Hypertension and diet

[Article updated on 19/09/2023]

There are currently 15 million hypertensive patients in France, 1 in 3 adults are affected. In France, the average age of hypertensives is 62 years.

Hypertension is one of the risk factors for many cardiovascular diseases.

Hypertension (hypertension) is a silent disease that represents a major public health challenge.

Definition

Blood pressure (BP) is the pressure with which blood flows through the arteries.

The TA is defined by two figures:

• the first is that of the systolic blood pressure (SBP) : this is the maximum pressure, at the moment when the heart contracts and the blood is ejected into the arteries;
• the second is that of the diastolic blood pressure (DBP) : this is the minimum pressure, when the heart is completely relaxed

The BP is expressed on the basis of these 2 figures. Values ​​are measured in millimeters of mercury (mm Hg).

The ideal pressure is: < 130/85

The diagnosis of hypertension is made when the BP: ≥ 140/90

Blood pressure is not constant: it varies throughout the day. It is low at night when lying down, it increases when standing, and even more during physical exertion.

These measures must be observed several times, during 3 successive consultations over a period of 3 to 6 months (in the event of very significant hypertension, treatment is implemented within a shorter period of time).

It is possible to ask your doctor or pharmacist for equipment to take self-measurements. The doctor may also recommend that you take your blood pressure with an ambulatory blood pressure measuring device (ABPM).

The causes of hypertension

There are two types of HTA:

→ essential hypertension: 90% of cases, the cause of which is undetermined and/or multifactorial

Modifiable risk factors	Risk factors that are not (or barely) modifiable
Diabetes Potassium deficiency Sedentary lifestyle Alcohol Hypercholesterolemia Overweight/obesity Tobacco Too much salt Unbalanced diet	Male gender Chronic kidney disease Premature birth Aging Low birth weight Sleep Apnea Stress Family history

→ secondary hypertension: 10% of cases, of which arterial hypertension is secondary to: adrenal gland disease, a kidney disease, a vascular disease, a endocrine disease, certain treatments (estrogens, cyclosporin, erythropoietin, etc.).

Warning signs

Symptoms appear at an advanced stage of the disease. However, there are certain signs that should alert you:

→ headaches → the feeling of flies flying in front of the eyes → the feeling of dizziness or ringing in the ears. These symptoms may be harmless but they should lead to BP measurement.

In more serious situations, certain signs are the manifestation of a complication of the disease: → pain in the chest (radiating to the jaw) → difficulty moving one arm (left most often)

From the age of 40, BP should be measured at least once a year. We can start earlier if there is a family history of hypertension, symptoms or an aggravating pathology (diabetes, high cholesterol).

Complications

The main complications to which people with hypertension are exposed are:

• cerebrovascular accident (CVA);
• ischemic heart disease (angina, myocardial infarction);
• arteriopathy of the lower limbs;
• chronic renal failure;
• retinopathy;
• a neurodegenerative disease (Alzheimer and related diseases).

Treatments

Antihypertensive treatment aims to bring blood pressure levels below normal values ​​in order to minimize the risk of long-term complications.

The first treatment action does not involve prescribing medication, but rather hygienic and dietary measures.

The recommendations

Dietary balance

• Eat 5 servings of fruits and vegetables and a handful of nuts every day.
• Limit the consumption of fats, especially saturated fats (pastries, pastries, cold meats) and ultra-processed products.
• Increase the consumption of whole grains (whole grain or cereal bread, rice, pasta, whole grain semolina, etc.).
• Limit the consumption of pastries, sweets and sugary drinks.

Composition of balanced meals:

Breakfast :

• 1 drink (tea, coffee, water);
• 1 starchy food (bread, cereals, rusks);
• 1 dairy product (milk, yogurt, cottage cheese);
• 1 seasonal fruit;

Lunch and dinner:

• Raw or cooked vegetables;
• Starchy foods (bread, potatoes, pasta, rice, wheat, corn, quinoa, etc.);
• Proteins (meat, fish, eggs, legumes);
• 1 dairy product (yogurt, cottage cheese, cheese);
• 1 seasonal fruit.

Salt

• Limit salt consumption to 6 g per day for an adult of normal build who does not suffer from any pathology because salt increases blood pressure.
• It is found in cold meats, cheeses, bread, meats, smoked fish and meats, ready meals, soups, sauces and certain mineral waters (carbonated).
• Cook yourself and avoid using processed products.
• Use spices and herbs instead of salt.
• Get into the habit of not re-salting at the table.

Alcoholic beverages

It is recommended to stay below 10 drinks per week with at least two days without alcohol. It is advisable to drink while eating if possible and to alternate glasses of alcohol and glasses of water.

The tobacco

Each cigarette causes, in smokers, an increase in blood pressure for a period of 20 to 40 minutes, as well as an increase in heart rate of around 40%, which prematurely wears out the heart and weakens the walls of the arteries.

The arterial narrowing induced by this increase in pressure can lead to spasms, that is to say a sudden closure of the artery which explains the sudden onset of cardiovascular accidents, heart attacks or strokes, in certain people.

Quitting smoking reduces the relative risk of having a heart attack by at least 50%.

Physical activity

Regular physical activity helps lower blood pressure and thus fight against hypertension.

It leads to:

• An increase in the force of contraction of the myocardium;
• A reduction in heart rate at rest and during exercise, the heart tires less on a daily basis and is better protected during physical exercise;
• An increase in the volume of blood ejected at the time of ventricular contraction means that the heart must work less when propelling blood through the body;
• An improvement in the vasodilation of the arteries and the ability of the blood to carry oxygen to the organs and muscles.

To regulate and lower blood pressure, it is recommended to regularly practice physical activity of low to moderate intensity and for a long time.

This involves opting for an endurance and aerobic type sport such as brisk walking, running, cycling, swimming, etc.