DASH to lower blood pressure

Hypertension is the medical term for high blood pressure. A normal blood pressure is less than 120/80 mm Hg and any blood pressure greater than 140/90 is considered hypertension. High blood pressure is dangerous because it places extra stress on the heart and can cause damage to other organs, especially the eyes and kidneys. Hypertension affects 25 percent of adult Americans and is particularly common among African-Americans and older Americans. Sixty percent of those over age 60 have hypertension. Medication can be used to treat hypertension, but some lifestyle changes are also effective. Patients who maintain a healthy weight, are physically active and follow a healthy eating plan can help control and even prevent hypertension.

The DASH diet (Dietary Approaches to Stop Hypertension) was studied by the National Heart, Lung and Blood Institute, which found that blood pressure can be lowered through dietary changes. In fact, the study found that the DASH diet could lower blood pressure by a few points in just two weeks and up to eight to 14 points over an extended period. In some people, this reduction might make it possible to reduce medication doses or even to avoid taking medication altogether. The basic DASH diet does not aggressively reduce sodium or salt intake, but a lower sodium DASH diet encourages an active reduction in the sodium you eat. The low-sodium DASH diet does not involve any modifications in the basic DASH diet except sodium reduction and it can reduce blood pressure even further than the standard DASH diet.

The DASH diet is based on consuming a broad variety of foods and increasing the intake of foods high in nutrients. It limits saturated fats and cholesterol. Depending on how many calories a day you require to maintain or lose weight, a day on the DASH diet might include the following food groups: six to eight servings of whole grains; eight to 10 fruits and vegetables; two to three fat-free or low-fat dairy servings; six or fewer servings of lean meats, poultry or fish; and two to three fats and oils. In addition, you could add four to five servings of nuts, seeds, and beans as well as five or fewer sweets weekly.

Finally, you should aim for sodium intake of 1,500-2,400 milligrams per day–that’s only two-thirds to one teaspoon of table salt per day. Remember, the lower the sodium intake, the lower the blood pressure. Key to succeeding with the DASH diet is understanding the importance of serving size. For example, a serving of meat is only 1 ounce. A 3-ounce piece of meat is about the size of a deck of cards.

You may need to introduce yourself to the DASH diet gradually. The DASH diet is rich in fruits and vegetables and whole grains, which can lead to bloating, gas and diarrhea in some people. You might try just adding a serving of fruit or vegetables to lunch and dinner. Gradually increase your use of dairy products to three servings a day–for example, you could substitute a glass of skim or 1 percent milk instead of soda, sweetened tea, or alcohol at lunch or dinner. Don’t make meat the center of your meal.

Although you might not use the salt shaker at the table, you may still be getting too much sodium in your diet. Processed foods account for most of the salt and sodium that Americans consume. Read food labels carefully to choose products lower in sodium. Buy fresh or ‘no salt added’ vegetables. Use fresh meats rather than canned or processed. Use spices at the table instead of table salt.

Talk to your doctor for more information about serving sizes and tips for following the DASH diet. Do not discontinue or reduce your medication without careful supervision from your doctor.

Dr. McMahon, a graduate of Yale University and the University of Pittsburgh School of Medicine, is board certified in Internal Medicine. She is a member of the American College of Physicians and the Allegheny and Pennsylvania Medical Societies. She is in solo practice in the North Hills.