Diet taboos for people with high blood pressure

The core dietary taboo for hypertensive patients is never "certain types of food are completely forbidden." The most important bottom line to adhere to is that the daily sodium intake does not exceed the standard, and at the same time, avoid the three major pitfalls of invisible high sodium, excessive free sugar, and trans fat. In particular, we must be wary of the misconception of "relying on dietary therapy instead of taking medicine." This is the most practical conclusion I have drawn from thousands of patients with hypertension after 12 years of practicing in the Department of Cardiovascular Medicine.

Don’t believe it. I just saw a 62-year-old man last month. He used very little salt when cooking at home and rarely touched soy sauce. As a result, his blood pressure fluctuated around 150/95mmHg for half a month, and he couldn’t stabilize it no matter how he adjusted his medicine. After careful questioning, I found out that he had two pieces of fermented bean curd and porridge for breakfast every day. The sodium content of one piece of red fermented bean curd is close to 600mg. Two pieces of it account for 80% of the recommended daily sodium intake (1500mg). No matter how light the porridge he drinks, it cannot make up for this gap. I should also mention here that low-sodium salt is currently quite controversial: patients with normal kidney function can use low-sodium salt instead of ordinary table salt, which can indeed reduce sodium intake by about 30% while maintaining the same saltiness, which is very helpful for blood pressure control. ； However, patients with renal insufficiency and abnormal blood potassium metabolism must not touch it. The excess potassium cannot be excreted and induces hyperkalemia. In severe cases, it can directly lead to cardiac arrest. This is no joke.

Speaking of this, someone must ask, does that mean that we don’t need to worry about anything else except salt? No, but many people’s understanding of “taboos” is too extreme. There was a 38-year-old programmer who once was diagnosed with high blood pressure and immediately gave up all animal fats and red meats, even the egg yolks, and only ate boiled vegetables and chicken breasts every day. After three months of persistence, his blood pressure did not drop much. On the contrary, due to the lack of fat-soluble vitamins, he often felt dizzy and was not energetic even at work. I told him at that time, you eat fried pork belly twice a week, only about one or two each time, there is no problem at all. Controlling stress is a lifelong matter, and living like an ascetic, eating and drinking in revenge after not being able to persist for half a month will only make things worse. There is no unified "absolute prohibition" requirement in the academic community on the intake of saturated fat. As long as the daily intake of saturated fat does not account for more than 10% of total calories, there is no need to completely draw a clear line with fat meat and butter.

What many people don’t know is that the biggest problem is never the visible salt, but the invisible sodium that doesn’t taste salty at all. Last week, there was a 26-year-old girl who ordered light snacks every day and said that she was eating very healthy. As a result, her blood pressure soared to 145/90. When I asked her, I found out that she squeezed in the two bags of salad dressing that came with the light snacks every time. One bag of salad dressing contains more than 600 mg of sodium. Two bags are equivalent to eating 3 grams of salt, which is equivalent to eating a boiled vegetable in vain. The usual toast, sugar-free soda, salt-baked nuts, candied plums, and even the milk caps in the milk tea you drink have surprisingly high sodium content. When buying, turn over and look at the nutritional label. If the sodium content exceeds 30%, don’t put it in the shopping cart. Seriously.

I should also say a few words objectively about the "hypertension foods" that are so popular on the Internet. Long-term consumption of foods with high potassium and dietary fiber, such as celery, onions, and black fungus, can indeed help improve blood vessel elasticity. This is supported by epidemiological studies. ； But saying "drinking a cup of celery juice every day can lower your blood pressure by 10mmHg without taking antihypertensive drugs" is pure deception. I met a patient last year who stopped his antihypertensive medication privately and started drinking celery juice three times a day. After half a month of drinking, his blood pressure soared to 180/110. He came to the emergency room with a headache that made him unable to stand, and he almost suffered a cerebral hemorrhage. Diet therapy is always a supplement and cannot replace medicine. There is no room for bargaining on this point.

There is another question that people often ask about drinking. There are indeed different opinions in the academic circles: one group believes that as long as you touch alcohol, it will cause damage to blood vessels, and it is best to quit completely.； Another school of thought believes that people who have a drinking habit and drink no more than 50ml of low-alcohol red wine a day will not have a big impact on blood pressure. They do not need to force withdrawal to cause emotional anxiety but increase blood pressure. My advice is to quit if you can. If you really can't, then strictly control the amount. Don't drink alcohol to a high degree or get drunk. After drinking, check your blood pressure twice a day. If it rises significantly, don't drink.

To put it bluntly, the dietary taboos for high blood pressure are not a long blacklist at all, but more like a flexible safety line for you. I really want to eat salted egg yolk. It’s okay to eat half of it. I’ll make up for it by skipping half a spoonful of salt when cooking that day. ； If you want to eat hot pot at a dinner party with friends, don’t dip it in satay sauce or hoisin sauce. Use some minced garlic, light soy sauce and spicy millet, and you can still have a good time. You don’t have to feel that life is no longer fun at the mention of taboos. After all, stress control is a lifelong matter, and a comfortable rhythm that can be maintained for a long time is the most suitable for you.