(1) Hypertension
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.
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