Part III – Prevention and Treatment
Critical Control Measures

1)      Maintain a healthy weight.woman eating bowl of cereal
2)      Be physically active on most days of the week.
3)      Follow a low-sodium eating plan that includes plenty of fruits and vegetables.
4)      Take blood pressure medication as prescribed.
5)      Avoid excess alcohol. 

When blood pressure is not too high, it can often be controlled entirely through dietary changes, losing weight if overweight, exercising regularly, and limiting alcohol. 

Spotlight on Sodium

Even in adults who do not have hypertension, a reduction in blood pressure of 2 to 3 mm Hg is generally seen when sodium intake is lowered from 4,000 mg daily to half that amount. Over several years, this can gradually build to as much as a 10 point difference, significantly reducing risk for heart disease. 

Additionally, a reduced sodium diet tends to enhance the effectiveness of blood pressure medications. A diet low in salt is also associated with less likelihood of experiencing a stroke, kidney stones, congestive heart failure, and osteoporosis. 

Salt sources in American diet:

a)  Five percent is added during home cooking.
b)  Six percent is added at the table.
c)  Twelve percent occurs naturally in whole, unprocessed foods.
d)  Seventy-seven percent of salt is consumed through processed foods and restaurant meals. 
According theInstituteofMedicine, various attempts to reduce sodium intake have been going on for more than 40 years with little success. There are numerous reasons why this is so including the following:  

  • The prevalence of inexpensive processed foods.
  • Our innate preference for flavor combinations of salt, sugar and fat.
  • The busy lifestyles of most Americans.
  • Family meals, prepared from whole, natural foods and eaten together at home are becoming less and less common.
  • Average preparation time for individual meals is now 10 minutes and consists mainly of warming processed foods in the microwave.

A reduced sodium diet is usually unpalatable at the onset, especially if it’s below 2,000 mg sodium; however, over the course of a few months to a year, most persons become accustomed to much less salt. It may take creativity and perseverance during the initial 90 days while you adapt to new tastes, but a low sodium diet can become highly enjoyable.
Potassium is Protective

Potassium consumption in the United States averages 2,600 mg per day which is far below the recommended intake. In fact, a recent report found that no more than 13 percent of the population is adequately controlling their salt consumption and well below 5 percent are achieving the recommended dietary intake for potassium. 

A moderate potassium deficiency is characterized by elevated blood pressure, greater risk of kidney stones, and increased calcium loss through urine. Good sources of dietary potassium include fruit, vegetables, legumes, fish, and dairy products. 

The recommended daily allowance of potassium for adolescents and adults is 4,700 mg per day. Consuming U.S. Dietary Guidelines recommended 7 to 13 daily servings of fruits and vegetables will more than adequately supply this quantity. 
Eating this much produce would also reduce risk of kidney stones as well as bone loss due to osteoporosis. Nutrition Nuggets on Osteoporosis, Part 1 tells how produce consumption protects against bone loss; Part II explains how excess dietary sodium leaches bone mineral.
Go to and click on My Pyramid Plan to find out how many servings of fruits and vegetables you need (based on age, gender, and activity level) along with a customized food guide. At you can find out what constitutes a serving, learn why fruit and vegetable intake is so important for good health, and read tips on how to include more in your daily diet. 

Physical Activity

At least 30 to 60 minutes of regular exercise on most days of the week can lower elevated systolic pressure by 4-9 mm Hg with corresponding reductions in diastolic pressure. Among those who’ve been physically inactive, the adoption of a daily exercise regimen is frequently able to reduce blood pressure within a few weeks. 

Cardiovascular (aerobic) exercise is the most important type of physical activity for controlling blood pressure. Any physical activity that increases your heart and breathing rates will strengthen your heart and lungs including:

  • House and Yard Work
  • Active Sports
  • Stair Climbing
  • Brisk Walking
  • Jogging
  • Bicycling
  • Swimming
  • Dancing

The American Heart Association recommends at least 150 minutes of moderate exercise, 75 minutes of vigorous intensity, or a combination of both each week.
If your blood pressure is normal, regular exercise can help keep it from rising as you get older. Being physically active also aids weight management and reduces risk for cardiovascular disease, diabetes, cancer, and many other forms of chronic, degenerative disease. 

Diet and Lifestyle Effects

In just four weeks, elevated LDL cholesterol can be lowered by 30 percent or more through a combination of dietary changes and exercise. Those changes include a diet low in animal fat and high in fiber such as the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. 

With the standard American diet typically including no more than two to three servings of fruit and vegetables daily, each additional serving added decreases the risk of heart disease by approximately four percent. This is primarily due to the abundant antioxidants and fiber in these whole, natural foods. 

Epidemiological studies have revealed that our bad habits of poor diet, lack of physical activity, smoking, and excessive alcohol use are responsible for 80 percent of our risk for cardiovascular disease. Heart patients who are willing to adopt and adhere to a healthy diet and lifestyle are frequently able to reverse their disease process and avoid further cardiac problems altogether.

A list of sources for this series of articles can be found here.