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The Physicians Committee




Section Five: Foods and Blood Pressure

Hypertension is among the most common problems that will confront your patients. One in every four American adults has, or is being treated for, high blood pressure, defined as a systolic pressure of 140 mm Hg or greater and/or a diastolic pressure of 90 mm Hg or greater. In 1992, medical treatment of hypertension cost $12.5 billion. The personal and social costs are many times higher.

The condition takes a disproportionate toll among African Americans. Among men, the age-adjusted prevalence is 34 percent for African Americans, compared to 25 percent for whites. For women, hypertension affects 31 percent of African Americans, compared to 21 percent of whites.1

High blood pressure is dangerous. It increases the risk of heart disease, stroke, and other serious problems. While pharmacologic treatment is often necessary for controlling blood pressure, diet plays a central role, both in its cause and treatment.

Reducing Sodium

Dietary sodium is a well-known contributor to high blood pressure. Sodium holds water, and the increased water content in the vascular system increases blood pressure. The effect of reducing salt intake is often modest, but is nonetheless important.

Patients often have little idea as to which foods contribute sodium to their diet. Aside from table salt, the highest-sodium foods by far are frozen meals and canned and snack products, due to the addition of salt during processing. Dairy products are the next highest in sodium, followed by meats. In their natural state, plant foods—grains, legumes, vegetables, and fruits—have almost no sodium. Patients should be encouraged to favor fresh or frozen vegetables and beans, rather than canned products, and reduced sodium products are also increasingly available.

SODIUM AND POTASSIUM IN FOODS (milligrams)

PLANT PRODUCTS

ANIMAL PRODUCTS

Source

Sodium

Potassium

Source
Sodium Potassium
Apple (1 medium)

1

159

Whole milk (1 cup)

120

370

Banana (1 medium)

1

451

Skim milk (1 cup)

126

406

Black beans (1 cup*)

6

801

Goat’s milk (1 cup)

122

499

Broccoli (1 cup*)

44

332

Human milk (1 cup)

40

128

Cauliflower (1 cup)

8

400

Yogurt (1 cup)

105

351

Cream of Wheat (1 cup*)

7

48

Cheddar cheese (2 oz.)

352

56

Grapefruit (1 medium)

0

316

Ground beef (4 oz.*)

69

253

Navy beans (1 cup*)

2

669

Roast beef (4 oz.*)

51

377

Orange (1 medium)

1

250

Chicken breast (4 oz.*)

82

286

Potato (1 medium*)

16

844

Haddock (4 oz.*)

98

447

Rice (1 cup*)

1

60

Swordfish (4 oz.*)

130

414

* Figures refer to cooked servings.

Source: Pennington JAT. Bowes and Church’s Food Values of Portions Commonly Used. 16th Edition, Philadelphia, J.B. Lippincott, 1994.


PROCESSING ADDS SALT IN CANNED AND SNACK FOODS

Source Sodium (mg)
Tomato (1, raw)

11

Tomato soup (canned, 1 cup)

872

 
Boiled black beans (1 cup)

6

Canned black beans (1 cup)

922

 
Boiled green beans (1 cup)

4

Canned green beans (1 cup)

340

 
Low Salt Wheat Thins (8 crackers)

60

Wheat Thins (8 crackers)

120

 
Potato (1 medium)

16

Potato chips (1 ounce)

168

SODIUM IN TYPICAL FROZEN PRODUCTS

Fish ’n Chips (Swanson) 963
Pancakes with Blueberries (Swanson) 796
Pasta Trio (Tyson) 890

Source: Pennington JAT. Bowes and Church’s Food Values of Portions Commonly Used. 16th Edition, Philadelphia, J.B. Lippincott, 1994.

Reducing or Eliminating Meat Consumption

Vegetarian diets are best known for their use in the reversal of atherosclerotic lesions in the coronary arteries. However, such diets are also invaluable for treating hypertension.

Vegetarians have a much lower prevalence of hypertension compared to meat-eaters. The research establishing the differential effects of meat-based and vegetarian diets began with comparisons of religious groups following different dietary customs. For example, both Mormons and Seventh-day Adventist avoid coffee, alcohol, tea, and tobacco, but most Mormons are omnivores, while about half of all Adventists are vegetarians. Vegetarian Adventists were found to have systolic pressures that were eight to nine points lower and diastolic pressures that were six to eight points lower, compared with Mormon omnivores.2

A study of Caucasian Adventists found hypertension in 22 percent of omnivores, but only 7 percent of vegetarians. Among African Americans, the prevalence was 44 percent for omnivores and 18 percent of vegetarians.3

Used clinically, a vegetarian diet reduces both systolic and diastolic blood pressure by as much as 10 percent, an effect that is independent of salt intake.4,5

The mechanism by which the diet change works is not clear. A vegetarian diet promotes weight loss, but the drop in blood pressure occurs before any substantial weight change. More likely, the change in blood pressure is due to the lower blood viscosity that follows a reduction in dietary fat.6,7 The vitamin C and omega-3 fatty acid content of vegetarian diets may also contribute to blood pressure lowering.8

For tips on helping patients to make a transition to a vegetarian diet, see Section 1 on reversing heart disease.

Foods and Blood Pressure Study Questions

  1. What kinds of diets are associated with high blood pressure?
  2. What foods would you recommend your patients avoid? What are the alternatives?

References
1. Burt VL, Cutler JA, Higgins M, et al. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension 1995;26:60-9.
2. Rouse IL, Armstrong BK, Beilin LJ. Vegetarian diet, lifestyle and blood pressure in two religious populations. Clin Exp Pharmacol and Physiol 1982;9:327-30.
3. Melby CL, Goldflies DG, Hyner GC, Lyle RM. Relation between vegetarian/nonvegetarian diets and blood pressure in black and white adults. Am J Publ Health 1989;79:1283-8.
4. Rouse IL, Beilin LJ. Editorial review: vegetarian diet and blood pressure. J Hypertension 1984;2:231-40.
5. Anderson JW. Plant fiber and blood pressure. Ann Intern Med 1983;98(Part 2):842.
6. Ernst E, Pietsch L, Matrai A, Eisenberg J. Blood rheology in vegetarians. Br J Nutr 1986;56:555-60.
7. Ernst E, Matrai A, Pietsch L. Vegetarian diet in mild hypertension. Br Med J 1987;294:180.
8. Berry EM, Hirsch J. Does dietary linolenic acid influence blood pressure? Am J Clin Nutr 1986;44:336-40.



 

Table of Contents

Study questions included at the end of each section

Introduction

Section One:
Preventing and Reversing Heart Disease

Section Two:
Cancer Prevention

Section Three:
Cancer Survival

Section Four:
Diabetes

Section Five:
Foods and Blood Pressure

Section Six:
Nutrition and Renal Disease

Section Seven:
Preventing and Reversing Osteoporosis

Section Eight:
Nutrition and Arthritis

 
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