Controlling High Blood Pressure: It's Not Just About Salt!

02 December, 2020
The consumption of food rich in antioxidants, potassium, and calcium is helpful for controlling high blood pressure.

Controlling blood pressure is something that many of us would like to know how to do. What steps should you take? What should you keep in mind?

High blood pressure affects many millions of people around the world. Controlling it with medication ends up requiring combined therapies that are very costly for a country’s health service.

However, eradicating salt consumption is unnecessary and insufficient. So, it’s essential to adopt non-pharmacological measures that will allow efficient control of arterial hypertension.

Current research shows that, rather than restrictive guidelines, adopting a healthy lifestyle is the ideal method to control arterial hypertension.

What is high blood pressure?

The concept of blood pressure (BP) refers to the pressure of blood on the artery walls. Systolic blood pressure (SB) refers to the pressure at the time the heart contracts and pumps blood throughout the rest of the body.

On the other hand, the diastolic blood pressure (DBP) refers to the blood pressure value when the heart fills up with blood. We speak of high blood pressure (HBP) when the SB is more than 140 mm Hg and/or the DBP is more than 90 mm Hg in 3 non-consecutive measurements.

HBP affects thousands of millions of people

Experts consider HBP (High Blood Pressure) to be a public health problem that could affect over a billion people around the world. Experts estimate that 30% of the population suffers from it and its prevalence exceeds 50% in subjects over 50 years old.

When we don’t properly control it, it ends up seriously damaging the heart, brain, eyes, and kidneys, according to an article published in The Medical Clinics of North America.

In fact, HBP is considered the leading cause of stroke and heart failure and the second leading cause of chronic kidney disease. It’s also behind some of the leading causes of chronic blindness. Also, according to WHO data, HBP is the cause of 15% of deaths worldwide.

Controlling it is essential. However, its high prevalence makes the cost of drug treatment unsustainable. In addition to this, the progressive need for combined drug therapies means an increase in side effects.

Taking blood pressure.
The number of patients affected by high blood pressure is quite alarming. In fact, the disease is cataloged as a public health problem.

What can we do to control high blood pressure?

Lifestyle is one of the factors with the greatest impact on the development of HBP, and the good news is that it’s something we can change. Drug treatment should be reserved for cases of hypertension that are resistant to other measures.

So far, non-pharmacological treatment has been based almost exclusively on reducing salt intake to avoid its attraction to fluids. But is this a necessary and sufficient measure?

Avoiding salt consumption isn’t necessary

Current scientific evidence shows that salt intake does not increase arterial tension (AT) in all people. Some examples are:

Salt consumption only impacts the AT of the so-called “salt-sensitive” subjects and these only represent 50% of cases.

However, while we don’t know the exact cause-effect relationship, and there are no tools available that allow simple detection of these sensitive subjects, it’s advisable to maintain a prudent consumption (1 teaspoon of salt per day = 5 grams of salt per day = 2.3 grams of sodium per day).

The consumption of ultra-processed foods is not recommended as they have a very high salt content. They’re also harmful for other reasons.

Controlling high blood pressure apart from by reducing salt

In general terms, an adequate approach to HBP involves taking measures that achieve the following:

  • Normalize the volume of liquids
  • Reduce the viscosity of the blood
  • Increase the caliber of the arteries
  • Avoid arterial stiffness

Thinking about the pressure inside a pipe can help us understand the strategy here. What you’d do with a pipe is to normalize the flow, reduce the impurities in the water, replace them with bigger pipes, or make them out of a flexible material.

Increase the supply of potassium, calcium, and magnesium

The beneficial role of potassium in controlling blood pressure is indisputable. This is because it promotes urinary sodium excretion, relaxes smooth muscles, and decreases peripheral resistance.

In other words, it normalizes the circulating blood volume and favors the adaptive capacity of the arteries.

Potassium food.
Consumption of potassium-rich foods, such as avocado and banana, helps to keep AT numbers within normal limits.

Calcium and magnesium have also been shown to be effective in controlling AT. Calcium allows good management of AT by inhibition of parathyroid hypertensive factor (PHF).

Magnesium does this by a mechanism that isn’t yet known. However, a higher incidence of high blood pressure has been detected in people with a deficit consumption of this mineral.

Other minerals such as zinc, manganese, and copper may also be involved in how HBP develops. However, there hasn’t been enough research to draw any conclusions.

Discover: Magnesium, a Complete Mineral

Increase fiber and protein consumption

The consumption of 25-40 g/day of fiber has a reducing effect on the blood pressure because it:

  • Decreases vascular resistance and improves the entry and exit of blood through the heart.
  • Slows down the activity of the ACE enzyme, which is responsible for creating a hypertensive substance (angiotensin II) and inhibiting hypotension (bradykinin).
  • Increases the retention of hypotensive minerals such as potassium or magnesium.

Also, food containing fiber is usually very rich in antioxidants and these have also been shown to be beneficial in controlling blood pressure.

Beilin, Burke, Giangiulioi, Hodgson, Puddey & Rogers (2001) found that, when combined with increased protein intake, the hypotensive effect is greater.

Vitamins D and K are essential

Only having low levels of vitamin D and K in your body has been associated with an increase in blood pressure. Both appear to be actively involved in regulating a protein that inhibits artery calcification (MGP). Vitamin D increases its amount and vitamin K activates it.

These are very new findings (the first research on this subject was published in March 2017) and, therefore, further research is required. However, research by Beulens, Brouwer, Cepelis, van Ballegooijen, van Schoor & Visser (2017), after analyzing 171 subjects, firmly concluded that low levels of these vitamins would be playing an important role in the development of HBP.

Reducing the consumption of high glycemic index carbohydrates

Excess glucose in the blood means an increase in the viscosity of the blood and, therefore, an increase in the AT figures. In fact, people with diabetes mellitus often end up developing HBP or hypertension.

Avoiding harmful fats

Transgenic fatty acids and most saturated fats predispose to HBP. Its effect is due to the accumulation of cholesterol inside the arteries by increasing LDL protein and reducing HDL.

Read more: 5 Remedies To Help You Regulate High Cholesterol

Maintaining proper hydration helps control high blood pressure

Adequate hydration promotes blood purification and reduces the viscosity of the blood. This means lower blood pressure.

Physical cardiovascular activity is key to controlling high blood pressure

More sedentary individuals have a 30-50% higher risk of suffering from HBP. The Spanish Heart Foundation considers that cardiovascular physical activity, such as walking, is one of the most suitable measures for the control of blood pressure.

Its benefits are attributed to its vasodilatory effect, the elimination of sodium through sweat, and its contribution to weight loss.

Excess body fat poses a 2 to 6 times greater risk of HBP. This figure is even higher when the fat is accumulated in the trunk (central obesity or “apple-shaped obesity”).

Ensure adequate sleep

Sleeping well is essential. Different studies link sleep problems to a higher prevalence of HBP. Likewise, it has been shown that sleeping well helps reduce blood pressure.

Good stress management is key to controlling high blood pressure

Stress activates a whole range of hormones that stimulate the sympathetic nervous system and this is directly related to blood pressure. Thus, learning how to manage stress would mean a considerable reduction in blood pressure.

Avoiding tobacco and alcohol consumption

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 does so because of its role in the development of several health conditions directly related to increased blood pressure.

  • Some examples are diabetes mellitus, hypercholesterolemia, and central obesity.

The intestinal microbiota is key in the control of high blood pressure

As with other chronic diseases, those with high blood pressure share characteristics in the intestinal microbiota that haven’t been found in those without HBP. Some hypotheses suggest that this could be due to the consumption of salt.

The study by Alm, et al. (2017) showed a lower presence of Lactobacillus in the intestinal microbiota of mice that the scientists gave a diet rich in salt for several weeks.

The reduction of this bacterial population was associated with an increase in proinflammatory T(H)17 cells and thus with an increase in blood pressure. The conclusions were identical in a pilot study with 12 people. The intestinal microbiota could have the answer to why “only 50% of people with high blood pressure react negatively to salt intake.

Food as a method of controlling hypertension

In terms of food, one of the best diets is the Mediterranean diet, as it’s an ideal basis to be able to apply all the above-mentioned nutritional recommendations.

However, remember that it’s also necessary to maintain a healthy lifestyle that includes sleeping well, staying active, managing stress, and not consuming toxic substances. Also, supplementation with Lactobacillus could help.

Overall, the best way to control high blood pressure is to take a comprehensive approach that goes beyond just reducing salt consumption.

  • Textor SC., Renal arterial disease and hypertension. Med Clin North Am, 2017. 101 (1): 65-79.
  • Forman JP., Scheven L., Jong PE., Bakker SJL., et al., Association between sodium intake and change in uric acid, urine albumin excretion, and the risk of developing hypertension. Circulation, 2012.
  • Medina Remón A., Vallverdú Queralt A., Arranz S., Ros E., et al., Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross sectional study of the PREDIMED trial. Nutr Metab Cardiovasc Dis, 2013. 23: 944-52.
  • Navas Santos L., Nolasco Monterroso C., Elena Carmona C., López Zamorano MD., et al., Relación entre la ingesta de sal y la presión arterial en pacientes hipertensos. Enferm Nefrol, 2016.
  • Wilck N., Matus MG., Muller DN., Satl responsive gut commensal modulates TH17 axis and disease. Nature, 2017.