Controlling High Blood Pressure: Beyond Salt
Consumption of foods rich in antioxidants, potassium and calcium is positive in the management of high blood pressure.
What steps can you take to control high blood pressure? This disease affects billions of people around the world. Its pharmacological control ends up requiring combination therapies which involve a high health cost.
Eliminating salt intake is unnecessary and insufficient. It is therefore essential to adopt non-pharmacological measures to effectively control high blood pressure.
Current research shows that, far from restrictive guidelines, adopting a healthy lifestyle is the ideal method for controlling high blood pressure.
What is high blood pressure?
The concept of blood pressure (BP) refers to the pressure of blood on the walls of the arteries. Systolic blood pressure (SBP) refers to the pressure when the heart contracts and pumps blood to the rest of the body.
On the other hand, diastolic blood pressure (DBP) refers to the value of blood pressure when the heart fills with blood. Arterial hypertension (hypertension) is defined by a PAS> 140 mmHg and / or a DBP> 90 mmHg during 3 non-consecutive measurements.
High blood pressure affects billions of people
This pathology is considered a public health problem that affects billions of people around the world. It is estimated that 30% of the population suffers from it and its prevalence exceeds 50% in people over the age of 50.
When not properly controlled, it ends up seriously damaging the heart, brain, eyes and kidneys, according to an article published in The Medical Clinics of North America.
High blood pressure is considered the number one cause of stroke and heart failure, and the second leading cause of chronic kidney disease. It is also the root cause of some of the leading causes of chronic blindness. In addition, according to WHO data, it is responsible for 15% of deaths worldwide.
It is clear that its control is essential. However, the high prevalence makes the cost of pharmacological treatment unsustainable. In addition, the increasing need for drug combinations means that the side effects are more and more numerous.
What can we do to control high blood pressure?
Lifestyle is one of the biggest factors in the genesis of hypertension and the good news is that it is a changeable factor. Drug treatment should be reserved for cases of hypertension which resist other measures.
Until now, non-pharmacological treatment has been based almost exclusively on reducing salt intake to avoid its attraction to liquids. But is this a necessary and sufficient measure?
It is not necessary to avoid the consumption of salt
Current scientific evidence shows that salt intake does not increase blood pressure in all people. Here are a few examples:
- The study by Baker, Curhan, de Jong, Forman, Gansevoort & Scheven (2012) concluded that salt intake increased blood pressure only in subjects with pre-existing vascular damage.
- The research of Arós et al. (2013) showed that, despite its high salt content, consumption of gazpacho was inversely correlated with arterial hypertension figures.
- A study by Carmona, Crespo, López, Navas, Nolasco & Santamaría (2016) also found no link between sodium intake and blood pressure.
Consumption of salt has an impact on blood pressure only in so-called “salt sensitive” subjects and these only represent 50% of cases.
However, as long as the cause and effect relationship is not known with precision, and there are no tools to easily detect such sensitive subjects, it is recommended to maintain a cautious consumption (1 teaspoon coffee of salt per day = 5 grams of salt per day = 2.3 grams of sodium per day).
How to control hypertension beyond salt?
In general terms, a proper approach to hypertension involves taking measures that normalize the volume of fluids, reduce the viscosity of the blood, increase the caliber of the arteries, or prevent arterial stiffness.
Thinking about the pressure inside a pipe can help us understand the strategy : normalize the flow, reduce impurities in the water, put bigger pipes or make them out of flexible material.
Increase potassium, calcium and magnesium intake
The beneficial role of potassium in controlling blood pressure is indisputable. Indeed, it promotes urinary sodium excretion, relaxes smooth muscles and decreases peripheral resistance.
In other words, it normalizes the circulating blood volume and promotes the adaptability of the arteries.
Calcium and magnesium have also been shown to be effective in controlling hypertension. Calcium helps good blood pressure management by inhibiting parathyroid hypertension factor (HPT).
Magnesium does this by a mechanism that is not yet known. However, a higher incidence of hypertension has been detected in populations with a deficit in consumption of this mineral.
Other minerals such as zinc, manganese and copper may be involved in the genesis of hypertension. However, research on this topic is too immature to draw any conclusions.
Increase fiber and protein intake
Consuming 25-40g / day of fiber has a lowering effect on blood pressure due to
- The fibers decrease vascular resistance and improve the entry and exit of blood through the heart.
- They slow down the activity of an enzyme (ACE) responsible for the production of a hypertensive substance (angiotensin II) and the inhibition of a hypotensin (bradykinin).
- They increase the retention of hypotensive minerals such as potassium or magnesium.
- Foods that contain it are generally very high in antioxidants and these have also been shown to be beneficial for blood pressure control.
Vitamins D and K are essential
The combination of low vitamin D and K levels has been linked to increased blood pressure. Both appear to be actively involved in the regulation of a protein that inhibits artery calcification (MGP): vitamin D increases its quantity and vitamin K activates it.
This is a very innovative finding (the first research on this topic was published in March 2017) and therefore there is a need for further research.
However, research by Beulens, Brouwer, Cepelis, van Ballegooijen, van Schoor & Visser (2017), after analyzing 171 subjects, firmly concluded that both vitamins play an important role in the development of hypertension.
Reduce consumption of high glycemic index carbohydrates
The excess of glucose in the blood leads to an increase in the viscosity of the blood and therefore an increase in blood pressure. In fact, people with diabetes mellitus often end up developing high blood pressure.
Avoid harmful fats
Trans fatty acids and most saturated fats predispose to hypertension. Their effect is due to the accumulation of cholesterol inside the arteries by increasing LDL proteins and reducing HDL.
Maintaining adequate hydration helps control high blood pressure
Adequate hydration promotes blood purification and reduces blood viscosity. The result is a drop in blood pressure.
Cardiovascular physical activity is essential for controlling high blood pressure
People who are more sedentary have a 30-50% higher risk of developing high blood pressure. The Spanish Heart Foundation considers cardiovascular physical activity, such as walking, to be one of the most appropriate measures for controlling blood pressure.
Its benefits are attributed to its vasodilator effect, the elimination of sodium through sweat and its contribution to weight loss.
Excess body fat has a 2-6 times higher risk of hypertension, being even higher when fat accumulates in the trunk (central or “apple-like” obesity).
Ensure a sufficient night’s rest
Getting a good night’s sleep is essential. Different studies establish a link between sleep problems and a higher prevalence of hypertension. Getting a good night’s sleep has also been shown to help reduce high blood pressure.
Good stress management is essential for controlling high blood pressure
Stress activates a whole series of hormones that stimulate the sympathetic nervous system and this is directly linked to hypertension. Thus, learning to manage stress would lead to a considerable reduction in the number of people with this pathology.
Avoiding the consumption of tobacco and alcohol
Tobacco and alcohol are toxic substances capable of increasing blood pressure. The hypertensive effect of tobacco is due to the increased viscosity of the blood. Alcohol works this way because of its role in the genesis of various health problems directly linked to an increase in blood pressure.
- Examples are diabetes mellitus, high cholesterol and central obesity.
The gut microbiota is the key to controlling high blood pressure
As with other chronic diseases, people with hypertension share characteristics of the gut microbiota that have not been found in healthy people. Some hypotheses suggest that it could be due to the salt intake.
The study by Alm, et al. (2017) showed a lower presence of Lactobacillus in the gut microbiota of mice given a high salt diet for several weeks.
The reduction in this bacterial population has been associated with an increase in pro-inflammatory T (H) 17 cells and therefore an increase in blood pressure.
The findings were the same in a pilot study of 12 people. The gut microbiota could explain why “only 50% of people with hypertension react negatively to salt intake ”.
Diet as a method of controlling hypertension
In terms of food, the Mediterranean diet is ideal for applying all the nutritional recommendations mentioned above.
However, remember to maintain a healthy lifestyle that includes : sleeping well, being active, managing stress and not consuming toxic substances. In addition, supplementation with Lactobacillus may contribute to better results.
The best way to control high blood pressure is to take a holistic approach that goes beyond eating salt.
