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I don’t normally cover disease “awareness days”, appointed by medical charities to bring their topic extra focus and funding. But my attention was caught by the British Heart Foundation’s current campaign around May Measurement Month.
This is a drive for everyone to get their blood pressure measured, and the charity has used the occasion to release a check list of eight steps for lowering blood pressure – some of which may be less well known.
High blood pressure is said to be the single biggest modifiable risk factor for poor health in developed countries, such as the UK. It raises the risk of heart attacks, strokes and several other conditions, and yet may go unnoticed for years.
People may be put off getting their blood pressure checked if they are reluctant to start taking medicines but, as the BHF checklist highlights, there are several lifestyle changes you can make that might mean you don’t need medication.
Most of them are well known – like losing weight and cutting down on salt – but here are some you may not have heard of. (The full BHF checklist is at the end of this article.)
Think about potassium, not just sodium
Most people are aware that blood pressure can be lowered by eating less salt, a.k.a. sodium chloride. That’s because sodium is a key mineral in body fluids and its concentration in the blood cannot be allowed to get too high.
“When you have too much salt in your blood, your body tries to dilute it,” said Dell Stanford, a BHF dietitian. That greater volume of fluid within our blood vessels is what raises blood pressure.
But there’s a relationship between the body’s sodium levels and potassium, another mineral. If we consume more potassium, it helps the body get rid of sodium in the kidneys.
Potassium is found in fruit and vegetables, especially bananas, avocados and leafy greens, as well as beef, chicken, oily fish and dairy products.
Many low-sodium forms of table salt replace some of the sodium with potassium, and this may help explain why they reduce blood pressure. People with kidney problems are advised not to use these salt substitutes, though.
The BHF also recommends people don’t take potassium tablets unless medically advised to do so, as it can disturb the heart rhythm. “Too much can be harmful,” said Professor Bryan Williams, chair of medicine at University College London.
Dairy’s back on the menu
Calcium is usually seen as something to help keep bones strong, but it also helps lower blood pressure. The mechanism is unclear but it may be because it boosts sodium excretion, like potassium. It may also help in relaxing and widening blood vessels.
But calcium may not be the only reason why studies show a correlation between dairy consumption and lower blood pressure.
Milk contains a group of related compounds called dairy peptides, which trials have shown relax blood vessels by blocking production of a hormone called angiotensin II. This is the same way ACE inhibitors, an important class of blood pressure drugs, work. “Dairy foods are unique in that you’ve got all of these things going on,” said Stanford.
The BHF advises people to include dairy in their diet for this reason, even as dairy foods are not usually seen as heart healthy. They advise, however, that people choose lower-fat options, like semi-skimmed or skimmed milk, to avoid saturated fat, which may increase cholesterol levels, causing plaques that raise the risk of heart attacks.
Brilliant beetroot
Nearly every source of healthy eating advice recommends that people eat plenty of fruit and vegetables. But the latest BHF report singles out a group of produce that is high in compounds called nitrates.
Beetroot is particularly high in nitrates, with other good sources including spinach, kale, celery, strawberries and bananas.
The body converts nitrates into a hormone-like compound in the body called nitric oxide, which relaxes the muscles in blood vessels and so widens them. (This is the same hormone boosted by the erectile dysfunction drug Viagra, which works by opening up blood vessels to the penis.)
“As soon as you’ve got open arteries, the blood pressure will drop,” Stanford said.
Blood pressure drugs in disguise
Another study released this week points to an alternative approach to blood pressure control, involving medicines usually seen in a different light.
People taking weight loss jabs experience a fall in their blood pressure about the same as when they start taking a specific blood pressure drug, according to research released at the European Congress on Obesity.
Merging the results from 32 large-scale trials of the slimming jabs showed that people had a reduction in their systolic blood pressure of about 5 millimetres of mercury, on top of weight loss.
The figures showed that only about three-quarters of the impact was a result of the weight loss, suggesting the jabs also had a direct effect on blood pressure through some other biological mechanism.
“These findings support a meaningful role for [weight loss injections] in blood pressure management in overweight and obesity,” said the researchers, led by Dr Marcel Muskiet at Leiden University Medical Center in The Netherlands.
Eight steps to blood pressure control from British Heart Foundation
Check your blood pressure Regular exercise Five portions of fruit and veg daily Include dairy in your diet Cut down on salt Moderate your drinking Manage weight Take medicines as prescribedI’ve also written
Eating too many meat substitutes like veggies sausages and burgers could potentially harm your health because they contain food toxins usually found only in hot countries.
These “mycotoxins” develop mainly in tropical or subtropical regions, when mould starts growing on crops like grains, nuts, beans and fruit. But mycotoxins were found in over 200 plant-based meat substitutes sold in British supermarkets, according to a recent investigation.
I’ve been reading
For my book club, I have been reading Julia, by Sandra Newman, set in the world of George Orwell’s classic, 1984, but written from the perspective of the female lead, Winston Smith’s girlfriend.
To prepare myself I reread 1984 and the one way it disappointed was the sparse details around how that Britain became such an authoritarian communist state. Newman gives her imagination free reign, and her alternative history is riveting – and entirely believable.
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