An Ally in the Battle to Lower Blood Pressure

It is of concern that a third of all adults in the United States have elevated blood pressure. High blood pressure is a major cause of heart attacks and strokes. Although blood pressure can be reduced with medications, these have known risks and side effects.

It is much better to lower your blood pressure (or even better prevent its rise) by adopting healthy patterns of living: weight reduction, regular exercise, good quality sleep, good nutrition, and stress reduction.

When patients come to me to discuss possible surgery they are sometimes surprised when I ask them about their nutritional and exercise history. One might ask, “What does this have to do with plastic surgery?” My simple answer, “Everything!”

First of all people with excellent patterns of nutrition and exercise that undergo surgery have fewer complications and recover more quickly than people without these benefits. Second, it helps me with my research into the healthy patterns that lead to optimum existence even at quite advanced age. Third, if a patient needs to change certain habits, a date for surgery can be a wonderful motivator to quit smoking, lose a certain number of pounds, or eat more foods rich in antioxidants. I have also found that the time around surgery can be a powerful inflection point for permanent habit change.

One of the reasons that so many Americans have high blood pressure is excess sodium (aka salt) in the diet. In fact the average US adult consumes over twice the recommended amount of sodium on a daily basis. As I have discovered, it is difficult indeed to bring your sodium intake to a healthy level. This is because salt is everywhere in our diet: processed foods contain huge amounts of sodium, and our taste buds have become so distorted by our salt rich environment that restaurants must put an abundance of salt in their food to avoid the risk of being labeled “bland.”

It is possible to take action to bring our relationship with sodium to healthy levels. Sodium in itself is not unhealthy; in fact a certain amount of it is necessary for our bodies to function normally. Several of my friends who dine regularly at certain restaurants get to know the chef and ask him to reduce the amount of salt that is served in the dishes they order. Of course it is essential to avoid fast food and processed food. It is easier when you do your own cooking, since then the salt issue truly is in your own control. This is much easier now that the labels on food in the grocery store must specify the sodium level. Always make sure you check the serving size, since this may be made artificially low which makes the sodium content appear weaker. A can of soup, for example, may be listed as two servings, so that if the sodium content is listed at 800mg in a serving, that can delivers a whopping 1600 mg, which is essentially the entire daily recommended intake!

Another useful trick that is not yet widely appreciated is to increase the amount of potassium in the diet. The kidneys are charged with maintaining the levels of sodium and potassium in the bloodstream. If you increase the amount of potassium in the diet, this will make its way into the bloodstream, which automatically causes the kidneys to excrete more sodium in the urine.

A diet that is relatively low in sodium and high in potassium would seem to be the ideal solution. Foods that you should avoid have high sodium and low potassium content. Examples include cheese, processed foods, fast food, and most soups. The best foods with low sodium and high potassium happen to be some of the most nutritious. Fruits and vegetables, milk, and yoghurt are all in this category.

One caveat: if you have a serious medical condition, especially any element of kidney failure, please check with your doctor before boosting your potassium intake.

Current food labels do not list potassium content, so it is necessary to do a little homework if you are looking for the foods with the highest potassium. Here is one helpful list I found on the healthaliciousness.com website. They ranked the top 10 foods for potassium in descending order: white beans, spinach and other dark leafy beans, baked potatoes with skin (but watch the carbs), dried apricots, baked acorn squash, yoghurt, salmon, avocados, mushrooms, and bananas. Not an unpleasant list, at least for me.

Last year a landmark study, Sodium and Potassium Intake and Mortality Among US Adults, was published in the July 11, 2011 issue of the Archives of Internal Medicine. The take home message from this study is that a diet high in sodium and low in potassium is associated with a doubling of the risk of heart attack and a 25% increase in the risk of death from any cause.

Although this study doesn’t prove a direct cause and effect (to do so you would have feed groups of people different ratios of sodium and potassium and follow them for many years to see which group died off the most), this evidence is good enough for me.

I’m eating more bananas and other wonderful foods rich in potassium.