Updated April 29, 2015.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Hypertension (high blood pressure), often referred to as "the silent killer," is a major risk factor for cardiovascular disease and diabetes. The Center of Disease Control reports that 67 million Americans have high blood pressure, but only 16 million people are receiving treatment. I see it all the time - this week I was educating a patient with a blood pressure of 160/100 (normal 120/80) and he said he didn't feel a thing.

Although high blood pressure can be heredity, the American Heart Association suggests that for one in three people with high blood pressure, a high sodium diet is to blame. Excess sodium intake can elevate blood pressure; sodium holds extra fluid in the body, putting stress on the heart, and increasing blood volume and blood pressure. 

The 2010 Dietary Guidelines for Americans recommends that adults and children limit their sodium intake to less than 2300mg/day (equivalent to 1 tsp of salt) -  the average adult eats about 3,400 mg/day of sodium. For those persons with high blood pressure and diabetes, the American Diabetes Association and American Heart Association recommend that sodium should be restricted to no more than 1500mg/day. It's not just us adults who are overindulging either - our youth is eating just as much salt as the adult population. A recent study published in the American Academy of Pediatrics found that adolescents are eating nearly double the amount of the recommended daily sodium intake (of the American Heart Association).

The study also reported that those eating a high sodium diet were positively associated with abdominal adiposity and inflammation - other risks factors for heart disease and diabetes. 

It is important that adults and children decrease their sodium intake. Reducing sodium intake may help to reduce blood pressure, abdominal adiposity and inflammation. And even if it can't - it certainly won't do any harm. It may even enhance our taste buds.

How Do I Know if I Have High Blood Pressure?

Each heart beat circulates blood to the rest of the body.The force of the blood on the wall of the arteries as blood moves through them is called blood pressure. Blood pressure is measured by the rate at which the heart contracts and relaxes. Systolic blood pressure is the when the heart contracts and diastolic blood pressure is when the heart relaxes.  The amount of blood pumped by the heart and the diameter of an artery can affect your blood pressure. Excess sodium can increase blood volume and therefore increase blood pressure. 

Blood pressure is a Measurement of Systolic Blood Pressure/Diastolic Blood Pressure:  

Normal	120/80 mmHg or lower
Pre-hypertension	systolic 120-139 mm Hg, OR diastolic 80-89 mmHg
Hypertension	Stage 1 hypertension: systolic 140-159 mmHg, OR diastolic 90-99 mmHg Stage 2 hypertension: systolic greater than 150 mmHg, OR diastolic greater than 99 mmHg

 

The reason blood pressure is called the "silent killer" is because typically there are no real symptoms of elevated blood pressure and you shouldn't rely on warning signs to tell you you have high blood pressure. That is why it is so important to be a proactive patient and know your numbers. 

There is, however, something called a hypertensive crisis. The American Heart Association states that: only when blood pressure readings soar to dangerously high levels (systolic of 180 or higher OR diastolic of 110 or higher) may obvious symptoms occur. Blood pressure this high is known as hypertensive crisis, and emergency medical treatment is needed.

In addition to extreme readings, a person in hypertensive crisis may experience

• Severe headaches
• Severe anxiety
• Shortness of breath
• Nosebleeds

How Can I Lower My Sodium Intake?

Do Not Add Salt: A chef once told me - if you can actually taste the saltiness of a food - it's too salty. Prepare your meals with herbs and spices (dried or fresh) that flavor food without adding excess salt or calories. The less salt you eat, the less you will crave. Excess salt can desensitize taste buds and inhibit you from tasting foods' natural flavor. Not to mention, one teaspoon of salt is equivalent to 2400mg of sodium - that is enough for the whole day. Not sure what to do with herbs and spices?

You can find some tips here: 

http://herbsspices.D106/od/top5herbspicecookbooks/tp/Top-5-Herb---Spice-Cookbooks.htm

Focus on whole foods: Processed foods have additives, like sodium, to preserve shelf life and prevent food borne illness. Aim to avoid foods that are prepared or packaged. 

Eat This                                                            Not That

Baked "French fries" with olive oil, pepper, and rosemary	Frozen French fries
Whole wheat macaroni with broccoli, garlic, hot pepper, olive oil and a sprinkle of Parmesan cheese	Boxed macaroni and cheese or Pasta with jarred sauce
Roasted unsalted almonds or nut variety	Trailmix with salted nuts
Homemade salad dressing: olive oil, vinegar, lemon, parsley	Store bought salad dressing
Egg whites with spinach and avocado	Frozen breakfast sandwich or Fast food sandwich
Homemade vegetable soup	Canned soup

 

Be Label Savvy: Some foods contain sodium naturally, but the majority the of high sodium foods are packaged or processed foods. In this fast paced life, you may not always be able to eat whole, natural foods. When you are in a pinch and need to pick something quickly, choose foods that are low in sodium. When reading labels, always look at the serving size. You will have to adjust the sodium content based on the serving size. The key is, a product that claims it is reduced or less sodium does not make it a low sodium food. The following measures are claims based on one serving.

Sodium free or no sodium	Less than 5 milligrams of sodium and no sodium chloride in ingredients
Very low sodium	35 milligrams or less of sodium
Low sodium	140 milligrams or less sodium
Reduced or less sodium	At least 25 percent or less sodium than the regular product.

 

Cut Down on the Fast Food: Even the lowest calorie options at fast food restaurants are typically rich in sodium. A low calorie option doesn't always guarantee it to be healthy. For example: A small chili (about a cup) at Wendy's is only 180 calories, but it has 790mg of sodium, which equates to about 33% of your total needs for the day, and if you are someone with diabetes and have high blood pressure, this is more than half of your daily needs for the day. 

Follow the DASH diet: The DASH diet has been proven to help lower blood pressure. It is a diet that focuses on whole foods: fruits, vegetables, whole grains, lean protein and low-fat dairy. 

Are There Any Other Foods That Can Help to Lower My Blood Pressure? 

Foods rich in potassium: If you are someone suffering from kidney disease, you should ask your physician before incorporating foods rich in potassium into your diet. Studies have shown that diets rich in potassium are associated with lower blood pressure. Foods rich in potassium include things like: oranges, tomatoes, bananas, artichokes, spinach, sunflower seeds, almonds. 

 

Sources: 

<sub>Zhu, Haidong, et. al. (2014) Adolescents - Dietary Sodium, Adipostiy, and Inflammation in Healthy Adolescents. Pediatrics. Accessed on-line, February 5, 2014: http://pediatrics.aappublications.org/content/early/2014/01/28/peds.2013-1794.abstract

American Heart Association. Sodium (Salt or Sodium Chloride). Accessed on-line, February 5, 2014: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Sodium-Salt-or-Sodium-Chloride_UCM_303290_Article.jsp

Center for Disease Control. When it Comes to Blood Pressure, Make Control Your Goal. Accessed on-line, February 6, 2014: http://www.cdc.gov/Features/HighBloodPressure/

National Institute of Health. High Blood Pressure. Access on-line, February 6, 2014: http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm

Unknown author. American Academy of Nutrition and Dietetics. Eating Right with Less Salt.

American Heart Association. The Myths of Symptoms. Accessed on-line, February 6, 2014 http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/SymptomsDiagnosisMonitoringofHighBloodPressure/What-are-the-Symptoms-of-High-Blood-Pressure_UCM_301871_Article.jsp</sub>