NUTRITIONAL CARE FOR HYPERTENSION (Modern approach)
The goal of medical nutrition therapy in hypertension is to reduce the death rate and disability from , hypertension-associated complications like stroke, other heart and renal diseases. The major risk factors for hypertension are-
- Alcohol consumption
- Physical inactivity or sedentary lifestyle
- Mental stress
Dietary management coupled with proper lifestyle modification is highly effective in treatment of hypertension as it can take care of all the risk factors mentioned above.
As you know our food is a composite blend of various nutrients. All these nutrients affect hypertension (high blood pressure) in their own manner. The important factors of dietary management can be discussed as follows-
It is a proven clinical fact that weight reduction is an effective remedy for any type of hypertension (mild, moderate and severe). A body mass index ( BMI) value of more than 27 is associated with increased high blood pressure. Even excess abdominal fat (waist circumference >34 inches in women and 39 inches in men) is also suggestive to hypertension as well as other chronic heart diseases. The risk of developing hypertension in obese person is 2 – 6 times higher as compared to normal weight people. To avoid such serious consequences of obesity proper weight management programme is to be followed.
According plan your meal through this interactive meal planner.
DASH ( Dietary Approach to Stop Hypertension) diet In details
Clinical studies have supported an important relationship between salt intake and hypertension. The chloride ion (present in salt) in conjugation of sodium ion raises the blood pressure. Due to this all patients of high blood pressure are, generally advised to restrict their salt intake. Some people does not react to salt intake with an eleVataed blood pressure. This specific type of hypertension is known as salt-resistant hypertension. Salt sensitivity test can be used to determine the nature of person. Salt restriction can do wonders for salt sensitive (hypertensive) population but it is of no use for salt-resistant people.
Salt restriction can enhance the efficiency of oral drugs also.
Salt restriction diets can be of five forms depending on the severity of hypertension.
- 4 g (1.5 tsp= 9 gms of salt) of sodium per day. Up to 1/2 tsp table salt is used and high sodium foods are limited.
- 2 g ( 3/4 tsp= 4.5 gms of salt) of sodium per day. Table salt is not allowed and high sodium foods are eliminated.
- 1 g ( (1/3 tsp=2.25 gms of salt) of sodium per day. Table salt is not allowed and high as well as moderate sodium foods are eliminated.
- 500 mg (1/5 tsp=1.12 gms of salt) of sodium per day. Table salt is not allowed and high as well as moderate sodium foods are eliminated. This diet is not palatable and is used for short time periods.
- 250 mg (1/10 tsp=.6 gms of salt) of sodium per day. Table salt is not allowed and high as well as moderate sodium foods are eliminated. This is an extreme diet and rarely used.
Diets which are very low in sodium content should be used with caution as low sodium diets can cause the depletion of sodium from body.
Read the food labels carefully as most of the processed foods has high salt concentration.
Fats and lipids
Vegetarian people generally has low blood pressure as compared to non-vegetarians. Vegetarian diet is rich in poly unsaturated fatty acids (PUFA’s) and low in saturated fats and cholesterol.
Cardio- vascular diseases are an usual accompaniment of hypertension so try to avoid foods which are rich in saturated fats and cholesterol. Instead of these fats, include foods rich in unsaturated fats such as low-fat dairy products, yoghurt, fish, sunflower and olive oil.
It has been observed (through clinical studies) that there is an inverse relationship between potassium intake and hypertension. It means if you increase your potassium intake your blood pressure will come down. There are some specific age groups in which blood pressure can be controlled effectively by increasing the daily potassium intake. These age groups are
- Persons suffering from high or very high blood pressures.
- Elderly people with some kidney disease association.
- Persons taking any type of non-steroidal anti- inflammatory drugs (NSAID’s)
- Persons taking potassium sparing diuretics and angiotensin-converting enzymes as drugs.
You can enhance your potassium intake by adding fruits, fruit juices and vegetables in your regular diet.
There is no definite relationship between calcium intake and hypertension. However, some clinical studies show that high calcium intake has a little hypertensive effect.
Magnesium can play an important role in the regulation of blood pressure as it is a potent inhibitor of vascular smooth muscle contraction and can be a vasodilator. However, adequate information regarding its role in hypertension is not available yet.
Excessive alcohol intake is an independent risk factor for hypertension. Three drinks per day (3 fl. oz. or 90 ml) is the brink (verge) for high blood pressure and is able to raise the blood pressure by 3mm of Hg. So, it is clear that if you want to reduce the chances of development of hypertension restrict your alcohol intake 2 drinks. For males of less stamina and women this limit is up to 1 drink per day.
If there is no problem in urine output you should not restrict your fluid intake, if any kind of edema is present the fluid intake should be regulated according to the urine output.
Smoking has an injurious effect on hypertension and can further complicate the situation.