One out of three adult Americans has hypertension (high blood pressure), and nearly 20% do not even know they have it.[1] Most people who have hypertension have no symptoms.[2] When symptoms occur, it is usually when blood pressure spikes suddenly and is extreme enough to be considered a medical emergency. Hypertension occurs when the pressure in the arteries increases, causing the heart to work harder than usual to pump blood throughout the body.
Blood pressure (BP) is measured using two numbers. The first number, systolic blood pressure, represents the pressure in your blood vessels when your heart beats. The second number, diastolic blood pressure, represents the pressure in your blood vessels when your heart rests between beats. Blood pressure is measured in millimeters of mercury (mmHg).
Medical professionals have generally agreed that the upper limit of “normal” BP is 140/90 mmHg. If your BP is consistently above that on three occasions, your healthcare provider will diagnose you with hypertension. An ideal BP is around 115/75 mmHg—this is where the BP-related risk of death from heart attack and strokes is near zero. But is it even possible to get your blood pressure that low? For those eating a healthy diet and making other lifestyle modifications, it’s not just possible. It’s normal.
Hypertension puts your health and quality of life in danger. Left uncontrolled, it can lead to:[3]
Stop thinking that now! Your blood pressure is more a consequence of your lifestyle habits than your genes. In The China Study, Dr. T. Colin Campbell explains how genes need to be “expressed” to participate in disease formation:
“Genes give us our predispositions. We all have different disease risks due to our different genes. But while we will never know exactly which risks we are predisposed to, we do know how to control those risks. Regardless of our genes, we can all optimize our chances of expressing the right genes by providing our bodies with the best possible environment—that is, the best possible nutrition.”
If you have a family history of hypertension, it is even more important that you make lifestyle changes. Genes might be the gun, but lifestyle is the trigger.
Nutrition
A mountain of studies dating back to the early 1920s show that those eating a plant-based diet have lower blood pressure than those eating meat, eggs, and dairy.[4][5] The Adventist 2 Study, which looked at 89,000 Californians, found that those who only ate meat once a week had 23% lower rates of high blood pressure. Those who cut out all meat except fish had 38% lower rates. Those eating no meat at all had less than half the rate. Vegans—cutting out all meat, fish, dairy, and eggs—appeared to have thrown three-quarters of their risk for this silent killer out the window![11]
One of the most impressive diet intervention programs was conducted by John McDougall, MD.[6] The study followed 500 subjects with various health problems who attended a 12-day residential lifestyle modification program. They consumed a low-fat whole food, plant-based (WFPB) diet including fruit, vegetables, whole grains, and legumes; and excluding all animal products and alcohol. There were no restrictions on portion size. Subjects also exercised and practiced stress management techniques. Within 11 days, subjects experienced significant drops in blood pressure. In most cases, all blood pressure medications were stopped shortly after beginning the program. How cool is that? Plants instead of pills!
So, you might wonder, does the American Heart Association recommend a 100% plant-based diet? Nope. They recommend the DASH diet—a low-meat diet. Why don’t they promote a completely plant-based diet? When the DASH diet was being created, were the authors unaware of the mountain of research on plant-based diets? No, they were aware. The DASH diet was designed to capture the blood pressure-lowering benefits of a vegetarian diet while still containing enough animal foods to make it palatable to the general population. They didn’t think the public could handle the truth.
In their defense, this is what their thought behind the messaging was—drugs don’t work unless you actually take them, and diets don’t work unless you actually eat them. They thought no one was going to eat a strictly plant-based diet, so they water-downed the message. They figured that a compromise diet, consumed on a large enough scale, would impact more people.
Tell that to the over thousand American families a day that loses a family member or friend to hypertension.[15] Is it not time that we start telling Americans the truth?
Sodium
Even a small reduction of sodium in your diet can diminish blood pressure measurements by 2 to 8 mm Hg.[7] In general, limit sodium to less than 2,300 mg a day or less. However, a lower sodium intake—1,500 mg a day or less—is appropriate for people with greater salt sensitivity. To decrease dietary sodium, consider these tips:
Exercise
Regular physical activity, for at least 30 minutes most weekdays, can lower your blood pressure by 4 to 9 mm Hg.[7] Consistency is key because once you stop exercising, your blood pressure can creep back up.
Alcohol
No more than one drink a day for women or men older than 65; no more than two a day for men 65 and younger.[7] One drink equals 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
Drinking more than moderate amounts of alcohol can raise blood pressure significantly. It can also reduce the effectiveness of blood pressure medications.[7] Even at low levels of consumption, drinking regularly elevates blood pressure. Estimates suggest that the attributable risk for developing hypertension from alcohol is 16%.9 However, this is largely reversible within 2 to 4 weeks of abstinence or a substantial reduction in alcohol intake.
Smoking
Cigarette smoking is a cardiovascular risk factor, and smoking cessation is a powerfully effective lifestyle measure for the prevention of cardiovascular diseases.[13] Not only does smoking immediately raise your blood pressure at the moment, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure chronically. Secondhand smoke also can increase your blood pressure.[14]
Stress Management
Stress can cause hypertension through repeated blood pressure elevations or by stimulating the nervous system to produce large amounts of hormones that constrict the blood vessels and increase blood pressure.[10] Factors affecting blood pressure through stress include white coat hypertension, job strain, social environment, and emotional distress. We cannot always change our stressors, but we can change the way we manage those stressors. The following strategies are helpful to help combat the effects of stress:
Most of the burden of hypertension, and related medical conditions, is largely preventable or reversible through lifestyle changes. Trying to reduce high blood pressure with medication may not be as effective as lifestyle approaches, as they do nothing to address the underlying causes. Even those on blood pressure medication can get a further 78% drop in risk by eating and living healthfully.[12]
The available scientific evidence accumulated in the past 30 years collectively indicates that the widespread adoption of a WFPB diet, along with maintaining a healthy weight, not smoking, and regularly exercising, can make hypertension a diagnosis of the past. True health is a process of optimal living with continued improvement over time. No matter our age or clinical condition, we can all strive to eat better, move more, and think more positively. We have the power to take control of our health.
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