# Eating to Lower Your Blood Pressure **A guide for people with high blood pressure (hypertension)** --- ## Why food matters High blood pressure means the force of blood pushing against your artery walls stays too high. Over time this strains your heart, kidneys, brain, and eyes. Changing what you eat is one of the strongest tools you have. In research studies, people who followed the eating plan in this handout lowered their top blood pressure number by about **8 to 14 points** — similar to what one blood pressure pill can do. Many people see a change within **2 weeks**. Food does not replace your medicine. Keep taking any medicine your doctor prescribed unless they tell you to stop. But eating well may mean fewer pills, lower doses, or better protection over time. --- ## The plan in one picture: DASH DASH stands for **D**ietary **A**pproaches to **S**top **H**ypertension. It is not a crash diet. It is a normal way of eating, built around foods that are naturally rich in potassium, magnesium, calcium, and fiber — and low in salt and saturated fat. ### What a day looks like (based on about 2,000 calories) |Food group|Servings per day|What one serving looks like| |---|---|---| |Vegetables|4–5|1 cup raw leafy greens, ½ cup cooked veg| |Fruit|4–5|1 medium apple, ½ cup berries, ¼ cup dried fruit| |Whole grains|6–8|1 slice bread, ½ cup cooked rice or oatmeal| |Low-fat dairy|2–3|1 cup milk or yogurt, 1½ oz cheese| |Lean meat, poultry, fish|6 oz or less|3 oz cooked ≈ deck of cards| |Nuts, seeds, beans|4–5 per **week**|⅓ cup nuts, ½ cup cooked beans| |Fats and oils|2–3|1 tsp olive oil, 1 Tbsp light mayo| |Sweets and added sugar|5 or fewer per **week**|1 Tbsp sugar or jam| If you eat fewer calories than this, scale the numbers down. Ask your care team for a version that fits you. --- ## Step 1: Cut the salt (sodium) This is the single biggest change for most people. - **Aim for less than 1,500 mg of sodium a day.** - If that feels out of reach, cutting **1,000 mg a day** from what you eat now still lowers blood pressure. - The average adult eats about 3,400 mg a day — more than double the goal. ### Most salt is not from the salt shaker About **70%** of the sodium people eat is already in packaged and restaurant food before it reaches the table. Watch these six especially: 1. **Bread and rolls** — low sodium per slice, but it adds up fast 2. **Pizza** 3. **Sandwiches and deli meat** — turkey, ham, salami, bacon, hot dogs 4. **Soup** — canned and restaurant 5. **Burritos and tacos** 6. **Savory snacks** — chips, pretzels, crackers, popcorn Also high: canned vegetables and beans, frozen dinners, jarred sauces, salad dressing, soy sauce, ketchup, pickles, olives, cheese, seasoning packets, boxed rice and pasta mixes. ### How to read the label Look at the **Nutrition Facts** panel and find **Sodium**. - The **% Daily Value** is your quick guide: **5% or less is low. 20% or more is high.** - Check the **serving size** first. A can of soup is often 2 servings, so double the number. - Words on the front: - _Sodium-free_ — under 5 mg per serving - _Very low sodium_ — 35 mg or less - _Low sodium_ — 140 mg or less - _Reduced sodium_ — 25% less than the regular version (may still be high) - _No salt added_ — no salt added during processing, but the food may still contain sodium ### Easy swaps |Instead of|Try| |---|---| |Canned soup|Low-sodium broth with your own vegetables| |Deli turkey|Sliced roast chicken or turkey you cooked| |Canned beans|Dried beans, or canned "no salt added" — or rinse canned beans in a colander for 1 minute (removes up to 40% of the sodium)| |Seasoning packets|Garlic, onion powder, black pepper, paprika, cumin, oregano| |Soy sauce|Low-sodium soy sauce, and use half as much| |Salted nuts|Unsalted nuts| |Table salt at the stove|Lemon juice, lime, vinegar, fresh herbs| **About salt substitutes:** Products made with potassium chloride (such as "lite salt") can help lower blood pressure. **But do not use them without asking your doctor first.** They are unsafe for some people — see the potassium warning below. **Your taste will adjust.** Most people find that after 2–4 weeks of less salt, food they used to enjoy now tastes too salty. --- ## Step 2: Eat more potassium Potassium helps your body get rid of extra sodium and relaxes blood vessel walls. Most adults should aim for **3,500–5,000 mg a day** from food. **Good sources:** potatoes and sweet potatoes, beans and lentils, spinach and other leafy greens, bananas, oranges and orange juice, cantaloupe, avocado, tomatoes and tomato sauce, yogurt and milk, salmon, dried apricots, prunes, winter squash. > ### ⚠️ Important safety note > > **Do not increase potassium — from food, salt substitutes, or supplements — if you have kidney disease, or if you take any of these:** > > - ACE inhibitors (names ending in _-pril_, like lisinopril) > - ARBs (names ending in _-sartan_, like losartan) > - Spironolactone, eplerenone, triamterene, or amiloride > > These raise potassium in your blood, and too much potassium can cause a dangerous heart rhythm. **Ask your doctor or pharmacist what is right for you before making changes.** --- ## Step 3: Watch alcohol Alcohol raises blood pressure directly and adds calories. - **Limit to 2 drinks a day for men, 1 a day for women.** Less is better; none is fine. - One drink = 12 oz beer, 5 oz wine, or 1.5 oz liquor. - If you drink more than this now, cutting back can lower your top number by **several points**. Do not stop suddenly if you drink heavily every day — talk to your doctor first, because sudden withdrawal can be dangerous. --- ## Step 4: The rest of the picture - **Weight.** If you carry extra weight, losing even 5–10 pounds helps. Roughly, each 2 pounds lost drops blood pressure about 1 point. - **Movement.** Aim for 90–150 minutes a week of walking, cycling, or swimming. Adding strength work 2–3 days a week helps too. - **Caffeine.** It causes a short spike. It is usually fine in normal amounts, but skip it in the 30 minutes before a blood pressure check. - **Licorice.** Real black licorice (not the artificial kind) can raise blood pressure. Avoid large amounts. - **Pain relievers.** Regular NSAIDs — ibuprofen (Advil, Motrin) and naproxen (Aleve) — raise blood pressure. Ask about acetaminophen (Tylenol) instead. --- ## A sample day **Breakfast** - Oatmeal made with low-fat milk, topped with sliced banana and walnuts - Orange - Coffee or tea **Lunch** - Large salad: spinach, tomato, cucumber, chickpeas, grilled chicken - Dressing: olive oil and vinegar - Whole grain roll - Low-fat yogurt **Dinner** - Baked salmon with lemon, garlic, and dill - Roasted sweet potato - Steamed green beans with black pepper and a little olive oil - Brown rice **Snacks** - Unsalted almonds - Apple slices - Baby carrots --- ## Your starter grocery list **Produce:** spinach, broccoli, carrots, tomatoes, bell peppers, sweet potatoes, bananas, oranges, apples, berries, avocado **Protein:** chicken breast, salmon or canned no-salt-added tuna, eggs, dried or no-salt-added beans, lentils, unsalted nuts **Grains:** oatmeal, brown rice, whole wheat bread (compare labels — choose the lowest sodium), whole wheat pasta **Dairy:** low-fat milk, plain yogurt, low-sodium cheese **Flavor:** olive oil, vinegar, lemons, garlic, onions, black pepper, no-salt seasoning blends, dried herbs --- ## Making it stick **Start with one change, not all of them.** Pick the one that feels easiest: - ☐ Stop adding salt at the table - ☐ Swap one packaged meal a week for a home-cooked one - ☐ Add one vegetable to dinner every night - ☐ Switch to unsalted snacks - ☐ Read the sodium line on three items in your pantry **Eating out:** Ask for sauces and dressings on the side. Ask for your food cooked without added salt. Choose grilled or roasted over fried, breaded, or "crispy." Split an entrée or box half to go — restaurant portions often carry a full day of sodium. Many chains post nutrition info online; check before you go. **Track it.** Keep a home blood pressure log. Take readings at the same time each day, after sitting quietly for 5 minutes, feet flat on the floor, arm supported at heart level. Bring the log to your visits. --- ## Call your doctor if - Your blood pressure readings stay at or above **180/120** — if you also have chest pain, trouble breathing, weakness on one side, trouble speaking, or vision change, **call 911** - You feel dizzy, lightheaded, or faint after changing your diet or medicine - You have muscle weakness, numbness, or a fluttering heartbeat (possible potassium problem) --- ## Questions to bring to your next visit 1. What is my blood pressure goal number? 2. How much sodium should I aim for? 3. Should I increase potassium, or do my medicines or kidneys mean I should not? 4. Is a salt substitute safe for me? 5. Should I see a dietitian? 6. How often should I check my pressure at home? --- _This handout is general education, not personal medical advice. Your care team knows your kidney function, your medicines, and your history. Talk with them before making major changes to your diet or medications._