The role of diets, food, and nutrients in the prevention and control of hypertension and prehypertension

Slimko, M. L., & Mensah, G. A. (2010). The role of diets, food, and nutrients in the prevention and control of hypertension and prehypertension. Cardiology Clinics, 28(4), 665-674. doi:10.1016/j.ccl.2010.08.001

 

Abstract:

Hypertension is the leading risk factor for death worldwide, even surpassing tobacco use, high blood glucose, high blood cholesterol, and obesity. Globally, the estimated prevalence of hypertension is nearly 1 billion persons with an annual mortality of almost 7.5 million deaths. In the United States, hypertension affects an estimated 65 million Americans, and it is the leading risk-factor cause of death in women and only second to tobacco use as a contributory cause of death in men. Multiple sources of data from prospective observational, cohort, and randomized controlled clinical trials show that hypertension and its complications are highly preventable when the raised blood pressure (BP) is prevented, or treated and controlled. In fact, average reductions of just 5 to 6 mm Hg of diastolic BP in large, randomized, placebo-controlled trials resulted in an approximate reduction of 38% in stroke, 16% in incident coronary heart disease events, 21% in composite cardiovascular events, and 12% in death from all causes. A fundamental component of effective prevention, treatment, and control of hypertension is the adoption of recommended behavioral and lifestyle changes among which dietary intake of foods and nutrients play crucial roles. In this article, the authors focus on the role that diet, foods, and nutrients play in the prevention and control of hypertension and prehypertension. The report of the 2010 Dietary Guidelines Advisory Committee (DGAC) is reviewed, and its recommendations relevant to the promotion of nutrition education and the prevention and control of hypertension are summarized. The role of the dietitian, as a critical member of the care team for the management of hypertension, is also discussed. Finally, the role of the food system, including food manufacturers and restaurants, in addressing dietary sodium intake, calorie density, and other strategies in support of energy balance to support the prevention and control of hypertension and prehypertension is discussed.