DASH diet to lower high blood pressure
DASH stands for Dietary Approaches to Stop Hypertension and is recommended by the US National Heart, Lung and Blood Institute. The DASH diet can help lower high blood pressure, cholesterol and other fats in your blood. It can help lower your risk for heart attack and stroke and help you lose weight. This diet is low in sodium (salt) and rich in nutrients.
A diet that is effective in lowering blood pressure is called Dietary Approaches to Stop Hypertension (DASH).
Carrying a lot of extra weight around your middle or sprinkling too much salt onto your food at each meal can cause high blood pressure, otherwise known as hypertension. Stress and your genes can also bring your blood pressure up. Sometimes when your blood pressure is high, your doctor might not be able to find any direct cause for it. That's what's called essential hypertension. When your doctor talks to you about your blood pressure, he's referring to the force of your blood pushing against your artery walls. The top number in your blood pressure is called the systolic blood pressure. That's the pressure in your blood vessels while your heart is pumping. The bottom number is called the diastolic blood pressure and that's the pressure when your heart rests between beats. You want your blood pressure to stay at 120 over 80 or less. A blood pressure of 140 over 90 or more is considered high. Why is high blood pressure a problem, you ask? Well, you can think of high blood pressure as being like a river that's rushing too hard, eventually it's going to damage its banks. With high blood pressure, the extra force of your blood pushing against your artery walls eventually damages them. It can also damage your heart, your kidneys, and other organs. So, how do you know if you have high blood pressure? Often you don't know, because high blood pressure doesn't have symptoms like a fever or cough. Usually there are no symptoms at all, and you won't be able to find out that you have high blood pressure unless you've had it checked, or you've developed complications like heart disease or kidney problems. You can check your blood pressure yourself with a home monitor, or have it checked at your doctor's office. If it's high, you and your doctor will set a blood pressure goal. You can achieve that goal in different ways, like eating a healthy diet, exercising for at least 30 minutes a day, quitting smoking, eating less than 1,500 milligrams of salt per day, and using programs like meditation and yoga to relieve your stress. But if these lifestyle changes aren't enough, your health care provider might prescribe one or more medicines to lower your blood pressure. The reason why doctors are so serious about a patients' blood pressure is that having uncontrolled blood pressure can cause a lot of serious health problems, including heart attack, stroke, kidney disease, and loss of vision. When it comes to your blood pressure, it's best to be proactive. Call your doctor for a check-up if you haven't had one in a while, and get your blood pressure checked. If it's high, follow your doctor's advice for bringing it back into a healthy range.
How DASH Works
The DASH diet reduces high blood pressure by lowering the amount of sodium in your diet to 2300 milligrams (mg) a day. Lowering sodium to 1500 mg a day reduces blood pressure even more. The DASH diet also includes a variety of foods rich in nutrients that may help some people lower blood pressure, such as potassium, calcium, and magnesium.
On the DASH diet, you will:
- Get plenty of vegetables, fruits, and fat-free or low-fat dairy
- Include whole grains, beans, seeds, nuts, and vegetable oils
- Eat lean meats, poultry, and fish
- Cut back on salt, red meat, sweets, and sugary drinks
- Limit alcoholic beverages
You should also get at least 30 minutes of moderate intensity exercise most days of the week. Examples include brisk walking or riding a bike. Aim to get at least 2 hours and 30 minutes of exercise per week.
You can follow the DASH diet if you want to prevent high blood pressure. It can also help you lose extra weight. Most people can benefit from lowering sodium intake to 2300 mg a day.
Your health care provider may suggest cutting back to 1500 mg a day if you:
- Already have high blood pressure
- Have diabetes or chronic kidney disease
- Are African American
- Are age 51 years or older
If you take medicine to treat high blood pressure, do not stop taking your medicine while on the DASH diet. Be sure to tell your provider you are following the DASH diet.
Carrying a lot of extra weight around your middle or sprinkling too much salt onto your food at each meal can cause high blood pressure, otherwise known as hypertension. Stress and your genes can also bring your blood pressure up. Sometimes when your blood pressure is high, your doctor might not be able to find any direct cause for it. That's what's called essential hypertension. When your doctor talks to you about your blood pressure, he's referring to the force of your blood pushing against your artery walls. The top number in your blood pressure is called the systolic blood pressure. That's the pressure in your blood vessels while your heart is pumping. The bottom number is called the diastolic blood pressure and that's the pressure when your heart rests between beats. You want your blood pressure to stay at 120 over 80 or less. A blood pressure of 140 over 90 or more is considered high. Why is high blood pressure a problem, you ask? Well, you can think of high blood pressure as being like a river that's rushing too hard, eventually it's going to damage its banks. With high blood pressure, the extra force of your blood pushing against your artery walls eventually damages them. It can also damage your heart, your kidneys, and other organs. So, how do you know if you have high blood pressure? Often you don't know, because high blood pressure doesn't have symptoms like a fever or cough. Usually there are no symptoms at all, and you won't be able to find out that you have high blood pressure unless you've had it checked, or you've developed complications like heart disease or kidney problems. You can check your blood pressure yourself with a home monitor, or have it checked at your doctor's office. If it's high, you and your doctor will set a blood pressure goal. You can achieve that goal in different ways, like eating a healthy diet, exercising for at least 30 minutes a day, quitting smoking, eating less than 1,500 milligrams of salt per day, and using programs like meditation and yoga to relieve your stress. But if these lifestyle changes aren't enough, your health care provider might prescribe one or more medicines to lower your blood pressure. The reason why doctors are so serious about a patients' blood pressure is that having uncontrolled blood pressure can cause a lot of serious health problems, including heart attack, stroke, kidney disease, and loss of vision. When it comes to your blood pressure, it's best to be proactive. Call your doctor for a check-up if you haven't had one in a while, and get your blood pressure checked. If it's high, follow your doctor's advice for bringing it back into a healthy range.
How to get Started
On the DASH diet, you can eat foods from all food groups. But you will include more of the foods that are naturally low in salt, cholesterol, and saturated fats. You will also include foods that are high in potassium, calcium, magnesium, and fiber.
Here's a list of the food groups and how many servings of each you should have per day. For a diet that has 2000 calories per day, you should eat:
- Vegetables (4 to 5 servings a day)
- Fruits (4 to 5 servings a day)
- Low-fat or fat-free dairy products, such as milk or yogurt (2 to 3 servings a day)
- Grains (6 to 8 servings a day, and 3 should be whole grains)
- Fish, lean meats, and poultry (2 servings or less a day)
- Beans, seeds, and nuts (4 to 5 servings a week)
- Fats and oils (2 to 3 servings a day)
- Sweets or added sugars, such as jelly, hard candy, maple syrup, sorbet, and sugar (fewer than 5 servings a week)
The number of servings you have each day depends on how many calories you need.
- If you're trying to lose weight, you may need fewer servings than listed.
- If you are not very active, aim for the lower number of servings listed.
- If you are moderately active, have the higher number of servings.
- If you are very active, you may need more servings than listed.
Your provider can help find the right number of servings a day for you.
Know your Serving Sizes
To know how much to eat, you need to know serving sizes. Below are sample servings for each food group.
Vegetables:
- 1 cup (70 grams) raw leafy vegetables
- ½ cup (90 grams) chopped raw or cooked vegetables
Fruits:
- 1 medium fruit (6 ounces or 168 grams)
- ½ cup (70 grams) fresh, frozen, or canned fruit
- ¼ cup (25 grams) dried fruit
Fat-free or low-fat dairy products:
- 1 cup (240 milliliters) milk or yogurt
- 1½ ounce (oz) or 50 grams (g) cheese
Grains (Aim to make all of your grain choices whole grain. Whole grain products contain more fiber and protein than "refined" grain products.):
- 1 slice bread
- ½ cup (80 grams) cooked rice, pasta, or cereal
Lean meats, poultry, and fish:
- 3 oz (85 g) of cooked fish, lean meat, or poultry
Nuts, seeds, and legumes:
- ½ cup (90 grams) cooked legumes (dried beans, peas)
- 1/3 cup (45 grams) nuts
- 1 tablespoon (10 grams) seeds
Fats and oils:
- 1 teaspoon (5 milliliters) vegetable oil
- 2 tablespoons (30 grams) low-fat salad dressing
- 1 teaspoon (5 grams) soft margarine
Sweets and added sugars:
- 1 tablespoon (15 grams) sugar
- 1 tablespoon (15 grams) jelly or jam
- ½ cup (70 grams) sorbet, gelatin dessert
Tips for Following the DASH Diet
The DASH diet is designed to be easy to follow. But it might mean making some changes to how you currently eat. To get started:
- Do not try to make changes all at once. It's fine to change your eating habits gradually.
- To add vegetables to your diet, try having a salad at lunch. Or, add cucumber, lettuce, shredded carrots, or tomatoes to your sandwiches.
- There should always be something green on your plate. It's fine to use frozen vegetables instead of fresh. Just make sure the package does not contain added salt or fat.
- Add sliced fruit to your cereal or oatmeal for breakfast.
- For dessert, choose fresh fruit or low-fat frozen yogurt instead of high-calorie sweets, such as cakes or pies.
- Choose healthy snacks, such as unsalted rice cakes or popcorn, raw vegetables, or yogurt. Dried fruits, seeds, and nuts also make great snack choices. Just keep these portions small because these foods are high in total calories.
- Think of meat as part of your meal, instead of the main course. Limit your servings of lean meat to 6 ounces (170 grams) a day. You can have two 3-ounce (85 grams) servings during the day.
- Try cooking without meat at least twice each week. Instead, eat beans, nuts, tofu, or eggs for your protein.
Tips to Lower Your Salt
To lower the amount of salt in your diet:
- Take the salt shaker off the table.
- Flavor your food with herbs and spices instead of salt. Lemon, lime, and vinegar also add flavor.
- Avoid canned foods and frozen entrees. They are often high in salt. When you make things from scratch you have more control over how much salt goes in them.
- Check all food labels for sodium. You may be surprised at how much you find, and where you find it. Frozen dinners, soups, salad dressings, and prepared foods often have a lot of sodium.
- Choose foods that contain less than 5% of the daily value of sodium.
- Look for low-sodium versions of foods when you can find them.
- Limit foods and condiments that have a lot of salt, such as pickles, olives, cured meats, ketchup, soy sauce, mustard, and barbeque sauce.
- When dining out, ask that your food be made with no added salt or MSG.
Where to get More Information
There are many books about the DASH diet plan to help you get started. These books can also provide sample meal plans and recipe ideas.
References
Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. PMID: 30879355
Bakris GL, Sorrentino MJ. Systemic hypertension: mechanisms, diagnosis, and treatment. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 26.
Mozaffarian D. Nutrition and cardiovascular and metabolic diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 29.
National Heart, Lung, and Blood Institute (NIH) website. The DASH eating plan.
Rayner B, Charlton KE, Berman W. Nonpharmacologic prevention and treatment of hypertension. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 35.
Whelton PK, Carey RM, Aronow WS, et al. 2017CC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535
Version Info
Last reviewed on: 10/25/2022
Reviewed by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
