“How to Treat High Blood Pressure with Diet” High blood pressure ranks
as the #1 risk factor for death and disability
in the world. Previously, I showed
how a plant-based diet may prevent high blood pressure,
but what if you already have it? The American Heart Association,
the American College of Cardiology, and the Centers for Disease
Control and Prevention recommend as the first-line
treatment: lifestyle modification. If that doesn’t work
you start the patient on a thiazide diuretic,
water pill, and then you keep piling on the meds
until you get their blood pressure down. Commonly people will
end up on three drugs, though researchers are
experimenting with four at a time, and some people end up on five.
Why not jump straight to the drugs? Well, they don’t treat the underlying
cause, and they can cause side-effects. Less than half of patients stick
with even the first-line drugs, perhaps due to the adverse effects such as erectile dysfunction,
fatigue, and muscle cramps. So what are these recommended
lifestyle changes? They recommend to control one’s
weight, salt, and alcohol intake, engage in regular exercise,
and adopt a DASH eating plan. The DASH diet has been described as
a lactovegetarian diet, but it’s not. It emphasizes fruits and
vegetables and low-fat dairy, but just a reduction in meat.
Why not vegetarian? We’ve known for decades
that food of animal origin was highly significantly
associated with blood pressure. In fact, if you take vegetarians, And you give them meat, you can
watch their blood pressures go right up. I’ve talked about how there are
benefits to getting blood pressure down as low as 110 over 70,
but who can get that low? Populations eating plant-based diets. Like in rural China, about
110 over 70 their whole lives, with meat only eaten on special
occasions. Or rural Africa, where the elderly have perfect blood
pressure as opposed to hypertension. In the Western world, as the American
Heart Association has pointed out, the only folks really getting down
that low were the strict vegetarians, coming out about 110 over 65. So when they created the DASH diet
were they just not aware of this landmark research, done
by Harvard’s Frank Sacks? No, they were aware. The Chair of
the Design Committee that came up with the DASH diet was Dr. Sacks. In fact the DASH diet
was explicitly designed with the #1 goal of capturing
the blood pressure lowering benefits of a vegetarian diet, yet contain enough animal products to
make it palatable to the general public. In fact, Sacks found that the more
dairy the lactovegetarians ate, the higher their blood pressures, but
they had to make the diet acceptable. Research has since shown
that it’s the added plant foods, not the changes in oil, sweets, or dairy,
that appears to be the critical component, so why not eat plant-based? A recent meta-analysis showed
vegetarian diets were good, but strictly plant-based
diets may be better. Vegetarian diets in general
confer protection against cardiovascular diseases,
some cancers and death, but completely plant-based diets seem to
offer additional protection for obesity, hypertension, type-2 diabetes,
and heart disease mortality. Based on a study of 89,000 people,
those eating meat-free diets appeared to cut their risk
of high blood pressure 55%, but those eating meat-free, egg-free,
and dairy-free had 75% lower risk. If, however, you’re already eating
a whole food plant-based diet, no processed foods, no table salt, and
you’re still not hitting 110 over 70, there are a few foods recently
found to offer additional protection. Ground flaxseeds, a few
tablespoons a day, induced one of the most potent
antihypertensive effects ever achieved by a dietary intervention,
2 to 3 times more powerful than instituting an aerobic
endurance exercise program. Watermelon also appears
to have extraordinary effects but you’d have to eat
like 2 pounds a day. Sounds like my kind of medicine,
but it’s hard to get year-round. Red wine may help, but only if
the alcohol has been taken out. Raw vegetables or cooked? And the answer is both,
though raw may work better. Beans, split peas, chickpeas,
and lentils may help a little. Kiwifruits though don’t
seem to work at all, even though the study was
funded by a kiwifruit company. Maybe they should
have taken direction from the California
Raisin Marketing Board who came out with this study showing
raisins can reduce blood pressure, but only, apparently, compared to fudge
cookies, Cheez-its, and Chips Ahoy!