DASH diet


The Dietary Approaches to Stop Hypertension (DASH) diet has long been emphasized in the treatment of hypertension. This popular diet stresses the importance of fruits, vegetables, whole grains, and low saturated fat. In addition, DASH recommends consuming less than 1,500 mg per day of sodium in patients 51 and older.


Whole grains


Although treating hypertension is important, preventing its development in your patients is also important. Men who consumed 53 grams per day of whole grains daily were 19% less likely to develop hypertension, compared with men who consumed only a small amount of whole grains, regardless of their lifestyle. Current dietary guidelines recommend consuming 85 grams per day of whole grains, which is equivalent to three slices of whole wheat bread.



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Hand grip devices


For patients not wanting to change their diet, perhaps suggesting a hand grip device may be helpful. Zona Plus is a relatively expensive hand grip device that patients grip for two-minute intervals. The isometric action of gripping appears to relax the nervous system and improve the function of blood vessels, which lowers blood pressure. These devices are not recommended for patients who have blood pressure higher than 180/110 mm Hg. Use of this device three to five times a week for two to three months can lower SBP and DBP by 10%.


Deep breathing devices


RESPeRATE is a deep breathing device approved by the FDA to train patients to breathe slowly and deeply. Using the device for 15 minutes, three to four days per week can lower SBP 4 mm Hg. The device is moderately expensive, but patients could possibly perform their own deep breathing exercises to achieve similar benefits.


Although drug therapy remains the mainstay in the treatment of hypertension, patients who are motivated to make changes in their diet and lifestyle can augment their hypertension treatment. As a primary care provider, encouraging patients to consider diet changes, supplements, and lifestyle changes can form a partnership with patients. This can help lower their blood pressure and overall risk of morbidity and mortality related to this silent but deadly disease.

Jennifer A. Bold, APRN, CNP, is affiliated with the Department of Family Medicine at the Mayo Clinic in Rochester, Minn.


References


  1. Johnson SA, Figueroa A, Navaei N, et al. Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial. J Acad Nutr Diet. 2015;115(3):369-377. 

  2. 2. Rodriguez-Leyva D, Weighell W, Edel AL, et al. Potent antihypertensive action of dietary flaxseed in hypertensive patients. Hypertension. 2013;62(6):1081-1089. 

  3. Khalesi S, Sun J, Buys N, Jayasinghe R. Effects of probiotics on blood pressure: A systematic review and meta-analysis of randomized, controlled trials. Hypertension. 2014;64(4):897-903. 

  4. Rosenfeldt FL, Haas SJ, Krum H. J Hum Hypertens. 2007;21(4):297-306.

  5. Tracey E. Extra-virgin olive oil reduces need for blood pressure 
medication. WebMD, March 29, 2000. Available at: webmd.com/hypertension-high-blood-pressure/news/20000329/extra-virgin-olive-oil-reduces-need-
blood-pressure-medication?print=true

  6. Juraschek SP, Guallar E, Appel LJ, Miller ER 3rd. Effects of vitamin C supplementation on blood pressure; a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012;95(5):1079-1088.


All electronic documents accessed on June 16, 2015.