products are major sources of calcium. Choose dairy products that are low fat or fat-free. Add fruit to unsweetened yogurt for a healthier dessert. Fish, such as salmon, herring and tuna are high in heart-healthy omega-3 fatty acids and should be favored over beef, pork and other meats. Nuts, seeds and legumes are good sources of magnesium and potassium, as well as other healthy micronutrients. In particular, soybean products, such as tofu and tempeh, contain high quality protein suitable as a meat substitute.
     Compared to the 35-40 percent fat intake of the average American diet, the DASH Eating Plan limits total fat to 27 percent or less of daily calories, with a focus on the healthier monounsaturated rather than saturated fat. Monounsaturated oils include olive, canola, peanut, sunflower and sesame. DASH limits daily saturated fat to less than 6 percent of total calories by limiting use of meat, butter, cheese, whole milk, cream, eggs, lard, solid shortenings, and palm and coconut oils.
Weight loss can be a positive side benefit of the DASH Eating Plan, especially if you cut back on sugar with its ‘empty calories’- calories that are not accompanied by healthful nutrients. When you eat sweets, choose those that are fat-free or low-fat, such as sorbets, hard candy, graham crackers or low-fat cookies. Avoid sugary pop by limiting your beverages to water, low fat milk and unsweetened fruit juice diluted half and half with water. Combining the DASH Eating Plan with physical activity makes it more likely that you’ll reduce both your weight and your blood pressure.
Since the DASH Eating Plan can begin lowering blood pressure in just two weeks, discuss the addition of DASH with your primary care provider, especially if you take medication for hypertension.

Resources–

NHLBI- What is the DASH Eating Plan?
http://www.nhlbi.nih.gov/health/health-topics/topics/dash

Mayo Clinic- Sample menus for the DASH Eating Plan
http://www.mayoclinic.com/health/dash-diet/HI00046

Mayo Clinic- DASH Diet: Healthy eating tot lower your blood pressure
http://www.mayoclinic.com/health/dash-diet/HI00047

About the Author–
Dr Patterson is past president of the Kentucky Academy of Family Physicians and is certified in family medicine, integrative holistic medicine, mind body medicine, mindfulness-based stress reduction (MBSR), Mindful Practice in Medicine, yoga therapy and physician coaching. He is on the faculty of Saybrook College of Integrative Medicine and Health Sciences (Pasadena) and the Center for Mind Body Medicine (Washington, DC). He teaches stress management for the University of Kentucky Health and Wellness Program and operates the Mind Body Studio in Lexington, where he offers integrative medicine consultations and group classes. He can be reached through his website at www.mindbodystudio.org