If you don’t have high blood pressure, odds are that someone very close to you does. Nearly half of American adults have it, and many have no idea. High blood pressure, or hypertension, is referred to as the “silent killer” because there often are no symptoms. Yet the condition dramatically raises the risk for heart attack, stroke, kidney failure — even blindness.
The American Heart Association and the American College of Cardiology updated the guidelines last fall to redefine hypertension and how doctors should treat it.
The numbers for healthy blood pressure haven’t changed much except that 120/80 mmHg is now the upper limit for normal. The first number (systolic) represents the pressure on our vessel walls when our heart beats; the second number (diastolic) is the pressure when our heart rests between beats.
If blood pressure is higher than 120/80, risk goes up.
For years, “hypertension” was defined as a blood pressure of 140/90 or higher. Now, 130/80 or higher is considered hypertension, making it easier to catch and address the problem early on.
Although medication may be needed to treat high blood pressure, the new guidelines strongly recommend lifestyle changes as a first line of defense. Weight, physical movement, diet and alcohol consumption are all directly linked to blood pressure; here are five key strategies to help stack the odds in our favor.
Healthy weight: Being overweight is directly correlated with high blood pressure, making it more important than ever to maintain a healthful weight and to work toward losing extra pounds. The new guidelines note that we can expect to see about a one-point drop in systolic blood pressure for every 2 pounds lost.
More movement: Incorporating regular physical activity into our lifestyle reduces our risk of hypertension. It also helps to reduce stress levels, which even further lowers risk. Aim for some type of exercise daily (ideally at least 90 to 150 minutes per week for the potential benefit of shaving about 5 points off of systolic pressure). If that seems overwhelming, start with 5 to 10 minutes daily.
Less salt: Diet, sodium in particular, affects blood pressure. Not everyone with hypertension is sodium-sensitive, but for those who are it pays to find ways to trim extra salt.
The USDA Dietary Guidelines for Americans recommend that most of us limit daily sodium intake to no more than 2,300 mg. Those with certain risk factors – age 51 or older, African-Americans, high blood pressure, diabetes or kidney disease — are encouraged to keep sodium intake under 1,500 mg daily.
And it’s not as easy as ditching the salt shaker. Top sneaky sodium culprits include salad dressing, breads and cheese, as well as not-so-stealthr sodium bombs like deli meats, broths and soups, and fast food.
Here’s a rundown of my favorite salt swaps:
- Cheese: Swiss, goat, fresh mozzarella and burrata cheese have about 50 to 75 percent less sodium than cheeses like cheddar or feta.
- Bread: Ezekiel makes a “lower sodium” sliced bread that actually has zero sodium. Corn tortillas are naturally low in sodium with 5 mg per tortilla, compared to about 300 mg or more for a flour (or even whole-wheat) tortilla.
- Hot sauce: Tabasco is my go-to brand with 35 mg sodium per teaspoon, compared to 240 mg for Louisiana Hot Sauce.
- Cajun seasoning: Chef Paul Prudhomme’s Blackened Redfish Magic Seasoning is a staple in our house, with 95 mg sodium per quarter-teaspoon, compared to 350 mg for Tony Chachere’s Original Cajun Seasoning. Tony Chachere’s makes a no-salt seasoning as well.
- Salad dressing: DIY salad dressing with oil and vinegar is always an option. Locally made Hanley’s dressings are lower in sugar and sodium than most other varieties in stores. Look for Hanley’s in stores like Rouses Markets and Whole Foods Market.
More potassium: In addition to cutting back on salt, a potassium-rich diet is beneficial for blood pressure. Upping potassium intake to 3,500 to 5,000 mg daily can help to drop systolic pressure by about 4 to 5 points. And that doesn’t have to mean bananas all day. A one-cup serving of everyday foods like steamed or sauteed spinach (839 mg), red beans (717 mg), sweet potatoes (664 mg) or Greek yogurt (573 mg) all have more potassium than the 422 mg you’ll find in a banana.
Moderate alcohol. The recommended upper limit is one drink a day for women, two for men. Reminder: A standard “drink” is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor. I know, we can blow through this in no time in New Orleans. But it really matters, since dialing back to these “moderate” levels can improve systolic pressure by about four points.
The bottom line: The new blood pressure guidelines make it clear that lifestyle is the underlying issue in most instances of hypertension. So, while medication may be required for some, many of us might be able to head off high blood pressure by making changes in our eating habits and lifestyle, especially as we grow older.
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Editor’s note: Registered dietitian Molly Kimball offers brand-name products as a consumer guide; she does not solicit product samples nor is she paid to recommend items.
Molly Kimball is a registered dietitian in New Orleans. She can be reached at [email protected]. Comment and read more atNOLA.com/eat-drink. Follow her on Facebook, Instagram and Twitter, @MollyKimballRD.
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