Hypertension is when the blood in the body’s vessels flows at a higher pressure than normal (picture water flowing through a hose at high pressure). How and why it happens is not fully understood, but a combination of genetic and lifestyle factors which affect heart and kidney function can lead to hypertension.
When blood pressure is measured, the first reading reflects systolic pressure which is the pressure of blood within the vessels when the heart contracts or beats. The diastolic pressure is the second reading and represents pressure in the vessels when the heart is relaxed (between beats) and filling with blood.
A blood pressure of 135/85 mmHg or more measured at home is considered high. Depending on your age and if you have diabetes or other health complications, your healthcare team can work with you to set individualized blood pressure targets for you.
Many people may not experience obvious symptoms from high blood pressure. So, the next question might be, why does this even matter? It matters because over time, uncontrolled blood pressure can:
- strain the heart and blood vessels and lead to left ventricular hypertrophy where the left side of the heart becomes enlarged and the heart walls become thicker and less elastic
- increase the risk of heart attack, heart failure, stroke, brain hemorrhage, and vascular dementia
- damage small vessels of the kidneys leading to kidney failure
These complications can be prevented by managing lifestyle, nutrition, and taking medication as prescribed. If you’re not sure where to start, chat with your healthcare team about our suggestions below:
1) Blood Pressure Log: If there have been recent changes in your blood pressure, keep a record of daily blood pressures checked at home and review it with your healthcare team. Consult your nurse or family doctor to learn how to measure blood pressure accurately.
2) Fiber, Potassium, Magnesium, Calcium: The DASH (dietary approaches to stop hypertension) trials showed that specific nutrition changes can result in significant blood pressure lowering affects in those who have hypertension. For some individuals, improved blood pressure was seen within 2 weeks of beginning DASH. See below for details:
- High fiber diets have been linked to lower blood pressure. Increase fiber and B vitamins by swapping refined grains for high fiber options such as whole grain bread, barley, oatmeal, quinoa, brown and wild rice, whole wheat pasta, bulgur, spelt, kamut, and buckwheat. Other sources of fiber include legumes, vegetables, fruits, nuts, and seeds.
- Potassium-rich foods can help lower blood pressure and may decrease risks of heart disease and stroke. Boost potassium intake by regularly consuming bananas, oranges, kiwi, sweet potato, dark leafy greens, broccoli, kohlrabi, peas, tomatoes, avocado, 0% or 1% milk, yogurt, fish, nuts (e.g. pistachios, almonds), seeds, and legumes (e.g. pinto beans, black beans, chickpeas, lentils). Note that a high potassium diet may not be recommended for those with kidney disease or those using medications affecting potassium in the body.
- Magnesium has also been linked to better cardiovascular health. Include foods sources of magnesium such as nuts (e.g. almonds, cashews, peanuts), seeds (e.g. pumpkin, flax, sunflower), spinach, swiss chard, fortified cereals like bran cereals or oatmeal, low-fat dairy, legumes (e.g. edamame, black beans, kidney beans), nut butters, fish, chicken, and whole grains.
3) Sodium Smart: When we consume excess sodium, the body can retain more fluid causing blood volume to expand and blood pressure to increase. The average Canadian consumes 3400mg of sodium or more daily; recommendations are 2000-2300mg/day. Evidence has consistently shown that as sodium intake decreases, blood pressure decreases. Fast food and restaurant meals often contain greater than 1100mg of sodium, while packaged products such as sauces, soups, deli meat, sausages, breads, and wraps can be surprisingly high in sodium. The first step is to estimate how much sodium you’re eating. Next try choosing ‘no salt added’ canned goods, compare sodium content of foods when grocery shopping, and try some lower sodium options. Need more information? Check out these food sources of sodium or low sodium foods handouts.
4) Omega-3: Consuming fatty fish such as salmon, tuna, mackerel, sardines, herring, or anchovies twice a week has shown to help manage blood pressure. Some research suggests that higher supplemental doses of EPA (eicosapentaenoic acid) and DHA (docosahexanoic acid) may reduce blood pressure, but long-term safety of high dose supplementation is unknown.
5) Flavonoids: Flavonoids are plant compounds found in high concentrations in cocoa, green tea, grapes, cherries, onions, and dark-colored berries. Intake of flavonoids has been linked to improved elasticity in blood vessels. Studies have found that regular cocoa consumption over 2-4 weeks decreased blood pressure, improved dilation of vessels, and slightly improved cholesterol (decrease in LDL and increased HDL). Alternatively, other studies showed no change in blood pressure or cholesterol and one study mentioned a possibility of elevated blood pressure in participants older than 50 years. More research is underway to assess the safety and long-term effectiveness of cocoa supplementation. For those interested, a safe option may be to add small amounts of unsweetened cocoa to plain yogurt, oatmeal, smoothies and include other flavonoid foods.
6) Nitrate-Rich Vegetables: Naturally occurring nitrates in inorganic vegetables may promote blood vessel dilation, decrease blood pressure, and reduce platelet clumping. Including small amounts of arugula, beets, celery, fennel, spinach, cabbage, kohlrabi, and parsley regularly in your diet may be beneficial.
7) Move: Moving 20-30 minutes each day by walking, gardening, cycling, swimming, dancing, resistance training, or any other activity has the potential to lower blood pressure and strengthen the heart. Even high intensity exercise lasting 40-60 minutes, just a few times per week, may have similar blood pressure lowering benefits in some individuals.
8) Relax: Let’s not ignore the elephant in the room. Stress affects so many different body systems and organs! Sometimes, finding healthy ways to relax is a missing piece of the puzzle. Take 5-10 minutes daily to give yourself some “me-time” to deep breathe, walk, stretch, pray, draw, have a bath or do whatever calms you.
9) Caffeine and Alcohol: As alcohol intake increases above 2 standard drinks, blood pressure can rise. Additionally, research has shown that more than 2 cups of caffeine (250-300mg) can increase blood pressure in some individuals. 1 cup (250ml) of coffee contains approximately 135mg of caffeine. Chocolate, soda, energy drinks, tea, green tea, and other foods may contain caffeine. If you consume large quantities of these substances, try decreasing your intake for a few weeks to see if it makes a difference.
10) Smoking: Risks of blood vessels becoming stiff and rigid, coronary heart disease, lung disease, and cancer of the head, neck, and lungs can be significantly decreased by quitting smoking. Some studies even suggest that heart attack risk reduces to the rate of non-smokers within a few years of quitting smoking. Speak with your healthcare team and look into the free support services available to you.
References
https://www.hypertension.ca/en/hypertension/what-do-i-need-to-know/what-is-high-blood-pressure
http://hypertension.ca/images/2016_EducationalResources/2015_MyHomeBloodPressureLog_EN_P1018_PREVIEW.pdf
http://hypertension.ca/images/2015_EducationalResources/2015_HomeBPMonitoringPostcard_EN_P1002.pdf
http://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/basics/definition/con-20026690
https://www.projectbiglife.ca/sodium/
http://www.healthlinkbc.ca/healthyeating/high-potassium.html
http://www.edmontonsouthsidepcn.ca/classes-health-resources/brochures/
http://www.uptodate.com/contents/diet-in-the-treatment-and-prevention-of-hypertension
http://www.uptodate.com/contents/overview-of-hypertension-in-adults
http://www.uptodate.com/contents/high-blood-pressure-in-adults-beyond-the-basics
http://www.uptodate.com/contents/high-blood-pressure-diet-and-weight-beyond-the-basics
http://www.uptodate.com/contents/exercise-in-the-treatment-and-prevention-of-hypertension
http://www.uptodate.com/contents/potassium-and-hypertension
http://www.uptodate.com/contents/salt-intake-salt-restriction-and-primary-essential-hypertension
http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Caffeine/Food-Sources-of-Caffeine.aspx
http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Fat/Food-Sources-of-Omega-3-Fats.aspx
http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Minerals/Food-Sources-of-Sodium.aspx
http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Minerals/Functions-and-Food-Sources-of-Common-Minerals.aspx
http://www.healthlinkbc.ca/healthyeating/high-potassium.html
http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Minerals/Food-Sources-of-Magnesium.aspx
https://www.healthlinkbc.ca/healthyeating/pdf/antioxidants-and-your-diet.pdf
http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Fibre/Food-Sources-of-Fibre.aspx
https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#h3
http://www.ncbi.nlm.nih.gov/pubmed/26817716
http://www.ncbi.nlm.nih.gov/pubmed/26773016
https://www.sciencedaily.com/releases/2015/09/150910110832.htm
https://www.ncbi.nlm.nih.gov/pubmed/27037002
https://www.ncbi.nlm.nih.gov/pubmed/26537937
https://www.ncbi.nlm.nih.gov/pubmed/26514936
https://www.ncbi.nlm.nih.gov/pubmed/26013912
http://onlinelibrary.wiley.com/doi/10.1111/jch.12715/epdf
http://www.foodandnutrition.org/March-April-2016/Food-as-Protection-and-the-Fight-Against-Hypertension/
https://www.eatrightontario.ca/en/Articles/Food-technology/Biotechnology/Novel-foods/The-truth-about-nitrates.aspx
http://healthycanadians.gc.ca/healthy-living-vie-saine/tobacco-tabac/quit-cesser/help-someone-aider-quelquun/you-can-quit-vous-pouvez-cesser-eng.php
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