What is Hypertension?
At least 1.28 billion adults aged 30-79 are considered to be hypertensive worldwide (1). That means they have sustained systolic and diastolic blood pressure at or over 140/90 mmHg (1). There is more than one way someone may develop high blood pressure, and in any case, it increases the risk for other types of cardiovascular events, like stroke, myocardial infarction, and heart failure, among others (2).
The renin-angiotensin system (RAS) is a hormone (endocrine) system that regulates blood pressure, fluid & electrolyte balance and helps to maintain vascular health. The body produces various enzymes that act as a vasoconstrictor, increasing blood pressure, or as a vasodilator, decreasing blood pressure. RAS, when not functioning properly, can have an impact on the development of increased blood pressure (3).
Another important system that plays a role in hypertension is our sympathetic nervous system (3). This system is responsible for the messages sent through nerves/ organs to our brain, creating the fight-or-flight stress response. As stress continues to increase in our lives, so does our blood pressure.
In many of these cases, there are no consistent symptoms to note hypertension is present, which is why hypertension is often referred to as the “Silent Killer”.
Our diet plays a significant role in whether or not high blood pressure develops. The Standard American Diet (SAD) is full of processed and convenience foods known to be low in fiber. Over time, this can increase water retention, which, in turn, our blood vessels work harder, which increases blood pressure (2). What is important to note is that there are simple ways we can combat and even prevent this "silent killer" from appearing in the first place.
DASH Food Plan
Our food choices can have a marked impact on overcoming or preventing hypertension. Following a whole-food first-food plan is a good place to start. Thankfully, there is an exceptional food plan that is made specifically for lowering blood pressure, it is known as the DASH (Dietary Approaches to Stop Hypertension) Diet. The DASH food plan focuses on the following food groups*: (3)
Vegetables
Fruits
Whole grains
Lean meats, poultry & fish
Legumes
Low-fat dairy
Nuts & Seeds
Fats & Oils (limited)
Adequate amount of water, usually at least 64 oz. per day
*Serving sizes vary based on total caloric needs and intake.
Plant-based carbohydrates comprised of cellulose, which cannot be digested and help to increase fiber intake, which is beneficial for overall cardiovascular health (4).
As mentioned, it is important to include enough fluid to keep blood pressure steady. Incorporating at least 2 cups of green tea per day in place of coffee, for example, has been shown to have many antihypertensive benefits, such as being anti-inflammatory, improving endothelial function, and acting as a vasodilator (open blood vessels) (6). Beetroot juice is also a vasodilator; benefits can be seen when consuming as little as 1-2 cups per day. It is also effective as a supplement. (7). Check out the blog, Top 10 Supplements for Blood Pressure Support, for more information.
Other therapeutic foods to consider include (2)
4 Stalks of Celery Daily (water/fiber)
Small Piece of 70%+ Dark Chocolate Daily (polyphenols)
Handful of Pumpkin Seeds (magnesium)
The Mediterranean Food Plan
The Mediterranean diet (Med Diet) has some similarities to the DASH diet but also some distinctions. The Med Diet:
Places a heavy focus on consuming plenty of fruits and vegetables.
Is more gracious in including healthy fats, especially in extra virgin olive oil (EVOO).
Includes lean proteins with a preference toward fish, legumes, nuts and seeds.
Minimizes the consumption of red meats, refined carbohydrates, and processed foods.
Incorporates alcohol, specifically red wine, in moderation.
This diet provides high amounts of good fats, dietary fiber, antioxidants, polyphenols, and nutrients like magnesium and is an example of a larger type of dietary pattern known to help reduce overall inflammation, which contributes to cardiovascular health, among other benefits (4). This is a stark contrast from our typical Standard American Diet (SAD), which relies heavily on red meats, refined carbs, and very few vegetables. These are a few quick tips on how to start bringing the Mediterranean into your life:
Swap olive oil for vegetable oil when cooking.
Choose nuts as a quick portable snack that is high in omega 3’s. (3)
Use chickpea or other bean pasta instead of traditional refined pasta.
For a quick weeknight meal, add salmon and your favorite veggies to a foil pack with olive oil and throw it on a grill or place it in a glass dish and bake it in the oven.
Vegetarian/Vegan Food Plan
The most plant-forward food plan that can have benefits for cardiovascular improvement is vegetarian or vegan. But what does it really mean to follow a vegetable-forward diet? There are a few examples (2):
Vegan: Consume strictly planted-based with no animal bi-products (e.g. honey)
Vegetarian: Consume vegetables, fruits, legumes & nuts/seeds
Lacto-ovo-vegetarian: Do consume dairy products and eggs.
Lacto-vegetarian: Do consume dairy products.
Ovo-vegetarian: Do consume eggs.
Pescatarian/Flexitarian: Those who follow this diet avoid all meats except fish and other types of seafood.
A consistent finding shows that cardio-metabolic diseases, like hypertension, decrease when plant-based diets are implemented. This is highly due to the increased consumption of polyphenols (colors found in fruits and veggies) and vitamin C, which is known to have a positive impact on our blood vessels' ability to stay strong. It is worth noting that vitamin B12 is only found in animal products. Therefore, supplementation may be required to avoid deficiency if strictly vegetarian/vegan. (5)
Overall, there are many ways to support hypertension through our diet. One place to begin is to start incorporating a plant-forward diet. Find simple ways to make swaps for what you are currently consuming. Just as important, stay hydrated by carrying a water bottle with you throughout your day. By making these changes, you are supporting your cardiovascular health and reducing the risk of hypertension through food.
Check out the blogs Top 10 Supplements for Blood Pressure Support and 3 Major Lifestyle Factors that Impact Blood Pressure for more information on this topic.
Written by Kimberly King, MS
Last reviewed and Updated May 16, 2024
References:
1. World Health Organization. Hypertension. World Health Organization. Published March 16, 2023. Accessed May 13, 2024. https://www.who.int/news-room/fact-sheets/detail/hypertension
2. Rakel D. Hypertension. In: Integrative Medicine. S.l.: ELSEVIER - HEALTH SCIENCE; 2017:230-241.
3. Challa HJ, Ameer MA, Uppaluri KR. DASH Diet To Stop Hypertension. [Updated 2023 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482514/
4. Tomé-Carneiro J, Visioli F. Plant-Based Diets Reduce Blood Pressure: A Systematic Review of Recent Evidence. Curr Hypertens Rep. 2023;25(7):127-150. doi:10.1007/s11906-023-01243-7
5. Medawar, E., Huhn, S., Villringer, A., & Veronica Witte, A. (2019, September 12). The effects of plant-based diets on the body and the brain: a systematic review. Translational psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742661/.