High blood pressure, also known as hypertension or the “silent killer”, is a leading risk factor for heart disease that quietly damages blood vessels, impacting 45% of adults worldwide and 60% of adults aged 60 years and older.1 Rates have been climbing over the last few decades, impacting over one billion people.2 High blood pressure is often related to unhealthy lifestyle habits, including smoking, high alcohol intake, a sedentary lifestyle and a diet high in processed foods, salt and sugar.
Medications are commonly needed to treat hypertension; however, the good news is that you can often prevent or reverse hypertension through lifestyle changes, including dietary modifications. Following a whole-food plant-based diet can help lower blood-pressure levels to optimal ranges, and reduce your risk of heart disease.3
What is Hypertension?
Blood pressure changes throughout the day, with a usual rise beginning in the morning and continuing into the late afternoon and with a drop during the night.4 Hypertension is when the blood that is flowing through your arteries occurs at a higher-than-normal pressure. As your heart contracts with each beat, it pushes blood into circulation throughout your body. When the blood is ejected consistently with too much pressure, it can cause plaque to accumulate in your arteries and organ damage.
Blood pressure is considered high when you get consistent readings of a systolic blood pressure (SBP) of 130 mm Hg or more and a diastolic blood pressure (DBP) of more than 80 mm Hg, or both. This is called hypertension. Blood pressure categories for adults, based on the average of two or more readings taken at separate times, are:56
- normal (<120 systolic and <80 mm Hg diastolic)
- elevated (120–129 systolic and <80 mm Hg diastolic)
- stage 1 hypertension (130–139 systolic or 80–89 mm Hg diastolic)
- stage 2 hypertension (≥140 systolic or ≥90 mm Hg diastolic)
Most people with high blood pressure are asymptomatic, they exhibit no symptoms. This is why hypertension is referred to as the silent killer. Often the only way to find out if you have hypertension is by having your doctor measure it with a sphygmomanometer, commonly referred to as a blood pressure cuff.
When someone has more advanced stage hypertension, known as hypertensive crisis, they may experience symptoms, including blurred vision, chest pain, dizziness, headache, irregular heartbeats, nausea or vomiting, nose bleeds, or shortness of breath.
Why Improving Blood Pressure is Important for your Health
When blood pressure is consistently high over long periods of time, our blood vessel walls and organ tissues get continuously blasted, predisposing us to:
- Damaged blood vessels leading to and in the brain, including the blood vessels of the retina. This can lead to a narrowing of or blockages and blood clots in our vessels, and swelling of the optic nerve, resulting in stroke,7 cognitive decline, dementia,8 and vision problems or loss.9 This same process of plaque buildup and the narrowing and blocking of the coronary arteries can cause heart attacks.10
- A tired, weakened, enlarged and less effective heart, caused by the overexertion of the heart pumping out blood under high pressure. Over time, this can lead to heart failure.11
- Scarred and damaged kidneys, preventing the kidneys from properly filtering and cleaning blood, leading to chronic kidney disease.12
Hypertension often co-occurs with other cardiometabolic disease risk factors, including high blood glucose, high cholesterol, and abdominal obesity. More than 50% of hypertensive patients have additional cardiovascular risk factors.13 The most common additional risk factors among people with high blood pressure are:
- Diabetes (15%–20%)
- Hyperuricemia (25%)
- Lipid disorders, e.g., elevated low-density lipoprotein-cholesterol and triglycerides (30%)
- Metabolic syndrome (40%)
- Overweight/obesity (40%)
In addition to having high blood pressure, the presence of one or more additional cardiovascular risk factors, like those listed above, increases the risk of coronary, cerebrovascular, and renal diseases.14
Improve Blood Pressure with Changes to your Lifestyle
Lifestyle modifications are the first line of antihypertensive treatment, helping to bring high blood pressure back into normal ranges. Healthy lifestyle choices can prevent or delay the onset of high blood pressure and address other cardiometabolic risk factors, reducing rates of hypertension, cardiovascular disease, and metabolic dysfunction.
Here are lifestyle changes that you can make today to optimize your blood pressure:
- Eat a whole-food plant-based diet
- Limit sugar consumption
- Limit alcohol consumption
- Enjoy regular physical activity
- Manage stress
- Quit smoking
Modifications in lifestyle can also enhance the effects of antihypertensive treatment. Among people with only mild hypertension (Stage 1 or 2), there is conflicting evidence about the benefit of medications to improve outcomes, and reduce the risk of heart disease and mortality.1516 This suggests that if your blood pressure is slightly elevated and you are otherwise healthy, lifestyle interventions alone may be preferable to medications. This is something you could discuss with a clinician.
Improve Blood Pressure with a Whole-Food Plant-Based Diet
The whole food plant-based diet, high in micronutrients,17 is linked to preventing and even reversing hypertension.1819
You may have been told to reduce your salt intake. While high salt intake is linked to elevated blood pressure,20 there is a growing body of evidence that excessive sugar consumption may be the leading culprit.21 This research suggests that as we consume less sugar, we initiate a cascade of beneficial metabolic changes, including lowering our insulin levels and resistance and improving insulin sensitivity, which collectively improve our cardiometabolic health. These changes, in many cases, are enough to bring your blood pressure back into a normal range without needing to take blood pressure medication.
By focusing on a whole-food and largely plant-based diet, one that reduces your highly processed food and animal product intake and emphasizes eating plenty of vegetables, whole grains, and fruits in their most natural form, you will drop your excess sugar consumption significantly and consume a nutrient-rich diet that will benefit your health and help you achieve an optimal blood pressure.
While there are certainly medications that can help lower blood pressure, lifestyle interventions that address the root causes of hypertension may be more effective for mild cases and benefit anyone with high blood pressure. In fact, a healthy diet, exercise, avoidance of substances that increase blood pressure, and stress management, are lifestyle changes that can often get your blood pressure under control without medications and keep it there.
Try making a few adjustments to your diet today:
- Replace highly processed foods with their unrefined whole food counterparts
- Swap a soda for a glass of water
- Swap crackers for a piece of fruit and some nuts
- Swap fast-food for a home-cooked meal
- Consume mostly plants (vegetables, fruits, tubers, grains, nuts, seeds)
Small shifts to your life can make it easier to safeguard your health and reduce your risk for serious health problems down the road. You can do it!
- Iqbal AM, Jamal SF. Essential hypertension. StatPearls Internet. Published online 2020.
- Egan BM, Kjeldsen SE, Grassi G, Esler M, Mancia G. The global burden of hypertension exceeds 1.4 billion people: should a systolic blood pressure target below 130 become the universal standard? J Hypertens. 2019;37(6):1148-1153.
- Oparil S, Acelajado MC, Bakris GL, et al. Hypertension. Nat Rev Dis Primer. 2018;4:18014-18014. doi:10.1038/nrdp.2018.14
- Chadachan VM, Ye MT, Tay JC, Subramaniam K, Setia S. Understanding short-term blood-pressure-variability phenotypes: from concept to clinical practice. Int J Gen Med. 2018;11:241.
- Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2020;30(3):160-164.
- Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334-1357.
- Pistoia F, Sacco S, Degan D, Tiseo C, Ornello R, Carolei A. Hypertension and stroke: epidemiological aspects and clinical evaluation. High Blood Press Cardiovasc Prev. 2016;23(1):9-18.
- Iulita MF, Girouard H. Treating hypertension to prevent cognitive decline and dementia: re-opening the debate. Hypertens Basic Res Clin Pract. Published online 2016:447-473.
- Fraser‐Bell S, Symes R, Vaze A. Hypertensive eye disease: a review. Clin Experiment Ophthalmol. 2017;45(1):45-53.
- Pedrinelli R, Ballo P, Fiorentini C, et al. Hypertension and acute myocardial infarction: an overview. J Cardiovasc Med. 2012;13(3):194-202.
- Kannan A, Janardhanan R. Hypertension as a risk factor for heart failure. Curr Hypertens Rep. 2014;16(7):1-8.
- Mennuni S, Rubattu S, Pierelli G, Tocci G, Fofi C, Volpe M. Hypertension and kidneys: unraveling complex molecular mechanisms underlying hypertensive renal damage. J Hum Hypertens. 2014;28(2):74-79.
- Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. The lancet. 2006;367(9524):1747-1757.
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021-3104.
- Diao D, Wright JM, Cundiff DK, Gueyffier F. Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev. 2012;(8).
- Sheppard JP, Stevens S, Stevens R, et al. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension. JAMA Intern Med. 2018;178(12):1626-1634.
- Storz MA, Müller A, Lombardo M. Diet and consumer behavior in US Vegetarians: A national health and nutrition examination survey (NHANES) data report. Int J Environ Res Public Health. 2021;19(1):67.
- Esselstyn Jr CB. Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure. Penguin; 2007.
- Wright N, Wilson L, Smith M, Duncan B, McHugh P. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr Diabetes. 2017;7(3):e256-e256. doi:10.1038/nutd.2017.3
- He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. Bmj. 2013;346.
- DiNicolantonio JJ, Lucan SC. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart. 2014;1(1):e000167. doi:10.1136/openhrt-2014-000167