Hypertension increases the risk of coronary heart disease (CHD) and stroke. Diet and lifestyle are among the various factors that can contribute to hypertension, along with age, sex, genetics and stress. In addition to stopping smoking and exercising regularly, the following dietary advice is appropriate:
Reduce salt intake - There is evidence that high sodium intake increases the risk of hypertension and that reducing salt intake may reduce risk. However, the influence of salt on blood pressure may be smaller than that of obesity or alcohol. Salt restriction has more effect in older people and in those with higher initial blood pressure.
The UK recommendation is that the average adult sodium intake should fall by one-third (ie, from the current level of 9g/day to 6g/day). This can be achieved by cutting down on salt added during cooking or at the table. However, two-thirds of sodium is derived from processed foods (eg, pies, breakfast cereals, bread, canned soups, sausages, corned beef, savoury snacks), cheese, bacon and ham. Most fresh food contains little salt and should be recommended.
Increase potassium intake - An increased potassium intake may be protective because potassium is a metabolic counterbalance to sodium. Potassium is found in fresh fruit and vegetables, especially in bananas, blackcurrants, rhubarb, apricots, dried fruit, fruit juice, mushrooms and spinach. It is also in baked beans.
Avoid obesity and overweight - Obesity is a major determinant of hypertension, and weight reduction is an important part of its management.
Keep alcohol intake within sensible limits - There is a strong link between high alcohol intake (eg, >30 units/week) and hypertension. Alcohol intake should be limited to a maximum of two to three units/day. (One unit is equivalent to a glass of wine, a single measure of spirits or half a pint of ordinary strength beer, lager or cider.) Intake should be spread evenly through the week and binge drinking avoided. A large amount of alcohol in the evening may raise blood pressure significantly the following day.
This series of "dietary advice tips" is intended to be a reminder of the main points to be made by pharmacists when giving nutritional information to the public. The conditions included in the series are those where diet is a well recognised risk factor, those in which diet contributes to the management of the condition, and others for which patients may welcome sound dietary advice. The series is written by Dr Pamela Mason (a pharmacist with a postgraduate qualification in nutrition)
