Diet taboos for patients with hypertension

The total daily sodium intake should not exceed 2300mg (patients with complications are best controlled within 1500mg), do not touch any alcoholic beverages, and try to reduce the intake of ultra-processed foods high in oil and sugar. In addition, there are no 100% inedible foods. All dietary restrictions must be adjusted flexibly based on your own blood pressure fluctuations and underlying diseases. There is no need to follow the "fasting list" on the Internet and force yourself to not touch anything.

Last week at a community free clinic, I met Lao Zhou, who has suffered from high blood pressure for 5 years. He said that he had not dared to touch braised pork or cakes for half a year, and he only dared to take a small bite of his favorite banana. As a result, his blood pressure still soared to 160/100. When he took a look at his food diary, he found that the problem was all because he could not see. Regarding sodium - 10g of pickled mustard is added to the white porridge every morning, a large spoonful of bean paste is added to every stir-fry meal, and I also like to nibble on some salty soda crackers as snacks on weekends. After rough calculation, my sodium intake in a day has soared to 4000mg, which is more than double the recommended amount. It is strange that my blood pressure can be stable.

When it comes to sodium control, many people have heard the saying that "switching to low-sodium salt is healthier". In fact, the recommendations of doctors in different departments are really different. Most doctors in endocrinology and cardiovascular departments will recommend patients with completely normal kidney function to switch to low-sodium salt, which can reduce sodium intake by about 30% without changing the salty taste. ； However, doctors in the Department of Nephrology will repeatedly remind you that if the glomerular filtration rate is already lower than 60ml/min·1.73m², the potassium added in low-sodium salt cannot be excreted, which may easily cause hyperkalemia and, in severe cases, affect the heart rhythm. In this case, the right way is to eat ordinary refined salt and use less salt.

The first thing many patients ask when meeting them is "Am I never able to drink coffee again?" ”, in fact, there is no unified conclusion in the academic circles on this issue. Some studies have shown that blood pressure will rise slightly by 5-10mmHg within 1-2 hours after drinking strong coffee, but there is also 10-year follow-up data showing that long-term regular drinking of black coffee without sugar or creamer can actually improve blood vessel elasticity, which is beneficial to long-term blood pressure stability. I know an old head nurse who has a history of high blood pressure for 12 years. She drinks a cup of freshly ground black coffee every morning. Her blood pressure has been stable at around 130/80 for so many years. As long as you don’t experience panic or dizziness after drinking it, there is no need to quit hard. Just drink two or three strong cups at a time.

Oh, by the way, many elders used to believe that "drinking a small amount of liquor to activate blood circulation". This rumor really needs to be refuted. The research conclusions of the WHO just updated two years ago have been confirmed. Even a small amount of drinking is harmful to the cardiovascular system, especially for patients with high blood pressure. Alcohol will dilate blood vessels in a short period of time, and then constrict blood vessels, resulting in extremely large blood pressure fluctuations. My distant uncle was happy during the Chinese New Year last year. He drank two taels of white wine and suffered a headache that night that made him unable to stand. He was sent to the emergency department and his blood pressure was 190/110. Fortunately, he was sent to the emergency department in time and no cerebral hemorrhage occurred. Now he doesn’t dare to drink even a drop of alcohol.

Many people who have high blood pressure simply give up meat and eggs and eat porridge and vegetables every day. It is really unnecessary. Uncle Zhang, who lived downstairs before, was like this. He went on a vegetarian diet for 8 months, but his blood pressure did not drop much. Instead, his face turned sallow and he was diagnosed with iron deficiency anemia. Later, he followed the doctor's advice and added one boiled egg and two taels of lean pork every day, and ate steamed fish once a week. After supplementing with enough high-quality protein, the elasticity of his blood vessels improved. In the past six months, his blood pressure has not exceeded 140/90. Even if it is fatty meat that everyone considers "taboo", if you are really craving for it and eat one or two pieces to satisfy your craving, it is not a big problem. It is better than eating half a bag of candied fruit or a few packets of spicy strips when you are so hungry. The invisible sodium and trans fatty acids in those processed snacks are much more harmful than one or two pieces of fatty meat.

I have been doing community health education for three years, and I have concluded that the invisible sources of sodium that are most easily ignored by ordinary people are actually the following: sauce packets that come with takeaways (a bag of salad dressing and ketchup can contain 300mg of sodium), soaked dried vegetables and bamboo shoots, soda crackers claimed to be "sugar-free" (many of which contain more than 500mg of sodium in one packet), and commonly used chicken essence, oyster sauce, and light soy sauce at home. After adding these, the daily salt consumption for the day must be reduced by at least half.

Having said that, there really aren’t that many rules and regulations regarding the diet for high blood pressure. You don’t have to make yourself look like an ascetic. You can go to a gathering with friends if you want to eat hot pot. Choose a clear soup pot, use less processed meatballs, use less sesame sauce and sand tea sauce as dipping sauce, cook more fresh vegetables and fresh lean meat, and drink two more glasses of water after eating, and your blood pressure will not fluctuate. If you're really not sure what you can and can't eat, just check your blood pressure half an hour after eating. If it's much higher than usual, try to touch less of it next time. It's much easier to use than copying someone else's taboo list.