This is a guest post by Laura Schoenfeld, a Registered Dietitian with a Master’s degree in Public Health, and staff nutritionist and content manager for ChrisKresser.com. You can learn more about Laura by checking out her blog or visiting her on Facebook.
High blood pressure, also known as hypertension, is a serious and common condition that can lead to life-threatening diseases such as heart attack, stroke, heart or kidney failure, and more. While 1 in 3 American adults have high blood pressure, this condition only affects 3% or less of hunter-gatherer populations that are following a traditional diet and lifestyle. (1, 2) This would suggest that hypertension is a disease of poor lifestyle choices, and one that can be effectively treated using simple diet and behavior changes, as well as strategic use of herbal remedies.
Blood pressure is measured by two numbers: the top number is the systolic pressure (when the heart is pumping blood) and the bottom number is the diastolic pressure (when the heart is at rest). A normal blood pressure number is below 120/80, prehypertension is diagnosed between 120/80 – 139/89, Stage 1 hypertension is between 140/90 – 159/99, and Stage 2 hypertension is blood pressure above 160/100.
While most doctors prescribe drug treatment when a patient has reached the prehypertension stage, there is no evidence to support pharmaceutical treatment in these patients. (3) But this doesn’t mean hypertension shouldn’t be addressed. Much like high cholesterol, elevated blood pressure (even in the prehypertension stage) is a sure sign of other problems going on in the body.
By addressing underlying issues with diet and lifestyle changes, you may be able to reduce your blood pressure without resorting to drug treatment. This article will address six dietary changes you can make to help lower your blood pressure naturally. (That said, medication should always be considered if these changes are unable to lower your blood pressure adequately. Please defer to your doctor’s advice here!)
1. Reduce excessive carbohydrate intake, especially refined carbs and sugars.
One of the most significant contributors to high blood pressure is high blood sugar and insulin resistance. (PDF) Some evidence suggests that pathological changes in glucose and insulin metabolism significantly affect the development and clinical course of hypertension, and thus should be primary targets for dietary intervention. Chronically high blood sugar, hyperinsulinemia, and high triglycerides are far more common in individuals with hypertension than those with normal blood pressure, and one of the major contributors to all three of these conditions is an excess intake of carbohydrate, particularly refined grains and sugars. (4, 5, 6)
Additionally, excess intake of sugar-sweetened beverages like soda, sweet tea, and other sugary drinks has been shown to directly influence blood pressure. (7, 8) Cutting out these beverages should be the first step in any hypertension treatment, and can also help with shedding excess weight and reducing high blood sugar – both issues that further contribute to hypertension. And don’t think switching to Diet will help either, since artificially-sweetened beverages also contribute to hypertension. (9)
While some research has suggested that high fructose intake may increase blood pressure, other research shows that fructose itself is not the problem; rather, it is the consumption of excess total carbohydrate that is the major issue. (10, 11, 12, 13) This means you shouldn’t be concerned with eating modest levels of naturally-occurring fructose, like that from fruit and honey, as these foods are healthy in the context of a moderate carbohydrate diet. Be sure to adjust your carbohydrate intake to your needs and health goals, and get your carbohydrates from nutrient-dense whole foods like fruits and starchy vegetables.
2. Increase intake of beneficial minerals like potassium, magnesium, and calcium.
While most conventional medical professionals will recommend sodium restriction as the primary method for blood pressure reduction, it appears that focusing on eating foods rich in other macrominerals is more beneficial than strictly focusing on avoiding sodium. (14, 15, 16, 17) More important than overall sodium intake is the sodium-to-potassium ratio; thus, eating a high-potassium diet is a better strategy than eating a low-sodium diet. Further, as Chris has shown in his series on the salt myth, restricting sodium to the levels recommended by the American Heart Association may actually be causing more harm than good.
I’ve included a chart of the Paleo foods richest in potassium to help guide you in increasing potassium intake (this chart is from the bonus chapter on hypertension from Chris’s new book, Your Personal Paleo Code; published in paperback as The Paleo Cure in December 2014). Those with hypertension should aim to get at least 4,700 milligrams of potassium per day. If you have hypertension and are unsure about the adequacy of your potassium intake, I recommend using a food diary for 3 days and analyzing your average potassium intake.
Also, don’t go too low carb when reducing your carbohydrate intake – many of the best sources of potassium and magnesium are starchy vegetables like white and sweet potatoes, or fruits like plantains and bananas. White potatoes are especially good sources of blood pressure-lowering minerals like potassium and magnesium; hypothetically you could eat three large baked potatoes per day to easily meet your potassium needs while only consuming around 180 grams of carbohydrate. While eating a potato at each meal isn’t necessary to get adequate potassium, I do think those who eat “strict” Paleo should consider reintroducing white potatoes if tolerated.
Also, those eating “strict” Paleo may be missing out on significant sources of calcium from dairy products, and calcium intake is another important predictor of high blood pressure and cardiovascular events. (18, 19) If you’re not eating dairy products, be sure to eat plenty of bone-in fish, leafy greens, bone broth, and nuts to make sure you’re getting adequate calcium. Keep a 3-day food diary to check on your intake; if you’re falling short of the minimum 600 milligrams per day, you can try adding bone meal to soups or stews to boost your calcium intake.
3. Eat grass-fed dairy products like ghee, butter, and cheese.
Beyond being a good source of calcium, full-fat grass-fed dairy has another contribution to the treatment of hypertension: vitamin K2. While this nutrient is hardly discussed by conventional medical professionals, preliminary data suggests K2 may be one of the most important nutrients to include in a disease-preventing diet. (20, 21, 22) Vitamin K2 may be protective against osteoporosis, cardiovascular disease, cancer, and more, so it’s definitely a nutrient you should be looking to get enough of no matter what your health situation.
Vitamin K2 may also be protective against hypertension. While there haven’t yet been any studies directly measuring K2’s effects on blood pressure, logic would suggest that this nutrient could help prevent high blood pressure by reducing vascular stiffness and arterial calcification. (23, 24, 25, 26, 27) High serum calcium levels are related to hypertension, and vitamin K2 (along with adequate vitamin D) is crucial to ensure that calcium is deposited in the bone where it belongs, and not in the arteries where it can cause vascular stiffness and calcification, leading to hypertension and heart disease. (28, 29, 30)
One of the most well-tolerated foods high in vitamin K2 is grass-fed ghee. Pure Indian Foods is my favorite brand of ghee, but you can also eat butter, cheese, and full-fat yogurt or kefir from grass-fed cows to get adequate K2. (Fermented dairy may actually have independent effects on hypertension as well. All the more reason to drink full-fat kefir!)
If you’re completely dairy intolerant or allergic, you can supplement with vitamin K2. My favorite supplement is one that contains the three fat soluble nutrients, A, D, and K2, in balanced form, which is the way these vitamins must be taken to support optimal health. If isolated nutrients aren’t your style, you can also take the Extra Virgin Cod Liver Oil from Rosita.
4. Eat at least one pound of fatty fish per week.
Fatty fish is high in essential omega-3 fats, and these fats have been shown to reduce the risk of hypertension and cardiovascular events in multiple studies. (31, 32, 33, 34) A meta-analysis demonstrated that fish oil supplementation may significantly reduce both systolic and diastolic blood pressure. (35) However, taking fish oil supplements to get your omega-3 fats is not an ideal strategy, since some studies suggest that high doses of fish oil may increase cardiovascular and total mortality, especially when used for more than four years. (36, 37)
The many benefits of fatty fish for promoting overall health are hard to argue against, and those with high blood pressure may especially benefit from including more fish in their diet. Also, certain fatty fish like halibut and wild salmon are high in potassium, as seen in the chart above. This demonstrates the benefit of choosing whole-foods over supplements when it comes to preventing disease; many foods have multiple and possibly synergistic effects that can provide significant health benefits over supplements containing their individual components. Eating one pound (16 ounces) a week of fatty fish like salmon, sardines, halibut, and mackerel is an important dietary strategy for reducing both high blood pressure and the risk of cardiovascular disease.
5. Drink tea.
Habitual tea drinking may help reduce blood pressure, as demonstrated by research mostly conducted in regions where tea is a significant component of the daily diet. (38) There are some teas that may be more effective at reducing blood pressure than others, however, and caffeinated tea may raise blood pressure in the short term. (39, 40) The following teas are ones I recommend consuming if you need to reduce your blood pressure. (If you are taking prescription medicines, talk to your health care provider before drinking these herbal teas.)
Hibiscus tea has been demonstrated to reduce blood pressure in pre- and mildly hypertensive adults. (41, 42) Hibiscus is a small tree with red flowers that are rich in flavonoids, minerals, and other nutrients. (43) Hibiscus tea has a fruity taste that makes it popular as both hot and cold beverage, and experts recommend two to three cups per day to achieve blood pressure reducing effects. I recommend making a large jug of iced, unsweetened hibiscus tea and drinking it in place of water for at least 3 cups of fluid. Add a little honey or stevia if you prefer sweetness, but this tea is delicious on its own.
Hawthorn tea may also be effective as a blood pressure-reducing beverage, and the plant has been used to treat heart disease as far back as the 1st century. (44, 45, 46) The antioxidant-rich tea may help dilate blood vessels and improve blood flow. Dosing guidelines have not been established, but three cups a day is recommended by some health professionals.
Gotu kola tea may be another helpful tea in lowering blood pressure, specifically in the case of venous insufficiency. (47, 48) It is believed that gotu kola might assist in the maintenance of connective tissue, which strengthens weakened veins and helps improve circulation. Again, three cups daily is the current recommendation for this tea.
Finally, oolong and green tea may be beneficial for lowering high blood pressure. One study of more than 1,500 subjects showed that drinking one half to two and a half cups of oolong or green tea on a daily basis can lower a person’s risk of hypertension by 46 percent. (49) As you can see, there are many different teas that can benefit those with high blood pressure, so find one or two you like and drink them regularly.
6. Eat more beets.
Some researchers hypothesize that a major reason the DASH diet is beneficial for lowering blood pressure is that the content of inorganic nitrate in certain vegetables and fruits provides a physiologic substrate for reduction to nitrite, nitric oxide, and other metabolic products that produce vasodilation, decrease blood pressure, and support cardiovascular function. (50)
So take a page out of the Dwight Schrute handbook and eat your beets! Beets are high in nitrates, which, as suggested above, may reduce blood pressure by improving vasodilation. Other foods high in nitrates include celeriac, Chinese cabbage, endive, fennel, kohlrabi, leek, parsley, celery, cress, chervil, lettuce, spinach, and rocket. (Ironically, bacon is another source of dietary nitrate…)
Beet juice in particular has been shown to lower blood pressure in multiple studies. (51, 52) So if you have a juicer, try making some fresh beet juice to drink on a regular basis. If you’re looking for an even healthier form of beet juice, you can also drink beet kvass, which provides probiotics in addition to hypertension-fighting nitrates. It’s an acquired taste for sure, but one that might be helpful to acquire if you’re suffering from hypertension that hasn’t responded to a healthier diet and/or weight loss.
Of course, there are many more recommendations for how to lower blood pressure, including strategic exercise, restful sleep, sun exposure, and meditation, yoga, or other stress management practices. There are also several different supplements that can aid in further lowering blood pressure once these dietary and lifestyle strategies have been made.
Chris has written a great bonus chapter on high blood pressure in his new book, Your Personal Paleo Code (published in paperback as The Paleo Cure in December 2014), which releases at the end of this year. (I’m so excited!) If you’re struggling with high blood pressure or other common but serious health conditions, I strongly recommend checking out this book for more information on how to address your symptoms by making nutritional and lifestyle changes that will greatly improve your overall health and wellbeing.
Now tell me – have any of you made any changes that helped reduce your blood pressure? Share your story in the comments below!