Introduction Blood Pressure and Vegetarian Diets, a global meta-analysis published Feb. 24, 2014, in JAMA Internal Medicine, finds a nutrient-packed vegetarian diet can lower blood pressure and reduce the risk of heart disease. 1 Background High blood pressure (hypertension) affects 31 percent of American adults. 2 Elevated blood pressure is rising nearly 30 percent in teens, 3 and by 2025, hypertension will affect 1.56 billion adults worldwide. 4 This is a growing health concern, since hypertension increases the risk for heart attack and stroke, which are the first and third leading causes of death in America. 5 Here are eight tips to naturally lower blood pressure from Neal Barnard, M.D., president of the nonprofit Physicians Committee, adjunct professor of medicine at the George Washington University School of Medicine and Health Sciences, and co-author of the new Blood Pressure and Vegetarian Diets meta-analysis published in JAMA Internal Medicine: Eight Ways to Lower Blood Pressure 1. Know Your Numbers. Aim for a total blood pressure less than 120/80 mm Hg. 2. Choose Plant-Based Foods. Vegetarian diets lower blood pressure by 7/5 mm Hg. 3. Reduce Salt Intake. Adults should consume no more than 1,500 mg of sodium each day. 4. Power Up with Potassium. Consume at least 4,700 mg of each day by consuming plenty of fruits and vegetables. 5. Maintain a Healthy Weight. Maintain a trim waistline. Keep BMI between 18.5 and 24.9. A plant-based diet will help you get there. 6. Exercise. Participate in at least 30 minutes of moderate physical activity each day. 7. Limit Alcohol Intake. Limit alcohol consumption. Women should consume less than one drink per day (due to breast cancer risk), men no more than two. 8. Avoid Tobacco. Smoking doubles your risk for heart disease. 2
1. Know Your Numbers Aim for a total blood pressure less than 120/80 mm Hg. Systolic blood pressure is the top blood pressure number, which measures the pressure in the arteries when your heart beats. Aim for systolic blood pressure less than 120 mm Hg (millimeters of mercury). A systolic blood pressure higher than 120 mm Hg indicates your heart is working overtime to pump blood through your blood vessels, which exerts maximum pressure on your arteries. Diastolic blood pressure is the bottom blood pressure number, which measures the pressure in the arteries when your heart is at rest between beats. Aim for diastolic blood pressure less than 80 mm Hg. A diastolic blood pressure reading above 80 mm Hg indicates your heart is working harder than necessary to fill your leftventricular heart chamber with blood. Over time this can lead to congestive heart failure. Prehypertension starts at 120/80 mm Hg and hypertension starts at 140/90 mm Hg: Classification SBP DBP Normal <120 and <80 Prehypertension 120-139 or 80-89 Stage 1 Hypertension Stage 2 Hypertension 140-159 or 90-99 >160 or >100 To gauge your blood pressure, stop by your physician s office or local pharmacy. A health care provider will use three tests to ensure accuracy. If you have or are at risk for hypertension, talk to your physician about a home blood pressure monitoring device. Blood Pressure Fact: An increase of 20/10 mm Hg, starting at 115/75 mm Hg, doubles the risk of cardiovascular disease. 6 2. Choose Plant-Based Foods. Vegetarian diets are associated with low blood pressure. New research published in JAMA Internal Medicine shows adults who follow a vegetarian diet have a blood pressure 7/5 mm Hg lower than adults who consume a diet including meat. 1 Changing the way you eat to favor fruits, vegetables, whole grains, and legumes can bring your blood pressure down and reduce need for antihypertensive medications. Based on clinical trials, people who make dietary changes can expect to see lower blood pressure, an average drop of 5/2 mm Hg, in just six weeks. 1 Include more of the following foods in your diet: Whole Grains Beans/legumes Vegetables Fruits Brown Rice, Whole-Wheat Bread or Pasta, Oatmeal, Millet, Barley, Buckwheat Groats, Quinoa Black-Eyed Peas, Kidney Beans, Pinto Beans, Lentils, Navy Beans, Chickpeas, Tofu Fresh or Frozen Broccoli, Collard Greens, Kale, Spinach, Carrots, Potatoes, Tomatoes, Squash Bananas, Oranges, Apples, Pears, Grapefruit, Strawberries, Mango, Papaya, Guava, Blueberries 3
Blood Pressure Fact: When you avoid animal fats and added oils, your blood becomes less viscous that is, it s less thick. It becomes more like water and less like grease, and that means it flows more easily through your arteries. Your heart no longer has to push as hard to keep your blood moving. Plant-based foods are naturally rich in and low in sodium, fat, and cholesterol. 3. Reduce Salt Intake. Adults should consume less than 1,500 mg of sodium each day. Instead of adding salt to recipes, try experimenting with spices and herbs, such as cinnamon, pepper, curry powder, and cilantro. On the go? Become savvy at reading nutrition labels. Packaged meals, snacks, and salt-added canned goods can easily supply a day s worth of sodium in just one serving. In addition to wreaking havoc on your heart, a diet rich in sodium can take a toll on your kidneys and disrupt calcium balance, increasing the risk for osteoporosis. 7 Here s how to decipher sodium content in food labels: Low Sodium: contains 140 mg or less sodium per serving. Very Low Sodium: contains 35 mg of less sodium per serving. Sodium Free: contains less than 5 mg of sodium per serving. Blood Pressure Fact: Just like fatty foods, sodium s blood-pressure-raising effect can strain your arteries, which makes your heart work harder to regulate blood flow in your body. Excess sodium consumption over time can increase the risk of a heart attack or stroke. 8 4. Power Up With Potassium. Aim for 4,700 mg of each day. Your kidneys use and sodium to balance blood flow in your body. By opting for foods low in sodium and rich in, your blood pressure will naturally fall. Adults should aim for 4,700 mg of each day. Especially good sources include: Tomatoes or Tomato Products Raisins or Figs Green Vegetables Lentils and Beans Orange Fruits and Vegetables Bananas Tomato Paste 1/4 Cup of Raisins (a small handful) Bok Choy Lentil Soup Butternut Squash One Medium Banana 2,657 mg 1,021 mg 631 mg 590 mg 474 mg 422 mg Blood Pressure Fact: Researchers from the Coronary Artery Risk Development in Young Adults (CARDIA) study find study participants who consume the most plant foods reduce their risk of developing hypertension by 36 percent. 9 5. Maintain a Healthy Weight. Maintain a trim waistline and BMI between 18.5 and 24.9. Excess weight can take a toll on your heart. The good news is losing even 10 pounds can lower blood pressure. 10 People who maintain a healthy 4
weight reduce risk for type 2 diabetes, heart problems, joint problems, and some forms of cancer. 11 Your body mass index (BMI) is a measure of your weight that is adjusted for your height and is used to assess health risk. You can use a variety of online calculators, including the simple tool at NutritionMD.org. A healthful BMI falls in the range of 18.5 and 24.9. 12 After you assess your BMI, measure your waistline. A waist circumference greater than 40 inches for men and 35 inches for nonpregnant women is linked to increased risk for high blood pressure. To measure your waist circumference, place a flexible measuring tape around your bare abdomen just above your hip bone. The tape should be snug but not tight. Exhale before measuring. Blood Pressure Fact: A healthful plant-based diet causes easy weight loss, and losing excess weight can help lower blood pressure by 5 to 20 mm Hg. 6. Exercise. Get at least 30 minutes of moderate physical activity each day. Exercise can help bring your weight and blood pressure down. All you need is a 30-minute brisk walk each day. Sixty minutes of aerobic exercise--swimming, biking, or kickboxing three times a week counts, too. Maintain a regular exercise program and expect to see lower blood pressure in just one to three months. 14,15 7. Limit Alcohol Use. Women should consume less than one drink per day (due to breast cancer risk), men no more than two. Alcohol can cause a sudden rise in blood pressure. Women should consume less than one alcoholic beverage per day (daily alcohol use increases breast cancer risk), 16 and men should limit themselves to no more than two drinks. 17 An alcoholic beverage is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80- proof distilled liquor. Blood Pressure Fact: The National Heart, Blood, and Lung Institute finds modifying alcohol consumption can lower systolic blood pressure by an average of 2 to 4 mm Hg. 13 8. Avoid Tobacco. There are many good reasons to quit smoking and healthier arteries is one. Each cigarette immediately raises blood pressure and damages the arteries. The Centers for Disease Control and Prevention finds people who smoke have twice the risk for coronary heart disease and stroke, compared to nonsmokers. 18 Blood Pressure Fact: Quit smoking for someone you love. Secondhand smoke increases heart disease risk by 25 to 30 percent. 18 Blood Pressure Fact: Becoming more active helps lower blood pressure by 4 to 9 mm Hg. 13 5
References: 1. Yokoyama Y, Nishimura K, Barnard ND, et al. Vegetarian diets and blood pressure: a meta-analysis. JAMA Intern Med. Published online February 24, 2014. doi:10.1001/jamainternmed.2013.14547. 2. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988 2008. JAMA. 2010;303:2043-2050. 3. Rosner B, Cook NR, Daniels S, Flakner B. Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988-2008. Hypertension. 2013;62:247-254. 4. Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365:217-223. 5. Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: final data for 2009. National Vital Statistics Reports. Hyattsville, MD: National Center for Health Statistics; 2012. 60(3). 6. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002; 360:1903-1913. 7. Nordin BE, Need AG, Morris HA, Horowitz M. The nature and significance of the relationship between urinary sodium and urinary calcium in women. J Nutr. 1993;123:1615-1622. 8. Bibbins-Domingo K, Chertow GM, Coxson PG, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med. 2010;362:590-599. 9. Steffen LM, Kroenke CH, Yu X. Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. 2005;82:1169-1177. Pressure_UCM_002052_Article.jsp. Accessed February 12, 2014. 11. U.S. Department of Health and Human Services. Do you know some of the health risks of being overweight? http://win.niddk.nih.gov/publications/health_risks.htm. Accessed February 12, 2014. 12. Centers for Disease Control and Prevention. Healthy weight it s not a diet, it s a lifestyle! http://www.cdc.gov/healthyweight/assessing/index.html. Accessed Feb. 12, 2014. 13. U.S. Department of Health and Human Services. Reference card from the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC7). https://www.nhlbi.nih.gov/guidelines/hypertension/phyc ard.pdf. Published May 2003. Accessed February 12, 2014. 14. Farpour-Lambert NJ, Aggoun Y, Marchand LM, Martin XE, Herrmann FR, Beghetti M. Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children. J Am Coll Cardiol. 2009;54:2396-2406. 15. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta analysis. J Am Heart Assoc. 2013;2:e004473. 16. Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 2011;306:1884-1890. 17. Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol. 2006;33:847-852. 18. U.S. Department of Health and Human Services. The health consequences of smoking 50 years of progress: a report of the surgeon general, 2014. http://www.surgeongeneral.gov/library/reports/50-yearsof-progress/. Accessed February 13, 2014. 10. American Heart Association. Understand your risk for high blood pressure. http://www.heart.org/heartorg/conditions/highbloo dpressure/understandyourriskforhighbloodpressure/ Understand-Your-Risk-for-High-Blood- 6