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A study in the New England Journal of Medicine shows that people whose blood pressures are slightly elevated are at increased risk for heart attacks. Blood pressure has two readings, the higher one when your heart contacts and a lower pressure when it relaxes. A normal blood pressure for North Americans is 120/80; 120 when your heart contracts, and 80 when it relaxes. Every increase in blood pressure results in an increased risk for heart disease.

This is exactly what you expect. When your heart squeezes blood to your arteries, your main artery is supposed to widen like a balloon and accept the blood. If your arteries are stiff, they cannot expand like balloons and because of this, your pressure rises much higher than normal. Heart attacks occur when your arteries are stiffened by plaques in their walls. So the people with the highest blood pressure have the stiffest arteries, that have the most plaques/ that are likely to block the arteries to cause heart attacks.

A major tragedy today is that people who go to their doctors are far more likely to get blood pressure medications than to be given instructions on diet. The DASH diet lowers blood pressure far more effectively than medications. More than 80 percent of people with high blood pressure who are placed on the DASH diet will have normal blood pressure within eight weeks.

The vast majority of physicians will tell their patients with high blood pressure to restrict salt, even though there is no evidence whatever that salt restriction alone lowers high blood pressure in North Americans. Your chance of lowering high blood pressure with a low-salt diet is almost zero. A very low-salt diet can raise blood pressure. When you restrict salt severely, your kidneys produces large amounts of renin, and your adrenal glands produce large amounts of aldosterone. Both hormones constrict arteries and raise blood pressure. Lack of salt can also make you insulin insensitive and increase your chances of developing diabetes.

The DASH diet includes lots of fruits, vegetables, whole grains, beans, seeds and nuts, and skim milk products, and restricts meat, chicken and whole mile dairy products. This diet is low in salt, even if you use salt for cooking your vegetables and whole grains. I advise my patients also to restrict refined carbohydrates in bakery products, pastas, and sugar-added foods.

If your blood pressure is above 120 over 80, check with your doctor immediately. Start a controlled exercise program; get on the DASH diet of fruits, vegetables, whole grains, beans, seeds and nuts, and cut back on meat, poultry, bakery products, pastas and sugar; lose weight, and plan on a long life. If you don't do this, expect to be at high risk for heart attacks, strokes, and kidney disease.

New England Journal of Medicine, November 1, 2001

Checked 8/31/05

May 21st, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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