Control high blood pressure: beyond salt

What measures should be taken to control high blood pressure? High blood pressure affects billions of people around the world. Its pharmacological control ends up needing combined therapies that suppose an unsustainable health cost.

Eradicating salt consumption is unnecessary and insufficient. Thus, it is essential to adopt non-pharmacological measures that allow hypertension to be controlled efficiently.

Current research shows that, far from restrictive guidelines, Adopting a healthy lifestyle is the ideal method to control high blood pressure.

What is hypertension?

The concept of blood pressure (BP) refers to the pressure exerted by the blood on the arterial walls. Systolic blood pressure (TAs) is used to refer to the pressure existing at the moment when the heart contracts and expels its blood to the rest of the body.

On the other hand, the diastolic blood pressure (TAd) refers to the value of blood pressure when the heart is filled with blood. There is talk of Hypertension (HTA) when TAs> 140 mmHg and / or TAd> 90 mmHg in 3 non-consecutive measurements.

HTA affects billions of people

HTA is considered a public health problem that affects billions of people around the world. It is estimated that it suffers 30% of the population and its prevalence exceeds 50% in subjects over 50 years. When not properly controlled, it ends up severely damaging the heart, brain, eyes and kidneys.

In fact, hypertension is considered the leading cause of stroke and heart failure and the second cause of chronic kidney disease. It is also behind some of the main causes of chronic blindness. In addition, according to WHO data, HTA is behind 15% of deaths worldwide.

It is clear that its control is essential. But nevertheless, the high prevalence makes the cost of pharmacological treatment unsustainable. In addition, the progressive need for combined pharmacological therapies implies an increase in side effects.

The number of patients affected by hypertension is quite alarming. In fact, the disease is classified as a public health problem.

What can we do to control high blood pressure?

Lifestyle is one of the factors with the greatest impact on the genesis of HT and the good news is that it is a factor Pharmacological treatment should be reserved for cases of HBP resistant to other measures.

So far, non-pharmacological treatment has been based almost exclusively on the reduction of salt intake to avoid its attraction to liquids. But is it a necessary and sufficient measure?

Avoiding salt consumption is not necessary

Current scientific evidence shows that salt intake does not increase the TA in all people. Some examples are:

• The study by Baker, Curhan, de Jong, Forman, Gansevoort & Scheven (2012) concluded that salt consumption only increased BP in subjects with preexisting vascular damage.
• The research by Arós, et al. (2013) discovered that, despite its high salt content, gazpacho consumption was inversely correlated with TA figures.
• A study prepared by Carmona, Crespo, López, Navas, Nolasco & Santamaría (2016)also found no relationship between sodium consumption and HBP

Salt consumption only impacts on the TA of the so-called "salt sensitive subjects" and these only represent 50% of the cases.

However, as long as the cause-effect relationship is not known exactly, and tools are not available that allow easy detection of the aforementioned sensitive subjects, It is advisable to maintain prudent consumption (1 teaspoon of salt per day = 5 grams of salt per day = 2.3 grams of sodium per day).

The consumption of ultra-processed foods is not recommended since they have a very high salt content. In addition, they are harmful for other reasons.

How to control hypertension beyond salt?

In general terms, an adequate approach to HTN involves taking measures that: normalize the volume of fluids, reduce the viscosity of the blood, increase the caliber of the arteries or prevent arterial stiffness.

Think about the pressure inside a pipe can help us understand the strategy: normalize the flow, reduce impurities in the water, put larger pipes or make them a flexible material.

Increase the contribution of potassium, calcium and magnesium

The beneficial role of potassium in the control of blood pressure is indisputable. This is because it promotes the urinary excretion of sodium, relaxes smooth muscle and decreases peripheral resistance.

In other words: normalizes the circulating blood volume and favors the capacity of adaptation of the arteries.

The consumption of foods rich in potassium, such as avocado and banana, helps to keep TA figures within normal limits.

Calcium and magnesium have also been shown to be effective in controlling BP. The calcium allows a good management of the TA by inhibition of the Parathyroid Hypertensive Factor (FPH).

Magnesium does it by a mechanism that is still unknown. However, a higher incidence of HBP has been detected in populations with a deficit of this mineral.

Other minerals such as zinc, manganese and copper could be involved in the genesis of HTN. However, the investigation in this regard is too immature to draw conclusions about it.

Discover: 6 foods to increase magnesium in the diet

Increase the consumption of fiber and proteins

The consumption of 25-40g / day of fiber has a reducing effect on TA because:

• It decreases vascular resistance and improves the entry and exit of blood through the heart.
• It slows the activity of an enzyme (ECA) responsible for generating a hypertensive substance (angiotensin II) and inhibiting a hypotensive (bradykinin).
• Increases the retention of hypotensive minerals such as potassium or magnesium.
• The foods that contain it are usually very rich in antioxidants and these have also been shown to be beneficial in controlling blood pressure.

Beilin, Burke, Giangiulioi, Hodgson, Puddey & Rogers (2001) found that When combined with an increase in protein consumption the hypotensive effect is greater.

Vitamins D and K are essential

The combination of low vitamin D and K levels has been associated with an increase in BP. Apparently, both actively participate in the regulation of a protein that inhibits the calcification of the arteries (MGP): vitamin D increases its amount and vitamin K activates it.

This is a very novel finding (the first research on this was published in March 2017) and therefore new research is required. However, the research of Beulens, Brouwer, Cepelis, van Ballegooijen, van Schoor & Visser (2017), after analyzing 171 subjects, concluded firmly that both vitamins would be playing an important role in the development of hypertension.

Reduce the consumption of high glycemic index carbohydrates

The excess of glucose in the blood supposes an increase of the viscosity of the same and, therefore, an increase of the figures of TA. In fact, people with diabetes mellitus often end up developing hypertension.

Avoid the consumption of harmful fats

Transgenic fatty acids and most saturated fats predispose to HTN. Its effect is due to the accumulation of cholesterol inside the arteries by increasing the LDL protein and reducing HDL.

Read more: How should you eat to control high cholesterol?

Maintaining proper hydration helps control high blood pressure

Adequate hydration favors the purification of the blood and reduces the viscosity Of the same. This assumes lower TA figures.

Adequate hydration is key to the management of hypertension.

Cardiovascular physical activity is key to controlling high blood pressure

The most sedentary individuals have a 30-50% higher risk of suffering from hypertension. The Spanish Heart Foundation considers that cardiovascular physical activity, such as going for a walk, it constitutes one of the most apt measures for the control of the TA.

• Its benefits are attributed to its vasodilator effect, the elimination of sodium through sweat and its contribution to weight loss.

The excess of body fat supposes a risk of HTA of 2 to 6 times greater, being still higher when the fat accumulates in the trunk (central obesity or "apple type).

Ensure an adequate night's rest

Sleeping well is fundamental. Different studies relate sleep problems with a higher prevalence of hypertension. Likewise, it has been shown that sleeping well helps reduce TA figures.

Good stress management is key to controlling high blood pressure

Stress activates a whole series of hormones that stimulate the sympathetic nervous system and this is directly related to AT. A) Yes, Learning how to handle stress would mean a considerable reduction in TA figures.

Avoid the use of tobacco and alcohol

Tobacco and alcohol are toxic substances capable of increasing AT. The hypertensive effect of tobacco is due to the increase in the viscosity of the blood. Alcohol does so because of its role in the genesis of various health conditions directly related to the increase in BP.

• Some examples are diabetes mellitus, hypercholesterolemia and central obesity.

The intestinal microbiota is key in the control of arterial hypertension

In the same way that happens with other chronic pathologies, those with HTA share characteristics in the intestinal microbiota that have not been found in those people without HBP. Some hypotheses suggest that it could be due to the consumption of salt.

The study by Alm, et al. (2017) showed a Less presence of Lactobacillus in the gut microbiota of mice that had been given a high-salt diet for several weeks.

The reduction of this bacterial population was associated with an increase in pro-inflammatory T (H) 17 cells and, therefore, with an increase in BP. The conclusions were identical when carrying out a pilot study with 12 people. The gut microbiota may have the answer to why "Only 50% of people with high blood pressure react negatively to salt intake".

In terms of diet, the Mediterranean diet is ideal to be able to apply all the nutritional recommendations mentioned. However, remember that it is necessary to maintain a healthy lifestyle that includes: sleeping well, being active, managing stress and not consuming toxic substances. In addition, supplementation with Lactobacillus could help achieve better results.

The best way to control high blood pressure is to perform an integral approach that goes beyond the consumption of salt.