High blood pressure ranks as the #1 risk factor

for death and disability in the world.

Previously, I showed how a plant-based diet

may prevent high blood pressure, but what if you already have it?

The American Heart Association, the American College of Cardiology,

and the Centers for Disease Control and Prevention

recommend as the first-line treatment: lifestyle modification.

If that doesn't work you start the patient

on a thiazide diuretic, water pill,

and then you keep piling on the meds until you get their blood pressure down.

Commonly people will end up on three drugs,

though researchers are experimenting with four at a time,

and some people end up on five. Why not jump straight to the drugs?

Well, they don't treat the underlying cause, and they can cause side-effects.

Less than half of patients stick with even the first-line drugs,

perhaps due to the adverse effects

such as erectile dysfunction, fatigue, and muscle cramps.

So what are these recommended lifestyle changes?

They recommend to control one's weight, salt, and alcohol intake,

engage in regular exercise, and adopt a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not.

It emphasizes fruits and vegetables and low-fat dairy,

but just a reduction in meat. Why not vegetarian?

We've known for decades that food of animal origin

was highly significantly associated with blood pressure.

In fact, if you take vegetarians,

And you give them meat, you can watch their blood pressures go right up.

I've talked about how there are benefits to getting blood pressure

down as low as 110 over 70, but who can get that low?

Populations eating plant-based diets.

Like in rural China, about 110 over 70 their whole lives,

with meat only eaten on special occasions. Or rural Africa,

where the elderly have perfect blood pressure as opposed to hypertension.

In the Western world, as the American Heart Association has pointed out,

the only folks really getting down that low were the strict vegetarians,

coming out about 110 over 65.

So when they created the DASH diet were they just not aware

of this landmark research, done by Harvard's Frank Sacks?

No, they were aware. The Chair of the Design Committee that came up

with the DASH diet was Dr. Sacks.

In fact the DASH diet was explicitly designed

with the #1 goal of capturing the blood pressure lowering

benefits of a vegetarian diet,

yet contain enough animal products to make it palatable to the general public.

In fact, Sacks found that the more dairy the lactovegetarians ate,

the higher their blood pressures, but they had to make the diet acceptable.

Research has since shown that it's the added plant foods,

not the changes in oil, sweets, or dairy, that appears to be the critical component,

so why not eat plant-based?

A recent meta-analysis showed vegetarian diets were good,

but strictly plant-based diets may be better.

Vegetarian diets in general confer protection against

cardiovascular diseases, some cancers and death,

but completely plant-based diets seem to offer additional protection for obesity,

hypertension, type-2 diabetes, and heart disease mortality.

Based on a study of 89,000 people, those eating meat-free diets

appeared to cut their risk of high blood pressure 55%,

but those eating meat-free, egg-free, and dairy-free had 75% lower risk.

If, however, you're already eating a whole food plant-based diet,

no processed foods, no table salt, and you're still not hitting 110 over 70,

there are a few foods recently found to offer additional protection.

Ground flaxseeds, a few tablespoons a day,

induced one of the most potent antihypertensive effects

ever achieved by a dietary intervention, 2 to 3 times more powerful

than instituting an aerobic endurance exercise program.

Watermelon also appears to have extraordinary effects

but you'd have to eat like 2 pounds a day.

Sounds like my kind of medicine, but it's hard to get year-round.

Red wine may help, but only if the alcohol has been taken out.

Raw vegetables or cooked?

And the answer is both, though raw may work better.

Beans, split peas, chickpeas, and lentils may help a little.

Kiwifruits though don't seem to work at all,

even though the study was funded by a kiwifruit company.

Maybe they should have taken direction

from the California Raisin Marketing Board

who came out with this study showing raisins can reduce blood pressure,

but only, apparently, compared to fudge cookies, Cheez-its, and Chips Ahoy!