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High Blood Pressure (Hypertension)
The Medical Research Council warns that poorly managed hypertension (high
blood pressure) is having a major impact on the burden of disease in South
Africa.
People with high blood pressure are at risk of damage to arteries and vital
organs. If high blood pressure is not treated, the heart becomes too weak for
the increased workload, which results in heart problems. Almost half of the
cases of heart disease and strokes in middle-aged South Africans are caused by
high blood pressure.
Fortunately high blood pressure can be easily detected, and once you know you
have it, it is possible to control it.
What is high blood pressure?
Blood is carried around the body in pathways called arteries and veins. If there
is too much blood flowing through these pathways, blood pressure increases and
hypertension develops.
Common causes and symptoms
Hypertension can be caused by various factors, such as kidney problems or
hormonal imbalances.. Although its cause is not completely understood, genetic
factors are known to play a role..
Most people with high blood pressure have no signs or symptoms, even if blood
pressure readings reach dangerously high levels. Some may experience dull
headaches, dizzy spells or a few more nosebleeds than normal, although these
signs and symptoms typically don't occur until high blood pressure has reached
an advanced, even life-threatening, stage.
Answering the questions below can help to determine whether you are at risk for
hypertension:
-
Are you overweight? Overweight people have a 2 to 6 folds greater risk
of blood high pressure than normal-weight people.
-
Do you exercise for less than 30 minutes a day? Regular exercise can
lower blood pressure substantially.
-
Are you a smoker? Smoking causes an increase in blood pressure and
affects your heartbeat.
-
Do you add too much extra salt to your food? Excessive salt in your
diet can lead to higher blood pressure.
-
Does anyone in your family suffer from high blood pressure? A
family history of high blood pressure puts you at greater risk.
If you answered ‗yes‘ to any of the above questions, you have a greater risk of
blood high pressure and it is highly recommended that you have your blood
pressure regularly checked..
The management of hypertension
Lifestyle changes can help you to prevent and to control high blood pressure —
even if you're taking blood pressure medication. Here's what you can do:
o
Maintain a healthy weight. If you're overweight, losing even 2 to 2.5kg
can lower your blood pressure. Reaching your ideal body weight will provide
an even greater blood pressure reduction.
o
Increase physical activity. Regular physical activity can help lower your
blood pressure and keep your weight under control. Strive for at least 30
minutes of physical activity a day.
o
Limit alcohol. Even if you're healthy, alcohol can raise your blood pressure.
If you choose to drink alcohol, do so in moderation — no more than one
drink a day for women and two drinks a day for men.
o
Decrease the salt in your diet. Although 2,400 mg of sodium a day is the
current limit for otherwise healthy adults, limiting sodium intake to 1,500
mg a day will have a more dramatic effect on your blood pressure. While
you can reduce the amount of salt you eat by avoiding the saltshaker, you
should also pay attention to the amount of sodium that's in the processed
foods you eat, such as canned soups, cold meats and sausages, bread or
frozen dinners.
o
Don't smoke. Tobacco injures blood vessel walls and speeds up the process
of hardening of the arteries.
o
Manage stress. Reduce stress as much as possible. Practice healthy coping
techniques, such as muscle relaxation and deep breathing. Getting plenty of
sleep can help, too.
o
Eat healthy foods. Try the Dietary Approaches to Stop Hypertension
(DASH) diet, which emphasises fruits, vegetables, whole grains and low-fat
dairy foods. This diet can lower your blood pressure by a few points in just
two weeks, and it offers other health benefits, too, such as protection against
osteoporosis, cancer, heart disease, stroke and diabetes.
The DASH diet: What to eat
The DASH diet is low in saturated fat, cholesterol, total fat and sodium, while
rich in protein, fibre and healthy nutrients, particularly magnesium, potassium
and calcium. The key to the DASH diet is variety, including lots of whole grain
foods, fruits, vegetables and low-fat dairy products. It also includes some fish,
poultry and legumes. Red meat, sweets and fats can be included in small
amounts.
Here are the food groups in the DASH diet and tips on incorporating them into
your meals:
Food group
Servings
Serving sizes
Whole grains
6 to 8 a day
1 slice wheat free rye, seed loaf or low GI
bread
30g low GI bran cereal
½ cup cooked oats porridge, brown rice or
pasta
Vegetables
3 to 5 servings a
day
½ cup of cooked or raw
1 cup leafy raw, shredded or chopped
½ cup cooked legumes, drained
200ml or ¾ cup 100% pure juices
Whole, e.g. apple 1 medium, approx. 100g
Grapefruit, ½ a fruit
Fruit
2 to 4 servings a
day
Melon, watermelon, pawpaw, 1 wedge, approx.
100g
Juices, ¾ cup / 200ml
Berries or small fruit, ½ cup
Diced, cooked, drained or canned, ½ cup
Dried, ¼ cup or 30g
Avocado, 1 heaped Tbsp pulp or ¼ medium
Olive, 3 olives or 30-50g
Fat-free or low-fat
dairy
2 to 3 a day
1 cup milk or yoghurt
30-40g Clover low fat, ricotta or mozzarella
cheese
½ cup cottage cheese
Lean meats, poultry
and fish
6 or fewer a day
30g cooked lean meats, skinless poultry or fish
(90g of meat is about the size of a deck of
cards)
Nuts, seeds and
beans
4 to 5 a week
1/3 cup nuts
2 Tbsp peanut butter
2 Tbsp sunflower or pumpkin seeds
Fats and oils
2 to 3 a day
1
1
1
2
Sweets
5 or fewer a week
1 Tbsp sugar or jam
1 cup sweetened drinks
Sodium
1,500 to 2,400
milligrams (mg) a
day (the lower the
amount of sodium,
the greater the
blood pressure
lowering effect)
1,500 mg of sodium equals about 4 grams, or
2/3 tsp of table salt
tsp soft margarine
tsp canola / olive oil
Tbsp mayonnaise / salad dressing
Tbsp low oil mayonnaise / salad dressing
Meat should not be the focus of the meal. Reduce meat portions and
increase the amount of vegetables you eat instead.
Enhance the heart-health benefits of the DASH diet by eating fish, such as
sardines, salmon, pilchards and herring. These types of fish are high in
omega-3 fatty acids, which can help lower your total cholesterol.
Saturated fat and trans fat are one of the main dietary culprits in raising
your blood cholesterol. Keep your daily saturated fat to a minimum by
limiting fatty meat, butter, brick margarines, cheese, full cream milk and
cream in your diet. You should also avoid trans fats — a type of fat found
mainly in hard margarines and processed foods, such as biscuits, baked
goods and fried items — as much as possible.
Although it can be high in energy, dark chocolate is another good choice if
you're craving something sweet. Dark chocolate contains a substance that
can help lower blood pressure and can enhance your results from the DASH
diet. Just be sure to keep your portion size small, 1 block (6g) of at least
60% cocoa dark chocolate.
If cutting back on sodium and table salt is difficult, do it gradually as this will
give your taste time to adjust. It can takes six weeks or more for your taste
buds to get used to less salty foods, but the drop in your blood pressure will
be worth the adjustment.
Here are some ways to reduce the sodium and salt in your diet:

Add spices or flavourings to your food instead of salt. For example,
season broccoli with lemon juice or oregano and popcorn with curry or
garlic powder.

Don't add salt when cooking rice, pasta or hot cereal.

Rinse canned foods, such as tuna, to remove some of the sodium.
High salt/sodium foods:
Soup or stock powders/cubes/instant gravy powders
Table salt and seasoned/herbal salts
Cooked and tinned ham
Bovril/Marmite/fish paste
Canned fish in brine (salt water) and crumbed fish
Canned vegetables and pickles
Hard cheeses and processed cheese, e.g. cheese spreads or wedges
Potato crisps, salted nuts and salted popcorn
Salted savoury biscuits
Butter and margarine – use the ―extra-light‖, soft margarines
Processed meats, e.g. polony, salami, sausages, bacon and biltong
Other important minerals
By following the DASH diet, you'll be getting more nutrients that can help lower
your blood pressure. The mix of potassium, calcium and magnesium in the DASH
diet acts as a diuretic, helping the body excrete salt.
Mineral
What it does
Where it's found
Potassium
Balances the amount of
sodium in your cells
Many fruits and vegetables, whole
grains, legumes, dairy products
Calcium
Not proved to prevent high
blood pressure, but eating
too little is linked with high
blood pressure
Dairy products, green leafy
vegetables, fish with edible bones,
calcium-fortified foods
Magnesium
Deficiency linked with higher Legumes, green leafy vegetables,
blood pressure
nuts and seeds, whole grains, lean
meats
Meal-planning Ideas
Breakfast
A small cup of oats porridge cooked in low fat milk with half a pawpaw and lemon
juice
A cup of bran flakes with low fat milk or yoghurt and one small sliced banana
A slice of brown toast with one poached or boiled egg with a grilled tomato and an
apple
Smoothie – blend a cup fat free yoghurt or milk with two fruits and one tablespoon
smooth peanut butter and oat bran
Snacks
A piece of fresh fruit and a small tub of low fat or fat free fruit yoghurt
Milo or Nesquik with low fat or fat free milk
Dried fruit with a handful of unsalted nuts
Carrot and cucumber sticks with mashed avocado dip
Light meal
One to two thin slices of seed loaf or rye bread with tuna in oil / skinless chicken /
lean beef and salad vegetables with half a small avocado or five olives
Two mini pitas filled with egg mayonnaise (two boiled eggs with one tablespoon
‗lite‖ mayo)
A salad made up of mixed greens, raw vegetables, avocado, skinless chicken,
mozzarella cheese, pawpaw and low oil dressing with a small baked potato
One small can of pilchards in tomato or chilli sauce on two to four rye crackers
with a mixed green salad and half a small avocado
Main meal
A small baked potato or sweet potato or a small cup of cooked brown rice or pasta
and 1 palm sized portion of skinless chicken / lean beef / pork fillet / fish and
vegetables or salad with half a small avocado or five olives
Stir fry vegetables with one palm-sized portion of beef, pork or chicken strips with
one tablespoon of sesame oil and soya sauce served with a small cup brown rice
mixed with split peas or spaghetti
Two pilchard fish cakes with sweet chilli sauce and two to three boiled baby
potatoes and steamed vegetables
Mushroom and tomato omelet (two eggs) served with roasted vegetables
Optional
dessert
A small piece of fruit with some low fat or fat-free yoghurt
Note – portion sizes are estimated and are only a guide. Contact a private
dietitian for an individualised meal plan and portion guide.