(Continued from Part 2) … here are the final three ways to reduce high blood pressure, and a note about the effective DASH diet…

8. Just a small drink

People who drink lots of alcohol can reduce their blood pressure by cutting back. In fact alcohol may increase blood pressure even in moderate drinkers. The National Heart Foundation recommends a maximum of two drinks per day for women and maximum three for men. A standard drink is 100mls wine, 300mls beer or 30mls spirits. A bottle of wine contains 7-8 standard drinks depending on the alcohol content.

9. Skip the sugar

When we cut back on saturated fat in pies, pastries, fatty, processed meat, full cream dairy foods what do we eat instead? One study compared three healthy, low saturated fat diets. One was high in monounsaturated fat, one high in protein and one high in carbohydrate. To put it in food terms, think of a sandwich. Instead of having a salami and cheese sandwich, they either had avocado or peanut butter (mono), baked beans or tuna (protein) or jam (carbohydrate). The protein and monounsaturated fat diets had the best effects on blood pressure and blood fats.

Many of us think if we just swap to the low fat, low glycemic index (GI) version of cakes, biscuits, sweet yoghurt and juice, we are doing the right thing. But a number of nutrition experts now think that eating a low fat diet with lots of processed foods containing sugar and especially fructose (the sugar naturally occurring in fruit and sometimes used by manufacturers to give foods a lower GI) may have harmful health effects including raising blood pressure. Fructose causes an increase in uric acid which in turn inhibits nitric oxide. It is nitric oxide that helps maintain normal blood pressure.

10. Control the coffee

The National Heart Foundation recommends a maximum of five cups of coffee a day. Remember that a double shot latte counts as about three to four cups of instant coffee. If you drink lots of coffee, cutting back to a more moderate level may help your blood pressure.

The DASH Diet

DASH stands for Dietary Approaches for Stopping Hypertension. In this well-known study, the people on the diet reduced their blood pressure within two weeks. Amazingly this was without reducing salt or alcohol! The people who also cut back on salt reduced their blood pressure even more. The DASH eating plan is low in saturated fat, total fat and cholesterol and high in protein, fibre, calcium, potassium and magnesium. It recommends 4-5 serves of fruit, 4-5 serves of vegetables and 2-3 serves of low fat dairy foods each day. It allows only small serves of lean meat and recommends a few vegetarian meals using dried beans, peas or lentils each week as well as some nuts or seeds most days. It limits sweets and sugars.

Here’s some more food ideas to keep your blood pressure under control (continued from part 1)…

4. Lots of fruit and vegetables

For healthy blood pressure we need less sodium and more potassium, magnesium and calcium. Potassium blunts the effect of sodium on blood pressure. The best way to get more potassium into your diet is to eat more fruit and vegetables. Aim for at least 2-3 serves of fruit and 4-5 serves (about 2-3 cups) of vegetables every day. Bananas, grapefruit, oranges, dried fruit, green vegetables, mushrooms, avocado and tomatoes are all high in potassium. And magnesium usually tags along in the same foods.

A word of warning about grapefruit: it can affect some blood pressure medications. If you are taking medication for high blood pressure, check with your doctor before splurging on grapefruit.

If you hope to by-pass the fruit and vegetables by taking a potassium supplement, think again. Too much potassium can be dangerous for your heart, and you will miss out on all the other health benefits of fruit and vegetables.

5. Low fat milk and yoghurt

Low fat dairy foods are important for strong bones and teeth and also for healthy blood pressure. If you don’t like dairy foods, eat sardines and salmon. The bones provide lots of calcium. There is no strong evidence that taking a calcium supplement will help lower blood pressure. It’s better to stick to real food. So whip up a banana smoothie, dollop some yoghurt on muesli or have sardines and sliced tomato on grainy toast for lunch.

6. Legumes, nuts and wholegrains

Dried beans, split peas, lentils, nuts and wholegrains are all rich in magnesium. Eat porridge or muesli for breakfast, snack on a small handful of nuts most days, and make a legume meal a couple of times a week – toss a few red lentils into stews and soups to thicken them, add a can of beans to mince or simply enjoy baked beans on grainy toast.

7. Omega-3 fats

Omega-3 fats found in oily fish, walnuts, flaxseed and canola oil help reduce high blood pressure. These fats help relax the blood vessel walls so they can expand as blood rushes through. One study of 46,500 people aged over 40, some with normal, some with high blood pressure, found that those who ate more omega-3 rich foods had lower blood pressure.  The NZ National Heart Foundation recommends that people get their omega-3’s from food. But if you don’t eat oily fish and are at risk for heart disease or stroke (this includes having high blood pressure) the New Zealand Cardiovascular Guidelines recommend taking an EPA/DHA supplement of 1 milligram per day. Be sure to let your doctor know if you take omega-3 supplements as the blood thinning effects are quite potent.

Part 3 here …

High blood pressure can be a ‘silent killer’ because there are usually no symptoms. The only way to find out whether your blood pressure is high is to get it checked. The top number (systolic) measures the pressure of the blood when your heart pumps it out around your body. The bottom number (diastolic) measures the pressure when your heart relaxes and fills up with blood, ready for the next pump. Think of your arteries as a garden hose with your heart as the tap. If you turn the tap on high the water pumps out at high pressure. If you turn the tap down the pressure drops. Sometimes we need to get blood out to our muscles fast: jumping out of the way of a speeding car is one good reason! In this case high blood pressure may be a life saver. But if your blood pressure is constantly high, you increase your risk of a stroke, heart attack, heart failure and kidney disease. Here are the first three changes you can make to help reduce high blood pressure.  More tomorrow…

1.  Eat less salt

Most of us eat more salt, or to be exact, sodium, than we need. The NHMRC recommends no more than 1600mg sodium a day for healthy blood pressure. In New Zealand we eat at least double that amount. That’s almost 2 teaspoons of salt a day. Even if you don’t sprinkle salt on your food, around three-quarters of the salt we eat comes from processed foods such as bread, sauces, soups, processed meat, some breakfast cereals, cheese and salty snacks.

High sodium foods don’t always taste salty. A plate of cornflakes or rice bubbles has as much sodium as a small bag of potato crisps. And a slice of bread can have the same amount of sodium as the teaspoon of Vegemite you spread on it!

If you have to cut back on salt, don’t despair. For the first three or four weeks food will taste bland but your taste-buds do adjust. Then you will find your old food far too salty.

Cutting back on salt will likely reduce your blood pressure. This is especially so for older people and those who already have high blood pressure, diabetes, kidney disease or are overweight. However some people are salt insensitive. This means that the amount of salt they eat has no effect on their blood pressure. What else can these people do?

2.  Reduce weight

If you are overweight, losing weight is one of the best ways to drop your blood pressure. If you are already on medication, losing weight often helps it to work better and you may even need a lower dose. Studies have found that people who lost 3-9% of their weight reduced their systolic (top number) and diastolic (bottom number) pressure by an average of 3 points more than people who did not lose weight (see BMJ Best treatments)

3.  Be active

Thirty minutes (not necessarily all at once) a day of moderate intensity exercise such as walking, cycling, dancing, gardening or swimming helps drop both your blood pressure and your weight. In fact it can reduce high blood pressure as much as some drugs. People who are physically active have a quarter to half the risk of high blood pressure. Building strong muscles is also important but skip the heavy weights if your blood pressure is already high. All that groaning and straining will likely send it shooting higher!

Part 2 here …