Published by PMR of NY & CT
A high blood pressure reading can feel like a warning without a clear next step. Food is one of the most useful places to start. The best-studied high blood pressure diet is the DASH eating plan, short for Dietary Approaches to Stop Hypertension, which was developed through research funded by the National Institutes of Health (NIH).
DASH isn't a short-term diet or a list of forbidden foods. It's a way of eating built on vegetables, fruit, whole grains, low-fat dairy, beans and nuts, with less sodium, red meat and sugar. It works alongside any medicine your doctor prescribes, not in place of it.
Why the DASH diet lowers blood pressure
DASH works on several fronts at once. It's naturally lower in sodium, so your body holds onto less fluid. It's rich in potassium, which helps your body get rid of sodium, along with magnesium and calcium. And its fiber and modest portions of fat and sweets make a healthy weight easier to reach, which also lowers blood pressure.
In NIH-funded studies, people who followed DASH lowered their blood pressure, and those who also cut sodium lowered it further. The effect appeared in people with and without high blood pressure.
Pairing DASH with regular activity, such as brisk walking on most days, adds to the benefit. If knee pain makes walking hard, that is worth treating too.
The DASH eating plan: daily servings at a glance
The NIH bases DASH servings on about 2,000 calories a day, so treat these as a starting pattern:
- Vegetables: 4 to 5 servings a day (1 cup of raw leafy greens or half a cup of cooked vegetables)
- Fruit: 4 to 5 servings a day (one medium piece or half a cup)
- Grains: 6 to 8 servings a day, mostly whole grains
- Low-fat or fat-free dairy: 2 to 3 servings a day
- Lean meat, poultry or fish: 6 ounces or less a day
- Nuts, seeds, beans and lentils: 4 to 5 servings a week
- Fats and oils: 2 to 3 servings a day
- Sweets and added sugars: 5 servings or fewer a week
DASH caps sodium at 2,300 mg a day, and a lower-sodium version at 1,500 mg brought blood pressure down further in research. Ask your doctor which target fits you.
Foods that lower blood pressure within the DASH pattern
No single food lowers blood pressure, but potassium-rich foods do much of the work in DASH. Good sources include:
- Beans and lentils, such as white beans and edamame
- Leafy greens such as beet greens and Swiss chard
- Plain low-fat yogurt and fat-free milk
- Fish such as salmon and halibut
- Fruits such as papaya, pomegranate and prunes
Nuts, seeds, whole grains and beans add magnesium, and low-fat dairy adds calcium. If you have kidney disease or take a medicine that raises potassium, ask your doctor before adding more potassium to your meals.
What to limit on a high blood pressure diet
Some foods and products push blood pressure up. Cut back on:
- Salty foods, especially restaurant meals, deli meats and canned soups
- Alcohol, which raises blood pressure; if you drink, ask your doctor how much is safe for you
- Fatty red and processed meats and full-fat dairy, which are high in saturated fat
- Sugary drinks and sweets, which add calories without nutrients
- Black licorice made with real licorice root, which can raise blood pressure and lower potassium
Some medicines can raise blood pressure too, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, and decongestants. Ask your pharmacist before using them.
Track your progress with home blood pressure monitoring
Home readings show whether your changes are working. The American Heart Association suggests:
- Use a validated upper-arm cuff that fits your arm.
- Avoid caffeine, alcohol, exercise and smoking for 30 minutes before checking.
- Sit quietly for five minutes with your back supported, legs uncrossed, feet flat and arm resting at heart level.
- Take at least two readings a minute apart, at the same times each day, and write them down.
- Bring your log to your appointments.
When a high reading is an emergency
If your reading is higher than 180/120, wait at least a minute and check again. If it is still that high and you have no symptoms, contact your doctor right away. Call 911 if a reading that high comes with chest pain, shortness of breath, back pain, numbness or weakness, a change in vision or trouble speaking.
Frequently asked questions
Can I stop taking blood pressure medicine if I eat better?
Not on your own. Some people who change how they eat, lose weight and become more active see their numbers improve enough that their doctor can lower a dose or stop a medicine. That decision should be based on your readings over time. Some medicines can cause a rebound rise in blood pressure if they are stopped suddenly.
Are bananas good for high blood pressure?
They can be a helpful part of a high blood pressure diet. Bananas are a convenient source of potassium, which helps your body balance the sodium you eat. They're one of many potassium-rich foods, though, and variety matters more than any single fruit. If you have kidney disease or take a medicine that raises potassium, check with your doctor first.
How long does it take for diet changes to lower blood pressure?
In the original DASH research, blood pressure began to drop within about two weeks. Your own results may come faster or slower, and they last only as long as the habits do. A few weeks of home readings, shared with your doctor, will show your own trend.
Move more with support from PMR
Your primary care doctor or cardiologist manages blood pressure, and a registered dietitian can tailor DASH to your tastes. If pain keeps you from the activity that also helps your numbers, Physical Medicine & Rehabilitation of NY & CT (PMR) can help, including physical therapy. Request an appointment and our team will contact you.
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