Unhealthy diet and physical inactivity contribute to around 30% of preventable morbidity and mortality from non-communicable diseases, including morbidity and mortality due to hypertension.
Hypertension is a condition associated with increased risk for stroke, cardiac failure, renal failure and peripheral vascular disease.
Excessive intake of saturated fatty acids and trans fatty acids, along with higher consumption of salt and sugar, are risk factors for cardiovascular diseases including hypertension.
Public health approaches (e.g. reducing calories, saturated fat and salt in processed and prepared foods and increasing community/school opportunities for physical activity) can achieve a downward shift in the distribution of a populations blood pressure, thus potentially reducing morbidity, mortality and the lifetime risk of an individuals becoming hypertensive.
These public health approaches can provide an opportunity to interrupt and prevent the continuing costly cycle of managing hypertension and its complications.
Risk factors related to high blood pressure
Sodium intake
- Higher sodium intake has been associated with higher risk of incident stroke, fatal stroke and fatal coronary heart disease.
- Reduction in dietary sodium intake will reduce the mean population blood pressure, as well as the prevalence of hypertension.
- A decrease in salt consumption of 3 grams per day would result in a reduction in blood pressure which in turn would lead to a reduction of 22% and 16% in stroke and ischaemic heart disease deaths, respectively.
- Even in hot, humid climates, there are only minimal loses of sodium through faeces and sweat. Acclimation to heat occurs rapidly; thus, within a few days of exposure to hot and humid conditions, individuals lose only small amounts of sodium through sweat.
- WHO recommends a reduction in sodium intake to less than 2 grams per day of sodium (5 grams per day of salt) in order to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease in adults (individuals 16 years of age and older).
Intake levels should be adjusted downward based on the energy requirements of children relative to those of adults.
Each country should determine the energy requirements of various age groups, especially within the paediatric population, relative to the recommended maximum intake value of 2 grams per day for adults.
Potassium intake. Dietary intake of potassium lowers blood pressure and is protective against stroke and cardiac arrhythmias. Potassium intake should be at a level which will keep the ratio of sodium to potassium close to 1:1, i.e. at daily potassium intake levels of 70–80 mmol per day.
This may be achieved through adequate daily consumption of fruits and vegetables.
Healthy weight. Physical activity has been shown to lower the overall risk of all-cause mortality between the ages of 45 and 84 by 18%. To reduce blood pressure, maintain a healthy weight with a body mass index between 18.5 and 24.9.
Healthy eating. Adapting the DASH (Dietary Approaches to Stopping Hypertension) eating plan can reduce blood pressure by 8–14 mmHg.
The DASH diet consists mainly of fruits, vegetables and low-fat dairy products and includes whole grains, poultry, fish and nuts while limiting the amount of red meat, sweets and sugar-containing beverages.
Saturated and trans fatty acid intake. Intake of saturated fatty acids should be reduced to less than 10% of total energy consumption, and trans fatty acids to less than 1%. Intake of trans fatty acids can be reduced by replacing them with polyunsaturated fatty acids.
Reducing or eliminating meat may influence blood viscosity. Numerous studies have linked beef, veal, lamb, poultry and animal fat to high blood pressure.
Saturated fat appears to influence blood viscosity. A higher proportional intake of fatty acids from polyunsaturated sources (linoleic acid and alpha-linolenic acids), compared with saturated fats, is associated with lower risk for developing hypertension.
WHO
