Controlling your blood pressure through lifestyle (The Basics)

What does my lifestyle have to do with my blood pressure? — The things you do and the foods you eat have a big effect on your blood pressure and your overall health. Following the right lifestyle can:

  • Lower your blood pressure or keep you from getting high blood pressure in the first place
  • Reduce your need for blood pressure medicines
  • Make medicines for high blood pressure work better, if you do take them
  • Lower the chances that you’ll have a heart attack or stroke, or develop kidney disease

 

Which lifestyle choices will help lower my blood pressure? — Here’s what you can do:

  • Lose weight (if you are overweight)
  • Choose a diet rich in fruits, vegetables, and low-fat dairy products, and low in meats, sweets, and refined grains
  • Eat less salt (sodium)
  • Do something active for at least 30 minutes a day on most days of the week
  • Limit the amount of alcohol you drink

 

If you have high blood pressure, it’s also very important to quit smoking (if you smoke). Quitting smoking might not bring your blood pressure down. But it will lower the chances that you’ll have a heart attack or stroke, and it will help you feel better and live longer.

Start low and go slow — The changes listed above might sound like a lot, but don’t worry. You don’t have to change everything all at once. The key to improving your lifestyle is to “start low and go slow.” Choose 1 small, specific thing to change and try doing it for a while. If it works for you, keep doing it until it becomes a habit. If it doesn’t, don’t give up. Choose something else to change and see how that goes.

Let’s say, for example, that you would like to improve your diet. If you’re the type of person who eats cheeseburgers and French fries all the time, you can’t switch to eating just salads from 1 day to the next. When people try to make changes like that, they often fail. Then they feel frustrated and tend to give up. So instead of trying to change everything about your diet in 1 day, change 1 or 2 small things about your diet and give yourself time to get used to those changes. For instance, keep the cheeseburger but give up the French fries. Or eat the same things but cut your portions in half.

As you find things that you are able to change and stick with, keep adding new changes. In time, you will see that you can actually change a lot. You just have to get used to the changes slowly.

Lose weight — When people think about losing weight, they sometimes make it more complicated than it really is. To lose weight, you have to either eat less or move more. If you do both of those things, it’s even better. But there is no single weight-loss diet or activity that’s better than any other. When it comes to weight loss, the most effective plan is the one that you’ll stick with.

 

Improve your diet — There is no single diet that is right for everyone. But in general, a healthy diet can include:

  • Lots of fruits, vegetables, and whole grains
  • Some beans, peas, lentils, chickpeas, and similar foods
  • Some nuts, such as walnuts, almonds, and peanuts
  • Fat-free or low-fat milk and milk products
  • Some fish

 

To have a healthy diet, it’s also important to limit or avoid sugar, sweets, meats, and refined grains. (Refined grains are found in white bread, white rice, most forms of pasta, and most packaged “snack” foods.)

Reduce salt — Many people think that eating a low-sodium diet means avoiding the salt shaker and not adding salt when cooking. The truth is, not adding salt at the table or when you cook will only help a little. Almost all of the sodium you eat is already in the food you buy at the grocery store or at restaurants (figure 1).

The most important thing you can do to cut down on sodium is to eat less processed food. That means that you should avoid most foods that are sold in cans, boxes, jars, and bags. You should also eat in restaurants less often.

To reduce the amount of sodium you get, buy fresh or fresh-frozen fruits, vegetables, and meats. (Fresh-frozen foods have had nothing added to them before freezing.) Then you can make meals at home, from scratch, with these ingredients.

As with the other changes, don’t try to cut out salt all at once. Instead, choose 1 or 2 foods that have a lot of sodium and try to replace them with low-sodium choices. When you get used to those low-sodium options, find another food or 2 to change. Then keep going, until all the foods you eat are sodium-free or low in sodium.

Become more active — If you want to be more active, you don’t have to go to the gym or get all sweaty. It is possible to increase your activity level while doing everyday things you enjoy. Walking, gardening, and dancing are just a few of the things that you might try. As with all the other changes, the key is not to do too much too fast. If you don’t do any activity now, start by walking for just a few minutes every other day. Do that for a few weeks. If you stick with it, try doing it for longer. But if you find that you don’t like walking, try a different activity.

Drink less alcohol — If you are a woman, do not have more than 1 “standard drink” of alcohol a day. If you are a man, do not have more than 2. A “standard drink” is:

  • A can or bottle that has 12 ounces of beer
  • A glass that has 5 ounces of wine
  • A shot that has 1.5 ounces of whiskey

 

Where should I start? — If you want to improve your lifestyle, start by making the changes that you think would be easiest for you. If you used to exercise and just got out of the habit, maybe it would be easy for you to start exercising again. Or if you actually like cooking meals from scratch, maybe the first thing you should focus on is eating home-cooked meals that are low in sodium.

Whatever you tackle first, choose specific, realistic goals, and give yourself a deadline. For example, do not decide that you are going to “exercise more.” Instead, decide that you are going to walk for 10 minutes on Monday, Wednesday, and Friday, and that you are going to do this for the next 2 weeks.

When lifestyle changes are too general, people have a hard time following through.

Now go. You can do it!

Patient education: Low-sodium diet (The Basics

 

What is sodium? — Sodium is the main ingredient in table salt. It is also found in lots of foods, and even in water. The body needs a very small amount of sodium to work normally, but most people eat much more sodium than their body needs.

Who should cut down on sodium? — Nearly everyone eats too much sodium. The average American takes in 3,400 milligrams of sodium each day. Experts say that most people should have no more than 2,300 milligrams a day.

Ask your doctor how much sodium you should have.

Why should I cut down on sodium? — Reducing the amount of sodium you eat can have lots of health benefits:

  • It can lower your blood pressure, which means it can help reduce your risk of stroke, heart attack, kidney damage, and lots of other health problems.
  • It can reduce the amount of fluid in your body, which means that your heart doesn’t have to work as hard to push a lot of fluid around.
  • It can keep the kidneys from having to work too hard. This is especially important in people who have kidney disease.
  • It can reduce swelling in the ankles and belly, which can be uncomfortable and make it hard to move.
  • It can reduce the chances of forming kidney stones.
  • It can help keep your bones strong.

 

Which foods have the most sodium? — Processed foods have the most sodium. These foods usually come in cans, boxes, jars, and bags. They tend to have a lot of sodium even if they don’t taste salty. In fact, many sweet foods have a lot of sodium in them. The only way to know for sure how much sodium you are getting is to check the label (figure 1).

 

Here are some examples of foods that often have too much sodium:

  • Canned soups
  • Rice and noodle mixes
  • Sauces, dressings, and condiments (such as ketchup and mustard)
  • Pre-made frozen meals (also called “TV dinners”)
  • Deli meats, hot dogs, and cheeses
  • Smoked, cured, or pickled foods
  • Restaurant meals

 

What should I do to reduce the amount of sodium in my diet? — Many people think that avoiding the salt shaker and not adding salt to their food means that they are eating a low-sodium diet. This is not true. Not adding salt at the table or when cooking will help a little. But almost all of the sodium you eat is already in the food you buy at the grocery store or at restaurants (figure 2).

The most important thing you can do to cut down on sodium is to eat less processed food. That means that you should avoid most foods that are sold in cans, boxes, jars, and bags. You should also eat in restaurants less often.

Instead of buying pre-made, processed foods, buy fresh or fresh-frozen fruits and vegetables. (Fresh-frozen foods are foods that are frozen without anything added to them.) Buy meats, fish, chicken, and turkey that are fresh instead of canned or sold at the deli counter. (Meats sold at the deli counter are high in sodium). Then try making meals from scratch at home using these low-sodium ingredients.

If you must buy canned or packaged foods, choose ones that are labeled “sodium free” or “very low sodium” (table 1). Or choose foods that have less than 400 milligrams of sodium in each serving. The amount of sodium in each serving appears on the nutrition label that is printed on canned or packaged foods (figure 1).

Also, whatever changes you make, make them slowly. Choose one thing to do differently, and do that for a while. If that change sticks, add another change. For instance, if you usually eat green beans from a can, try buying fresh or fresh-frozen green beans and cooking them at home without adding salt. If that works for you, keep doing it. Then choose another thing to change. If it doesn’t work, don’t give up. See if you can cut down on sodium another way. The important thing is to take small steps and to stick with the changes that work for you.

What if I really like to eat out? — You can still eat in restaurants once in a while. But choose places that offer healthier choices. Fast-food places are almost always a bad idea. As an example, a typical meal of a hamburger and french fries from a popular fast-food chain has about 1,600 milligrams of sodium. That’s more sodium than some people should eat in a day!

 

When choosing what to order:

  • Ask your server if your meal can be made without salt
  • Avoid foods that come with sauces or dips
  • Choose plain grilled meats or fish and steamed vegetables
  • Ask for oil and vinegar for your salad, rather than dressing

 

What if food just does not taste as good without sodium? — First of all, give it time. Your taste buds can get used to having less sodium, but you have to give them a chance to adjust. Also try other flavorings, such as herbs and spices, lemon juice, and vinegar.

What about salt substitutes? — Do not use salt substitutes unless your doctor or nurse approves. Some salt substitutes can be dangerous to your health, especially if you take certain medicines.

Do medicines have sodium? — Yes, some medicines have sodium. If you are buying medicines you can get without a prescription, look to see how much sodium they have. Avoid products that have “sodium carbonate” or “sodium bicarbonate” unless your doctor prescribes them. (Sodium bicarbonate is baking soda.)

Patient education: Diet and health (The Basics)

Use up at least as many calories as you take in.

  • Start by knowing how many calories you should be eating and drinking to maintain your weight. Nutrition and calorie information on food labels is typically based on a 2,000 calorie diet. You may need fewer or more calories depending on several factors including age, gender, and level of physical activity.
  • If you are trying not to gain weight, don’t eat more calories than you know you can burn up every day.
  • Increase the amount and intensity of your physical activity to match the number of calories you take in.
  • Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity – or an equal combination of both – each week.

Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness. If it’s hard to schedule regular exercise sessions, try aiming for sessions of at last 10 minutes spread throughout the week.

If you would benefit from lowering your blood pressure or cholesterol, the American Heart Association recommends 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week.

Eat a variety of nutritious foods from all the food groups.

You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have minerals, protein, whole grains and other nutrients but are lower in calories. They may help you control your weight, cholesterol and blood pressure.

Eat an overall healthy dietary pattern that emphasizes:•a variety of fruits and vegetables,

  • whole grains,
  • low-fat dairy products,
  • skinless poultry and fish
  • nuts and legumes
  • non-tropical vegetable oils

Limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If you choose to eat red meat, compare labels and select the leanest cuts available.

One of the diets that fits this pattern is the DASH (Dietary Approaches to Stop Hypertension) eating plan. Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences.

Eat less of the nutrient-poor foods.

The right number of calories to eat each day is based on your age and physical activity level and whether you’re trying to gain, lose or maintain your weight. You could use your daily allotment of calories on a few high-calorie foods and beverages, but you probably wouldn’t get the nutrients your body needs to be healthy. Limit foods and beverages high in calories but low in nutrients. Also limit the amount of saturated fat, trans fat and sodium you eat. Read Nutrition Facts labels carefully — the Nutrition Facts panel tells you the amount of healthy and unhealthy nutrients in a food or beverage.

 

As you make daily food choices, base your eating pattern on these recommendations:

  • Eat a variety of fresh, frozen and canned vegetables and fruits without high-calorie sauces or added salt and sugars. Replace high-calorie foods with fruits and vegetables.
  • Choose fiber-rich whole grains for most grain servings.
  • Choose poultry and fish without skin and prepare them in healthy ways without added saturated and trans fat. If you choose to eat meat, look for the leanest cuts available and prepare them in healthy and delicious ways.
  • Eat a variety of fish at least twice a week, especially fish containing omega-3 fatty acids (for example, salmon, trout and herring).
  • Select fat-free (skim) and low-fat (1%) dairy products.
  • Avoid foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
  • Limit saturated fat and trans fat and replace them with the better fats, monounsaturated and polyunsaturated. If you need to lower your blood cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.
  • Cut back on beverages and foods with added sugars.
  • Choose foods with less sodium and prepare foods with little or no salt. To lower blood pressure, aim to eat no more than 2,400 milligrams of sodium per day. Reducing daily intake to 1,500 mg is desirable because it can lower blood pressure even further. If you can’t meet these goals right now, even reducing sodium intake by 1,000 mg per day can benefit blood pressure.
  • If you drink alcohol, drink in moderation. That means no more than one drink per day if you’re a woman and no more than two drinks per day if you’re a man.
  • Follow the American Heart Association recommendations when you eat out, and keep an eye on your portion sizes.

Also, don’t smoke tobacco — and avoid secondhand smoke.

Learn more about quitting smoking.

For more information on the American Heart Association Diet and Lifestyle Recommendations:

  • Read the Diet and Lifestyle Recommendations (opens in new window).