Foods for Blood Pressure: DASH, Beets, Potassium and Hibiscus

Read this first. Potassium needs care with kidney disease and with some blood pressure medicines. MedlinePlus says that if you have chronic kidney disease your kidneys may not remove extra potassium from the blood, and that some medicines can also raise your potassium level. [1] The MedlinePlus page for lisinopril, a type of ACE inhibitor, says to talk to your doctor before using salt substitutes containing potassium. [2] The World Health Organization (WHO) describes lower-sodium salt substitutes as suited to people not at risk of hyperkalemia (high blood potassium). [3] Never stop or change a blood pressure medicine because of a food: ask the prescriber or pharmacist.

DASH and sodium

DASH stands for Dietary Approaches to Stop Hypertension. The US National Heart, Lung, and Blood Institute says the plan requires no special foods and provides daily and weekly nutritional goals, built on vegetables, fruits and whole grains. [4] In the original trial, 459 adults were fed a control diet, a fruit-and-vegetable diet or a "combination" diet. [5] The combination diet lowered systolic and diastolic pressure by 5.5 and 3.0 mm Hg more than the control diet, and by 11.4 and 5.5 in the 133 people with hypertension. [5] The fruit-and-vegetable diet alone lowered systolic pressure by 2.8 mm Hg more. [5] A later review of 30 trials (5,545 people) found a 3.2 mm Hg systolic and 2.5 mm Hg diastolic reduction. [6]

In the DASH-Sodium trial (412 people), cutting sodium lowered pressure on both the control diet and the DASH diet, and the DASH diet with low sodium gave the largest drops. [7] Official sodium limits differ by body: WHO recommends less than 2,000 mg a day of sodium for adults (under 5 g of salt) [8], the 2020 to 2025 US Dietary Guidelines say less than 2,300 mg a day for most people [9], and NHLBI notes 1,500 mg lowers blood pressure further than 2,300 mg. [4] WHO says most salt in many countries comes from processed foods. [3]

Potassium

A BMJ review of 22 trials found that higher potassium intake lowered blood pressure in people with hypertension but not in people without it. [10] The authors judged this potentially beneficial for most people without impaired kidney handling of potassium. [10] WHO says a potassium intake of at least 90 mmol a day (3,510 mg) may be beneficial for adults. [3] A dose-response review of 32 trials of potassium supplementation found a U-shaped pattern, with blood pressure rising at high excretion in people treated for hypertension with drugs. [11] Supplement trials do not show what foods do, so this page does not suggest potassium pills. See foods high in potassium and potassium.

Single foods and drinks

See beets, pomegranate and black tea. Hibiscus is an herbal tea, covered with its cautions in hibiscus tea. For the dietary pattern, see dietary patterns studied.