How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet
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The first-line treatment for hypertension is lifestyle modification, which often includes the DASH diet. What is it and how can it be improved?

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High blood pressure ranks as the #1 risk factor for death and disability in the world. Previously, I showed how a plant-based diet may prevent high blood pressure. But what if we already have it?

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend, as the first-line treatment, lifestyle modification. If that doesn’t work, you start the patient on a thiazide diuretic, or water pill, and then you keep piling on the meds until you get their blood pressure down. Commonly people will end up on three drugs, though researchers are experimenting with four at a time, and some people end up on five.

Why not just jump straight to the drugs? Well, they don’t treat the underlying cause, and they can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to the adverse effects such as erectile dysfunction, fatigue, and muscle cramps. So, what are these recommended lifestyle changes? They recommend to control one’s weight, salt, and alcohol intake, engage in regular exercise, and adopt a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it’s not. It emphasizes fruits and vegetables and low-fat dairy, but just a reduction in meat. Why not vegetarian? We’ve known for decades that food of animal origin is highly significantly associated with blood pressure. In fact, you can take vegetarians, give them meat, and watch their blood pressures go right up.

I’ve talked about how there are benefits to getting blood pressure down as low as 110 over 70, but who can get that low? Populations eating traditional whole food plant-based diets. Like in rural China, about 110 over 70 their whole lives, with meat eaten only on special occasions. Or rural Africa, where the elderly have perfect blood pressure as opposed to hypertension.

In the Western world, as the American Heart Association has pointed out, the only folks really getting down that low are the strict vegetarians, coming out about 110 over 65. So, when they created the DASH diet, were they just not aware of this landmark research, done by Harvard’s Frank Sacks? No, they were aware. The Chair of the Design Committee who came up with the DASH diet was Dr. Sacks. In fact, the DASH diet was explicitly designed with the #1 goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet containing enough animal products to make it palatable to the general public. In fact, Sacks found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it’s the added plant foods, not the changes in oil, sweets, or dairy that appear to be the critical component, so why not eat plant-based?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. Vegetarian diets in general confer protection against cardiovascular diseases, some cancers and death, but completely plant-based diets, vegan diets, seem to offer additional protection for obesity, hypertension, type 2 diabetes, and heart disease mortality. Based on a study of 89,000 people, those eating meat-free diets appeared to cut their risk of high blood pressure 55%, but those eating meat-free, egg-free, and dairy-free had 75% lower risk.

If, however, you’re already eating a whole food plant-based diet, no processed foods, no table salt, and you’re still not hitting 110 over 70, there are a few foods recently found to offer additional protection. Ground flaxseeds, a few tablespoons a day, induced one of the most potent antihypertensive effects ever achieved by a dietary intervention, two to three times more powerful than instituting an aerobic endurance exercise program.

Watermelon also appears to be extraordinary, but you’d have to eat like two pounds a day. Sounds like my kind of medicine, but it’s hard to get year-round. Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? And the answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may help a little. Kiwifruits don’t seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with this study showing raisins can reduce blood pressure–but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy!

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to via Mikalai Maminau.

High blood pressure ranks as the #1 risk factor for death and disability in the world. Previously, I showed how a plant-based diet may prevent high blood pressure. But what if we already have it?

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend, as the first-line treatment, lifestyle modification. If that doesn’t work, you start the patient on a thiazide diuretic, or water pill, and then you keep piling on the meds until you get their blood pressure down. Commonly people will end up on three drugs, though researchers are experimenting with four at a time, and some people end up on five.

Why not just jump straight to the drugs? Well, they don’t treat the underlying cause, and they can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to the adverse effects such as erectile dysfunction, fatigue, and muscle cramps. So, what are these recommended lifestyle changes? They recommend to control one’s weight, salt, and alcohol intake, engage in regular exercise, and adopt a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it’s not. It emphasizes fruits and vegetables and low-fat dairy, but just a reduction in meat. Why not vegetarian? We’ve known for decades that food of animal origin is highly significantly associated with blood pressure. In fact, you can take vegetarians, give them meat, and watch their blood pressures go right up.

I’ve talked about how there are benefits to getting blood pressure down as low as 110 over 70, but who can get that low? Populations eating traditional whole food plant-based diets. Like in rural China, about 110 over 70 their whole lives, with meat eaten only on special occasions. Or rural Africa, where the elderly have perfect blood pressure as opposed to hypertension.

In the Western world, as the American Heart Association has pointed out, the only folks really getting down that low are the strict vegetarians, coming out about 110 over 65. So, when they created the DASH diet, were they just not aware of this landmark research, done by Harvard’s Frank Sacks? No, they were aware. The Chair of the Design Committee who came up with the DASH diet was Dr. Sacks. In fact, the DASH diet was explicitly designed with the #1 goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet containing enough animal products to make it palatable to the general public. In fact, Sacks found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it’s the added plant foods, not the changes in oil, sweets, or dairy that appear to be the critical component, so why not eat plant-based?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. Vegetarian diets in general confer protection against cardiovascular diseases, some cancers and death, but completely plant-based diets, vegan diets, seem to offer additional protection for obesity, hypertension, type 2 diabetes, and heart disease mortality. Based on a study of 89,000 people, those eating meat-free diets appeared to cut their risk of high blood pressure 55%, but those eating meat-free, egg-free, and dairy-free had 75% lower risk.

If, however, you’re already eating a whole food plant-based diet, no processed foods, no table salt, and you’re still not hitting 110 over 70, there are a few foods recently found to offer additional protection. Ground flaxseeds, a few tablespoons a day, induced one of the most potent antihypertensive effects ever achieved by a dietary intervention, two to three times more powerful than instituting an aerobic endurance exercise program.

Watermelon also appears to be extraordinary, but you’d have to eat like two pounds a day. Sounds like my kind of medicine, but it’s hard to get year-round. Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? And the answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may help a little. Kiwifruits don’t seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with this study showing raisins can reduce blood pressure–but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy!

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to via Mikalai Maminau.

Doctor's Note

This is the companion video to How to Prevent High Blood Pressure with Diet.

The DASH diet is one of the best studied, and consistently ranks as US News & World Report’s #1 diet. It’s one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I’ve talked about the patronizing attitude many doctors have–that patients can’t handle the truth–in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs

For more on what plants can do for high blood pressure see:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

190 responses to “How to Treat High Blood Pressure with Diet

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  1. As noted in this clip, Dr Frank Sacks finds the ethics of scientific research a challenge. He modifies study results for political purposes. In a like manner, he states in this Harvard Newsletter that “recent evidence” indicates “no value” to the Omega 3/6 ratio (item #3):

    http://www.hsph.harvard.edu/nutritionsource/2007/06/19/ask-the-expert-omega-3-fatty-acids/

    When I asked him what “recent evidence” he was referring to, he declined to answer me for 3 weeks. I queried another fatty acid researcher who could not guess what “recent evidence” Dr. Sacks might be referring to. He also observed that some researchers feel themselves so lofty they decline to engage the rabble. Meanwhile, I read the abstracts of all 2035 Pubmed articles on Omega 3/6 ratio as well as all 146 studies published by Dr. Sacks and found no claim that the Omega 3/6 ratio was of no value. So I queried him again. He responded that he was “too busy” to answer my question. I then put the matter to the Harvard Letter Editor, pointing out that innuendo is an appropriate literary device for a dime novel but not a scholarly work. The editor told me they would invite Dr. Sacks to rewrite his article and include proper citations for all claims. I’m not holding my breath But I will stay on this until I get an answer.




    4
    1. Salbers: You read 2035 abstracts? My hat is off to you. Please write a book on the subject. (Based on my a lot more limited readings on the topic, the ratio of omega 6 to omega 3 seems not important but the daily intake of each is; there’s such a thing as essential fatty acid toxicity. I’d appreciate if you could kindly comment on this.)




      1
    2. I believe you misinterpreted him. The full quote from that article is “While there is a theory that omega-3 fatty acids are better for our
      health than omega-6 fatty acids, this is not supported by the latest evidence.”

      In other words, there is no evidence to suggest the theory is true. ie. the ball is in your court so to speak.




      1
  2. For those new to nutritionfacts.org (NF.O) and have made it here to the comments section, do note the dozen or so links above in “Doctor’s Note”. These appear with each video and are specific to each subject making it very easy to quickly find answers and more viewing/reading here at NF.O. If one needs more or is interested in the science on any other topic, try the site search above for 8 years of videos and articles. Also rest assured that when something of nutritional importance changes (as fish oil), Dr. Greger will update and change his recommendations as any proper MD should do. Also each video has a transcript and reference list and more hyperlinks to related topics. Finally, the commentary sections hre are generally filled with good discussions (physicians and scholars even) as well as some trolling and nay-sayers as well as serially confused, but the “signal to noise” ratio here is far better than is found in the Youtube comments. Enjoy!




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      1. Thought it might be helpful. Thank you for your dedication and cost-free access to top-quality, unbiased nutritional information.




        2
      2. I have reduced my blood pressure and total cholesterol significantly in just two months of Dr. Greger’s Daily Dozen! However, I seem to have one poor side effect: sleep disturbance. I am waking up at 3:00 am and having difficulty falling back to sleep. Nothing else in my life has changed. I have searched everywhere on this site to try to find what I need to increase or decrease to improve my chances of sleeping through the night. I am so committed to this program, as I have found every other benefit so worth it. What do you suggest?




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        1. There are a lot of things that can cause sleep disturbances, but since your sleeping trouble began after a change in diet, it’s likely that you just aren’t eating enough. You might try increasing your portion sizes of leafy greens and beans at dinner, which will keep your brain fueled for sleep, feed your microbiome, and promote steady blood glucose. Another thing that can promote deep, restful sleep is eating a mango a few hours before bed. Mangoes contain sleep-enhancing terpenes and amino acids.

          Dr. Jamie Koonce




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    1. My mother suffers from high blood pressure so I have learnt all about the condition. It has led me to spend countless hours of research & online discussion on how to lower high blood pressure and relieve her symptoms. Below is a few tips I wanted to share:

      1. Take Coenzyme Q10 (CoQ10) supplements. It works very well for cardiovascular system because it is involved in cellular energy production and is a powerful antioxidant. Maybe go speak to your doctor if you wanna know more on this.

      2. Follow every step in the the video & guide seen at the following link:
      curehealthproblem*com/highbloodpressure (obviously change the * for a dot as it won’t let me post links here) . This will tackle blood pressure in a NATURAL way. Very important.

      3. Take up one of the following: tai chi, yoga or meditation. Not only will it benefit blood pressure through exercise but it will improve mental state..

      Seeing my mum now and seeing how she was 5 years ago is a sight to behold and she is proof that sufferers should fight the condition as best as they can. The only other things she does now is exercise & doesn’t drink wine anymore. I hope that my comment will be of help to others. Good luck everyone <3

      x




      1
      1. Thanks for your comments Paulina, but they are tucked in as a reply to my reply to Dr. Greger’s reply to my comment. Follow? It’s fine, folks will find it, But to be clear: I don’t have any problems with hypertension. Never have.




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  3. Is there a dietary intervention strategy to combat the rashes that those of us who live in climates where the humidity level dives during a few of the winter months to the mid-35% levels or below? These are the rashes caused by dry climates and a predisposition of individuals.




    1
    1. Hi Mary. Some of our video’s are translated you can click the “cc” in the bottom right hand corner and see what is available as not every video have them. One way to translate the information is by clicking “view transcript” to read the text. Hopefully in the future all videos will be translated in multiple languages.




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      1. Thank you so much for your answer, Joseph! I will do as you suggest : ) I am usually tempted to pass the transcript via Google translator and send it as is but being a linguist myself I think important nutrition education must come in proper use of language and grammar or will lose credibility and understanding. You could do as many sites and do a collaborative/volunteer-based translation project. I’d be happy to help!




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    1. I looked up the author of the ajcn study you sited above…It was a fella named Robert H Knoop who was a prominent lipid-hypothesis opponent. He died relatively young in 2011 of a sudden heart attack. Can’t get much more real than that.




      1
    2. Its an editorial commenting on this paper, in which every diet group had progressively narrowing coronary arteries. Only after statistically massaging the data (adjusting for age, education, diabetes, smoking, medication, carb, protein, and total energy intake) did a trend emerge that indicated that those with lower saturated fat intake have worse declines. The also found high glycemic index carb intake and high overall fat intake had negative effects, Junk food is bad news.

      The only studies I’m aware of where lifestyle changes have lead to coronary disease reversal are those of Drs Ornish and Esselstyn, where overall fat intake is reduced to 10-15% of energy (extremely low fat by Western standards), and saturated fat to around the 3-4% intrinsic to whole plant foods. Whether its the lower saturated fat, absence of animal products, or greater amounts of whole plants that’s responsible for the benefit is an open question. The body of evidence I’ve seen is consistent with most of the risk that might be attributable saturated fats appearing in the 2-8% of energy range, intakes rarely studied in Western populations, and is disappearing with the Westernization of diets worldwide.




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      1. >> The only studies I’m aware of where lifestyle changes have lead to coronary
        >> disease reversal are those of Drs Ornish and Esselstyn, where overall fat
        >> intake is reduced to 10-15% of energy (extremely low fat by Western
        >> standards), and saturated fat to around the 3-4% intrinsic to whole plant foods.

        I have read a lot and seen a lot of video about this.

        If this can reduce coronary disease … does that mean it reduces blood pressure,
        and if so, why is that not specifically claimed. But how can you reduce coronary
        disease if the person still has high or increasing blood pressure?
        What I hear is – go on a vegan diet and everything will miraculously be fine.
        Yet I know to listen to what real scientists and researchers say, and I do not
        hear them saying that.

        >> Whether its the lower saturated fat, absence of animal products, or greater
        >> amounts of whole plants that’s responsible for the benefit is an open question.

        Exactly, it would be nice to know exactly what people need to do to get
        these benefits.

        A while ago a video was posted that said a doctor reversed heart disease
        in his patients by “forcing” them to eat nothing but rice and some fruits
        or veggies. If that works I’d like to know it, and what to expect. What if it
        doesn’t work?

        For example, are there any patients Dr. Gregor has where he has prescribed
        a WFPB diet and it has not worked, and he has gone ahead and prescribed
        BP medication?




        0
        1. Actually go on a whole-food plant-based diet with little or no added sugars, refined grains or liquid oils and you will vastly improve your *odds* of not developing a chronic disease and if you already have so damaged your body that you have one of the classic Western chronic diseases there is a pretty good chance that you might even be able to reverse it or at worst keep it from progressing further.

          Nowhere in does any professional (doctor, nutritionist, researcher) proponent of a WFPB diet say that everything will be fine for everybody. Do absolutely everything right and you still might develop high blood pressure or cholesterol.

          Study after study shows that a WFPB diet is probably the most effect treatment because it goes at the root cause of most Western diseases, the food. As such, IMHO, no ethical doctor should ever prescribe another course of treatment until a switch to an actual WFPB diet and not just a moderate change to the current crappy SAD diet is tried and found to not be effective. By this same token, no ethical doctor would ever not prescribe medication if a therapeutic diet change wasn’t effective or effective enough.

          As for the rice, fruits and veggies diet, I think you are refering to the Rice Diet pioneered by Dr. Walter Kemptner in 1939 at Duke University (not exactly a time and place that was a hotbed of Vegan radicals). He developed it to control malignant blood pressure with kidney failure at a time before BP medications when this could be a death sentence. The Rice Diet proscribed by Kempner was white rice, white sugar, fruit and fruit juices. That same diet was found to be highly effective against diabetes (type II) as well!

          Now I think we understand a bit more about the underlying causes of high BP, and understand that a non-boring, non-bland WFPB diet can be as effective in controlling BP as the Rice diet was.




          2
          1. For the last 9 years I have been prescribing a WFPB with adequate Vitamin B-12 intake for patients. I have done this in a traditional setting with the Kaiser Permanente program, in private practice, as a physician with the McDougall and Esselstyn Whole Foods Immersion programs and with EarthSave’s Meals for Health programs. When I give CME presentations to physicians it is hard to convey the professional satisfaction from supporting patients to improved health. I have come to view “hypertension” as the bodies NORMAL response to poor lifestyle habits primarily nutrition. Think about it… If you were the pump (heart) for 70,000 miles of pipes (arterial system) that was getting more inflexible and narrowed what would you do? I believe you would increase the pressure of the pump to keep things flowing Now my undergraduate Chemical Engineering training is a bit rusty and I can no longer do the math but it makes sense to me. When embarking on the correct lifestyle path, persons need to be patient as their arterial system repairs itself. They also need to avoid over treatment. If they are on medications they need to work with clinicians who can change, reduce and eliminate medications as needed. The arterial system will experience fairly rapid initial improvement as the nitrous oxide system improves but it will can take years for the cholesterol blockages to be reversed. The earlier you begin the best science based nutrition the better long term results will be and you will be less likely to be put on medication. It is worth the effort. Keep tuned to NutritionFacts.org for the best science.




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        2. As someone who usually eats WFPB except when out with friends when I’ll eat vegan, I’m a statistical anomaly and still have high blood pressure. I realise that I’ve had a lot of things happening in my life that are stressful and I’m mindful of the way that I breathe. For example, holding my breath while empty and even doing this while exercising ……If my blood pressure is too high I take meds. I think that exercise also plays a role in bringing the pressure down but for me I’ve had chronic fatigue and only now feel like i can do this.




          0
          1. Rosemary, I’ve been on a WFPB (no oil, low-sodium and low-fat) diet for a year and a half and I still need to be on BP meds, according to my cardiologist, who is also a vegan. So you are not alone. It’s frustrating but I’m staying with the diet because I’m convinced it’s the healthiest for me. Good luck!




            0
            1. Totally agree. i wouldn’t change because this one marker is not shifting. i suppose my point was that we might just need to try harder or try everything.




              0
            2. Michael Innis – I thought I’d chime in a little and share some of my story. I’m 9 years WFPB now. Luckily for me, I never had high BP. But I was having escalating cholesterol and other issues. My BP, when I began WFPB, was roughly 120/78. Not high, but not low either. Interestingly, my BP didn’t change until about 3 years ago. It is now 108/65.
              If one reads Dr. Esselstyne’s book, one sees that it took about 36 months for the veins and arteries to clear out of his patients. While I have no science to back this up, it would not surprise me if it takes the body a while to clear out the sludge well enough to allow the BP to fully come down. I’m supposing that this is what happened in my case. And I’m thrilled of course. But it also makes a case for sticking with the program. I see it as being akin to quitting smoking – which I also had to do, and did, 30 years ago. Physicians will tell you that if you quite smoking, after 25 years the lungs are healed such that its as if one never smoked. It takes lungs a while to rejuvenate, .. so why not the veins and arteries.

              So I say “Keep the Faith” and stick with it. It’s the right thing to do for your body.
              Best of luck –




              5
              1. Thanks NF Fan for your info. I have been vegetarian for 10 years and vegan for 1 year. I am moving toward WFPB diet and wondering if I could get off BP meds eventually. I think expecting it to take 3-6 years is realistic if it happens at all. I know there are no guarantees but that a WFPB diet improves my odds of avoiding many diseases drastically. Either way I will stick with it. Thanks.




                0
      2. Alnd all participants in the Mozaffarian study ate a high fat diet, just some worse than others. Also note that in the “low-fat/high-carb” group, as the editorial categorizes quartile one, fiber intake was only 25(+/-14) g/d as compared to 17(+/-7) g/d for a quartile four, the high saturated fat “group”. So Q1 just barely, on average, met the daily recommendation for women. So Q1 basically replaced some of the saturated (and monosaturated fat too which dropped from 13% in Q4 to 7%) with refined carbohydrates for the most part. Q1 was still getting 3.5-7% of their calories from saturated fat, so the women in Q1 were definitely not eating a WFPB diet.

        The real take away message from Mozaffarian is that if you are going to eat a junky diet you might get sicker slightly slower if you eat more saturated fat than if you eat more refined carbohydrates and added sugar. It has nothing to say about what diet to eat if you actually don’t want to get sicker.




        0
  4. My mother was vegetarian since in her 20’s (is now 85) yet she started getting high blood pressure about 10 years ago. How is such possible?




    0
    1. There are many factors, it’s hard to say in your situation. First of all, vegetarian does not mean healthy. As the video stated, dairy also raises blood pressure. I know vegetarians that eat a lot of pizza. It may be vegetarian, but certainly not healthy to eat so often.

      Medications can also have side effects like high blood pressure. As does stress. Other environmental/lifestyle factors, too, probably.

      It’s hard to answer your question specifically without knowing all the details since there are several potential reasons. But, it certainly is possible to have high blood pressure as a vegetarian. Just because someone doesn’t eat mean, they still need to watch what they eat, get exercise, among other things.




      0
    2. That’s a good question, I wish there were some good answers with some supporting research. What I hear when people ask questions like this is more faith-based support for veganism, and projections on the person that they did something wrong, such as eating tons of pizza, or dairy. If iodine is a factor, then why is this not mentioned in the video?

      One thing I find missing in this video is how. That is, if someone has high blood pressure and they begin say a strict vegan regimen and stick to it, how can you tell whether it is working or not? What would be the expect drop in BP, and how long would it be before the average person’s BP dropped to the tantalizingly low number Dr. Gregor cited here?

      I feel like most of these videos are cheerleading and rah-rah propaganda for veganism because of generalized studies that show plant-based diets have value. I don’t argue that. That seems to be indicated by all the research. But, it is never qualified here in these videos. I know it is hard, and maybe not even possible to say certain things because it might be considered medical treatment, or be misinterpreted, but I sure would like to hear, and see, a lot more detail on some of these videos.

      What kinds of diseases, or even genetic predispositions could lead to high blood pressure, and why is it so impossible to figure this out? I still never hear the causes or the frequency distribution of the causes across people. Lots of people who eat lots of meat do not have high blood pressure, true? So, what are we really talking here?




      1
      1. Brux – I realize that I am a study of n=1, but please see my post above re: my drop in blood pressure from 120/78 to 108/65. It did not happen immediately. And my supposition is that as my veins and arteries cleared out my BP responded accordingly. It took about 6 years for these numbers to change. But given I went WFPB at 55, I had many years of sludge-building. I am not surprised it took a while to clean out my vascular system.
        I will also add that I have always eaten what I thought was a healthy diet. Lots of salads and vegetables alongside chicken and fish. Almost no junk food (only on occasion and very little even then) no pizza, no milk since my teens and quit cheese in my 30’s. Not a cookie and cake eater per se. So compared to the rest of society, a healthier diet than most.
        So yes, . .I am a study of one. But a successful outcome for sure. Not only is my BP great but so is my gout that I reversed, prediabetes, LDL and cholesterol. At 64 am on no drugs typical of the aging individual in the US.
        I am profoundly grateful for Dr. Greger, his staff and this site. To anyone wanting to make these changes for the betterment of their health, I say stay the course and keep at. Have patience with your body and keep yourself encouraged. And if you fall off the wagon, . . don’t beat yourself up. Just get back on. That’s what I did when I stumbled. Your health is worth it all.




        1
    3. Maybe she should go the extra step and give up the dairy and eggs as well as the refined and packaged foods and see if her BP doesn’t improve. Even two weeks should be enough to see a difference.




      0
      1. Where did you read that her mother ate dairy and eggs? If you are a doctor, which I think you are not, you would never ask such a pointed question. These forums are full of this kind of thing, but I never hear the real doctors here say anything about it, because unrestrained enthusiasm and even attacks in the name of WFPB are tolerated here no matter how they are expressed or whether they are supported by facts or not.




        0
        1. I asked no question, pointed or not. Liz said that her mother was a vegetarian. The most common definition of a vegetarian is somebody who doesn’t eat flesh, but still will eat dairy and eggs. I was going with that definition. A vegan diet is sometimes called a strict vegetarian, but I have always seen it so qualified.

          I suppose I should have put qualifiers on my suggestion and said that if her mother, by the most common definition of vegetarian, still ate dairy and eggs, she might consider excluding those as a trial to see if her BP improved. Also other dietary foods though technically plant based, such as refined grains, added sugar and especially added oils might have an effect on arterial endothelial cell health and so her mother might consider remove those from her diet as well. Better?




          0
    4. As we age it is still possible for one’s arteries to stiffen and calcify despite a healthy diet. Xrays of the elderly will often show the outlines of major arteries. When pipes stiffen a diuretic tends to work well by emptying the arterial tank a bit.




      0
      1. From what I read it seems that both pomegranate and pyconogenol can clean up your circulatory system and possibly reduce blood pressure. Also vit K can help remove calcium deposits and put them into the bone. Have no links…could find some but…who’s interested?

        I’m looking for a science-based forum like this that focuses on elderly life extension….seems the dummies can’t get around to taking advantage of all the old farts coming along. Of course many of the “elderly” I know are already too calcified to care. I do my own “research”.




        0
    5. Hi Liz. Sorry to hear that. Has her diet changed much over the years? I see others have commented about the situation and are trying to be helpful. I don’t have much to add, but in addition to what her doctor prescribes I suggest some of the foods Dr. Greger highlighted in the video like flax, beans, watermelon, etc.




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    6. What did she really eat? Did she eat eggs and cheese? Did she eat chocolate? “Healthy” coconut oil? “heart healthy” olive oil? None of those are considered healthy by Dr. Ornish, Dr. Esselstyn, or Dr. Colin Campbell. One can be vegitarian and still eat an unheathy diet.




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  5. So If I’m trying to keep my fat % lower, say <20% and I'm eating chia seeds, am I better off switching to ground flax for the anti hypertensive properties? Thanks




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  6. Just another question, I read somewhere that the DRI for potassium among adults is 4700 mg…if we are prone to hypertension, should that number be amped up via high potassium foods? If so, to what levels? I noticed in the video that Kiwis did little yet they are relatively high in potassium.




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    1. Flaxseeds can be baked into bread at 350f without losing their beneficial qualities. Now i never make bread without them. Tons of flaxformation here. Search “flax”.




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        1. Oh absolutely, they can pass through our system whole if not ground a little bit. But once you grind them, they should be kept refrigerated or used fairly quickly. They keep great as whole seeds (as most do).




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    1. Doing the reverse: eating lots of meat and junk food. More stress too. Just kidding :) one question is if it hypotension makes you feel unwell, because my mother is pretty hypotensive (below 100 I think) yet she’s one of the most energetic people I know (knock on the wood). Do caffeine drinks help? They can be pretty healthy too – if done right (proper amount, quality, regimen)




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    2. There can be many reasons for low blood pressure. Dehydration, thyroid or heart concerns, medications, lack of nutrients (folate and B12 ) so it’s hard to say. Check with your doctor if low blood pressure persists, but actually this a super low level and no doctor would let you leave the hospital with that kind of blood pressure! Make sure you calibrate your home bp cuff with your doctor’s office cuff since it’s possible the home cuff is just reading low.




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  7. There are also quite a few studies reporting a moderate BP lowering effect of flavanol rich cocoa powder (as well as improved endothelial function and insulin sensitivity).




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    1. To add to your good list of ways to increase insulin sensitivity: Get good quality sleep, eat just the amount of food you need–don’t overeat, maintain a healthy weight, eat low fat and avoid meat and dairy fat.




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      1. Thanks, I keep forgetting stress and sleep as essential IS factors! Animal fat and food in general I sort of mentioned implicitly, but it’s probably a good idea to list them for anyone interested..




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    2. Thank you for your list of blood pressure lowering food. Did you know that sulfur very quickly can get control of your blood pressure? http://www.sciencedaily.com/releases/2015/02/150219115736.htm

      Although Hydrogen Sulfide is not thought to be a hormone, it could be, and it certainly is a neurotransmitter. It works very quickly to widen blood vessels. MSM contains very clean sulfur and can lower blood pressure. It is in very fresh vegetables, particularly the Alliums, the onions and garlics, and the mustards, broccoli and kale. I think watermelon has a lot of sulfur and that might be why melons can also very quickly lower blood pressure.

      This site has other recommendations for high blood pressure.

      beets
      hibiscus tea
      seaweed
      grapefruit
      beans
      brazil nuts
      whole grains
      vegan diet
      flax seed meal

      watermelon

      Perhaps other melons and very fresh vegetables like onions and kale should go on the list too.




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      1. Whoa, that’s a nice list! I do know for a fact garlic dramatically improves blood flow, because I experience this almost every day after having my dinner (I could easily list a number of immediate physical effects)! It would be interesting to explore a neurotransmitter thing in relation to brain/mood because I feel so good after my garlic filled dinners :) (although there quite a few more candidates for such as a glass of Cabernet, nice little coffee and/or cocoa and, well, food..:) ) But I definitely feel better when garlic is there, this has been tested on way too many separate occasions!




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        1. This list was culled in part from videos on this site, there is no one reference. I include the food and the video here. I can’t find the one for brazil nuts.

          beets http://nutritionfacts.org/video/hearts-shouldnt-skip-a-beet/

          “So if that’s how beets work, no wonder it lowers blood pressure as well.”

          hibiscus tea http://nutritionfacts.org/video/hibiscus-tea-vs-plant-based-diets-for-hypertension/

          “High blood pressure is where hibiscus may really shine,”

          seaweed http://nutritionfacts.org/video/which-seaweed-is-most-protective-against-breast-cancer/

          “Just two teaspoons of seaweed salad a day for a month dropped their blood pressure 14 points”

          seaweed salad was the blood pressure lowering sea vegetable.

          grapefruit http://nutritionfacts.org/video/tell-your-doctor-if-you-eat-grapefruit/

          “showing grapefruit consumers had a drop in weight, significant drop in cholesterol, and significant drop in blood pressure”

          beans http://nutritionfacts.org/video/beans-beans-theyre-good-for-your-heart/

          “,,,blood pressure lowering,..”

          brazil nuts

          whole grains http://nutritionfacts.org/video/whole-grains-may-work-as-well-as-drugs/

          flax seeds

          http://nutritionfacts.org/video/flax-seeds-for-hypertension/

          and at this video.

          Very fresh vegetables and allium crops, rich in selenium and sulfur, can very quickly control blood pressure in some cases. Dr. Greger says that blood pressure is the most important factor in longevity. Did you know that the jury is out on whether blood pressure is raised by Sodium? Many people with hypertension are on low sodium diets. The lack of Iodine may be an even more important public health concern.

          I hope this list is helpful to you.




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          1. Thanks, Matthew, it certainly is. I don’t have high BP issues (mine is actually on the low side…), but I have some stubborn friends who need something more than my word to believe in simple things.




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            1. Congratulations on your low blood pressure. I am sure this means many years of health for you. Blood pressure is perhaps the most important health variable.




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          2. It certainly is, thank you, Matthew! I don’t have hypertension myself (on the contrary, my BP tends to the lower side) but I have a couple of friends who need to read this.




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    3. Sounds like good suggestions for improving insulin sensitivity. Have you seen this video on what causes insulin resistance? Diet can be a huge factor! Here are a few randomized trials that look at improving insulin sensitivity with a strict plant-based diet: A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. From Dr. Barnard’s research, study participants received either a low-fat vegan diet or a typical diet for diabetes and found significant changes in weight loss and insulin levels. Dr. Greger presents the study in this video. Here is a link to more resources on type 2 diabetes. Thanks for your questions, albert — let me know what you think of these studies?




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      1. Thank you Joseph! Yeah, I’ve seen Dr. Barnard’s study and I was definitely meaning to read his book on diabetes, although I probably know the ending :) Did you notice a Barnard study mentioned in this video? Now I’m seriously wondering if dear Dr. Barnard speaks Japanese :))
        I’ve also seen the video (“cellular fat” in my comment above was actually my lame substitution for “intramyocellular lipids”, I just couldn’t remember the word), but I do need to dedicate an evening to an extensive comment discussion below, I’m sure some gems are buried there!
        The main recurring idea I’m having is that why not go a step further and do LFPB with low GI, namely do less grains and more legumes. In a way it takes care of the criticism of high-fat diet proponents about unavoidable sugar spikes after grain heavy meals. These days I have at least two meals based on red lentils and finally I’m able to get rid of some body fat that I couldn’t quite get rid of doing WFPB but with more oats and other high glycemic grains. And so much less (almost nonexistent) inflammation. In a language of physical intuition I feel that food that steamed veggies and lentils are the “cleanest” food one can eat – oh well, leanest too, right? Always interested in your further thoughts..




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        1. >> I feel that food that steamed veggies and lentils are the “cleanest” food one can eat –

          I like lentils … but since I never had them in my life or diet pretty much my whole life, I order the when I am at an Indian (hardly ever) or Middle Eastern (fairly often) restaurant. Can you tell me how you cook or prepare lentils and what kinds you use, what is best, what is the difference? I go to Whole Foods, in fact i went there today, and they have all these different colors and sizes of lentils … it makes me even more confused.

          My favorite was lentil soup from the Mediterranean restaurants, or the lentils on rice in Indian food. I sort of like plain tasting food. My local mediterranean place has lentil rice, rice mixed with lentils that is great, and lentil soup which is great too. I want to be able to do this entirely on my own and eat as much as I want. At the restaurants this stuff is way more expensive than it should be it seems.

          Any suggestions? Thanks, I agree lentils are great!




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          1. Well, here is what I know about lentils and perhaps there are people who know much more.
            There are basically two main varieties – with outer shell intact (green) and shell removed (red). (Yet it’s absolutely the same legume). No idea about the yellow ones, because there are not widely available where I live. Even though red lentils are somewhat not as “whole” they still are unprocessed and very high in fiber, while green variety is like one third fiber in mass (I’m exaggerating very little). I prefer red lentils exactly for this reason, since it may be tough to get enough calories and protein from green ones, especially for a male, while for a lady looking to lose some weight green ones may be a Godsend, for she may eat as much as she wants (or a little more) while still consistently losing extra weight. Red lentils are also easier to digest when eaten in large quantities, again because of a bit less fiber. And by the way, quite importantly, red lentils have none of digestion problems usually associated with high beans intake (as long as you don’t eat anything sweet including fruits for a while before and after lentils). At least for me. They also have one notable advantage over beans in cooking – no need for soaking, which leads us to a cooking part.
            Just as you, I prefer plain food, so my daily recipe is not complicated by any way. Put 1 part of lentils in the pan, add plenty of water, maybe 3 to 4 parts, set lot to medium fire, cook for 20-30 minutes till needed consistency (they will be becoming gradually mushier till turning into pretty homogenous purée). I prefer to keep some of the structure (meaning more nutrients too) and turn off the fire earlier. At some point they might try to attempt to escape the pan when water starts boiling to much. Just stir them a bit and lower the fire. There might be a little foam on top, but i usually let it be and it dissipates. The cooked lentils will be like a thick soup/liquid mash and I find it much easier to eat/digest than when they are more solid. Which they may become after sitting in the fridge, then add some hot water till needed consistency – great way to get them warm too. Then I would just add some freshly chopped dill and/or parsley, garlic, tomato sauce, soy sauce, cooked mushrooms for extra fun and nutrition. That’s basically it. Sometimes a little of flax or olive oil, but oftentimes i don’t when I feel I want some really clean food, if it makes sense. So, in essence, you appear in the kitchen for one minute when you put the pan on fire, then you might want to rush to the kitchen if you hear some hissing from lentils spilling over when the fire is too high, and then you appear in the kitchen to chop some greens, pour lentils and everything in the deep dish. Ramen noodle amount of effort. Blue Zones healthfulness/plainness kind of food. Let me know ;)




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            1. Thank you for the information Albert. I want to experiment with lentils and that is enough to get me started.
              1 part lentils 3-4 parts water, simmer for 20-30 minutes.
              I wonder if my rice maker which can make white and brown rice might work to make lentils too?
              Not really sure why lentils intimidate me so much … same with beans though too … just no experience on the cooking side of either of them.




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              1. I’m sure you’ll get it figured out pretty soon Brux! All those legumes are indeed somewhat mysterious at first but it’s just that we live in age of pre-cut bread and cheese, and what have you. Now legumes is an old civilizations stuff, lots of history and culture behind. Well, if you in a mood




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              2. Yes! Adding lentils to your rice and preparing in a rice cooker is a game changer! Saves time and boost nutrition. Can even add herbs and spices to rice cooker for extra flavor.




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                1. Thanks Joseph … I have never been much of a cook, but if this is so easy there is no excuse not to, plus I know what i am getting when I eat.




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                  1. There are so many lovely kinds of beans and legumes. I have found French Lentils to be wonderful. They are little bluish speckled things. If you have a Target with a grocery you can find them there. I have been buying a new kind of bean every time I go to the local Indian Market and it has been really fun.
                    One thing not mentioned is the fact that lentils that have their outer casing (the red ones won’t work) either the large of the small ones are wonderful for sprouting. They are delicious and you can eat them raw; so they make a great snack.
                    As you start experimenting with cooking beans, you might want to invest in a pressure cooker. There are several that are made of stainless steel, and they are a real time saver. A lot of Indian recipes use the pressure cooker in their instructions.
                    Of course, you should keep cans of beans in your pantry. Smith’s is in our area and they have their own brand of organic beans. I wait until they have them on sale and then stock up.




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                    1. Can you treat all lentils and all beans pretty much the same?
                      Except I guess you have to soak beans overnight in water?
                      Then … boil or simmer for about 20 to 30 minutes?
                      Is that it?
                      Keeping with my general philosophy I want to stay away from canned stuff.
                      I would eat stuff in glass jars if I can find thing in jars.
                      I want to stay away from the cans and plastic containers.
                      I’ll think about a pressure cooker once I figure out how to cook this stuff
                      and if I like it well enough to do it a lot.
                      Thanks.




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                    2. I’m sorry I didn’t back to your question earlier Brux!

                      You don’t usually have to soak smaller beans and lentils, but soaking doesn’t hurt and it almost always shortens the cooking time.

                      Lentils without their husks removed take about thirty minutes to cook at my house. I live at about 8200 feet, so they will probably cook in a shorter time for you. When they’ve been polished red by having the husks removed they take about ten minutes less to cook.
                      One of the reasons I have a pressure cooker is the altitude I live at. It can take a very long time to cook beans without it.

                      Regular garbanzo beans cook surprisingly fast and even though soaking doesn’t hurt, it isn’t necessary. There are some little reddish garbanzos that they sell at the Indian market that must be soaked for at least 8 hours or the little stinkers remain pebble like in their texture. They’re called Kala Chana. The are really tasty if cooked right.

                      Remember, you can also soak whole beans for a few days, changing the water each day and you kind of liven up the beans by sprouting them a little bit. Unless you know that they can be eaten raw, like lentils, you should always cook your sprouted beans.

                      Hope this helps!




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          2. I agree with albert on how to cook lentils…I usually just buy the greenish brown ones…they cook up pretty quickly and don’t need soaking like dried beans (but I *always* make up a pot of either beans or lentils each Sunday for my work week ahead!)…heaping 1/2 cup of lentils into 1 cup of water…I usually chop up some onion and celery and chuck that in with a bay leaf…bring to a boil, turn down the heat and then let it simmer for about 15 minutes. Easy peasy. I adore putting them into my leafy green salad with some red or white balsamic vinegar; or else mixed with cooked brown rice and salsa, steamed spinach on the side. (Trader Joe’s sells a lovely Fire Roasted Salsa which has NO added salt…yowsa! great stuff)




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        2. Oh, question, switching from grains to lentils, is it possible to be getting too much protein and move into the problem Americans have with getting too much protein, as in osteoporosis … or is that only with meat protein?




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          1. As far as I understand the amount of protein will be still quite moderate and absolutely healthy. The general rule of thumb suggested by Nutrition Facts/Barnard/Ornish/McDougal et al is that you may have as much varied whole-food plant based food as you want without worrying much about protein at all. Also worth mentioning Jeff Novick’s article regarding incomplete proteins http://www.jeffnovick.com/RD/Articles/Entries/2013/6/13_Completing_The_Limiting_Essential_Amino_Acid_Picture.html.
            Osteoporosis issue was mainly related to animal protein, which is acidic and causes calcium to be drained from bones to maintain body’s pH balance. Not so with mostly alkaline plant foods. I’m sure there are some great videos about this on the site..




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        3. Good point! In the Barnard studies our team (I helped co-authored the GEICO Study so I am pretty familiar with the dietary protocol) did educate participants on low GI foods and encouraged their intake. Some grains are actually low GI (oats, barley, sourdough, rye and pumpernickel breads, pasta), but I agree that beans are amazing!




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          1. So I was basically wondering what if we now compare metabolic effects of say oats vs lentils with respective GI and GL of somewhere around 55/15 vs 20/5.. wouldn’t it be just another improvement to already improved diet?.. :) Is Dr. Barnard up for new research ideas? :) Although we already know Blue Zones recurring dietary pattern, which is some nice mix of whole grains and legumes.. So why I asked about improving IS in the first place is that it may seem like a good idea to first maximize IS (via say legumes, exercise and intermittent fasting among other things), get really lean (looks like I’m actually moving there with my current regimen) and “carb-efficient” and then be ok doing more grains (if needed, say, given increased physical activity) while staying maximally lean and healthy.
            Lucky you Joseph – working with both Dr. Barnard and Dr. Greger!!




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  8. I would like to tell my story. I have been eating a whole-foods plant-based diet for almost 3 decades. I eat fish once in a great while, and no other animal products. I eat no processed foods. I buy everything in bulk and cook it from scratch. No added salt. So why did I have astronomically high blood pressure?

    And where was all this fatigue and muscular pain coming from? And the high LDL?

    It took me two years and three months to figure it out.

    It was my night eating.

    I ate a generous dinner past 10:30 PM every night. That was when I was finished work. After that, I showered and went to bed.

    It was ruining my health. The best foods in the world could not compensate for my night eating.

    After I stopped eating past 6:30 PM, it took a few weeks, but my blood pressure pretty much normalized, although I do tend to spike. The muscular pains are subsiding, but the damage has been extensive, and I am still in a long recuperative phase. I exercise for several hours per day.

    It’s been four months since I stopped eating at night. I am still not healthy. I want to warn everybody that night eating is not a small thing. It can undo all of the benefits of an excellent diet, and it can take a long time to recuperate. I am very fortunate that I did not have a stroke in the interim.




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    1. How do you know your HBP is due to night eating?
      How exactly would that work? What do you suppose eating
      at night is doing to your body that causes you to have HBP?
      It seems that four months is not a very long time to determine
      that you have found the cause of your HBP.
      What have your BP measurements done, from what to what is
      what amount of of time.
      Don’t get me wrong, I often eat at night, so if it was a question
      of stopping it to decrease BP I’d certainly give it a try.
      Also, by eating at night, do you mean eating after the sun goes
      down or eating before you go to bed? I’m assuming your mean
      eating before you go to bed, is that correct?

      Also, were you eating any particular thing at night that might
      cause this, such as sweets or salty stuff, drinking coffee or
      alcohol?




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      1. I tinkered with many different dietary experiments. None of it mattered. No coffee, no alcohol, no salt, no sweets, before or after the change in timing. No real change in choice of foods at all. Just the timing.

        Yes, eating before I went to bed, shortly before midnight. My systolic pressure has dropped from the 180s to about 103. Diastolic has dropped from 110 to 69. Resting pulse has dropped from the 70s to 55. A full stomach at midnight put indescribable stress on my system.




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        1. Thank you Nina. I am on plant based diet too, and I do not eat late, if I do just a couple berries, or 1/4 apple, but my HP is still high. I could not figure it out yet why is that and I am developing kidney stones since I started this diet. I just do not know what I have to change in my diet, but I still reading and trying. Flax seeds seams not helping much too.




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    2. Because every rule has exceptions. I am confused as to your “BP normalized”, but then you “are not healthy”. This somewhat contradicts your “benefit” story. Is your B12 sufficient? Have you tried flaxseed? There yet can be lots of issues on WFPB because we are all a bit different, but at least the “normal” issues/causes are eliminated.

      I’m quite certain that timing of daily meals has nothing to do with my health, but have never had hypertension or even near it. Now that I’m done with animal products I expect it to get even healthier.




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      1. What I mean by that is that my muscles are still very sore and inflamed. I still have not regained complete range of motion. I still have a lot of back pain, and there are a lot of daily activities that I still cannot do. I cannot sit and use a keyboard. I use voice recognition software. If I skip exercise for a few days, my blood pressure goes up again.

        Not to go into details, but trust me, my night eating was the cause of my high blood pressure and high LDL. In Ayurvedic medicine, when you eat is at least as important as what you are eating. My experience has confirmed that assessment.

        As for flaxseed, my digestive system is still too fragile to tolerate nuts or seeds. As for B12, I do take these supplements.




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        1. Certainly glad you have found some improvement, and better BP’s. I’m no doctor and have no idea what level of analysis you’ve gone through. Could something be interfering with your body’s ability to utilize the B12 supplements? Still sounds seriously amiss. Do hope you find more complete recovery. Namaste




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    3. Perhaps you should consider eating some melon, fresh onions, garlic, kale, and broccoli. An MSM supplement might help if your diet is not under your control.

      beets
      hibiscus tea
      seaweed
      grapefruit
      beans
      brazil nuts
      whole grains
      vegan diet
      flax seed meal

      watermelon
      are all recommended here for high blood pressure.




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      1. Matthew, thank you for your efforts, but you do not know who you are talking to. I eat these foods every day. There is not a bit of junk in my diet. None of these perfect, magical foods made a bit of difference. I tried them all. I’d like to repeat: My blood pressure dropped by half, without any changes in food choices at all, just by not eating past 6:30 PM.

        When I stopped eating late, I was able to resume exercise. My muscular pains had been so severe that I had to cut back on an extensive exercise routine. My muscles could not tolerate the effort. I could do nothing but walking and a little bit of stretching. I could not swim or go to the gym. I had to eliminate half of my yoga poses. You are talking to a trained yoga teacher. I was very sick, people, believe me. I am very fortunate that I got through this illness without a stroke.




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        1. I am glad you already fixed your problem by eating a early dinner. Eating vegetarian frees up a lot of cooking time, I’ve found. It is very convenient. There are also lots of packaged foods readily available for vegetarians. Being a vegetarian does not involve a great sacrifice. Shopping as a vegetarian is easier and less time consuming. I’m only holding myself back by not embracing this as a way of life for me. Many people say “buy organic if you can afford it ” Buying organic could be cheaper for many families in the long run. I am not accepting that my community accepts decisions to not eat meat and is willing to serve. There are many people who are just like you, and they should stay away from eating before bed, as weight lifters know, because this is quickly turned into fat. I am glad you found your motivation. As a yoga instructor, where do you suggest we find it? The recent economy has lead many people to keep creative schedules.




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  9. Unfortunately most doctors don’t even push the DASH diet that much. There are some fast advice regarding lowering the intake of salt, weight loss and exercise and BP control one month later – surprise! Still hypertension. First line treatment are diuretics. Maybe 10% risk hyperglycemia and impaired glucose tolerance as side effect, rarely even diabetes mellitus! So first line treatment can leave you with an equal or even bigger problem – but of course Big Pharma has another pill for this new condition….




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  10. The table at 2:15 makes me wonder why in rural africa the blood pressure goes up until age 30 (appr. 126/84) and only then starts to decline. Is the target of 110/70 perhaps only valid for the elderly?




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  11. My blood pressure is 110 over 60, I am 42.
    It has always been like that no matter my eating style. In my life I have been omnivore, vegetarian (22 years) and vegan (2 years). Granted, I might be just one lucky case, but I suspect it is more due to the quality of what you eat (refined vs. intact), rather than the presence of meat in your diet.




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    1. Mine has always been “low normal” too. I’m 48. Although I haven’t checked it or been checked in some time, I do expect now that it won’t get the “popular” SAD climb with aging. How are you with blood loss? I gave blood once, passed out onto floor. Fell out in the hospital when they tried to get me to walk too soon after a vascular surgery (accident trauma 1988) . Had to have extra IV “unit” of fluid(?) (after getting 47 stitches from auto accident, 2007) in order to stand up and walk a few steps. I always figured the “low normal” BP had to do with extra-sensitivity to blood loss. You?




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  12. Great video! I’m going to have to work some of these references into my next shared medical appointment lecture on hypertension. I have to agree with Sacks that a mostly vegetarian diet gets more takers than a wholly plant-based diet will, although I encourage my patients to go all the way plant-based.




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    1. A method I think would be helpful is to have them start their menu planning with the first and largest volume item of each menu being the starchy food (rice, potatoes, pasta, beans etc.), the second being the non-starchy vegetable (kale, broccoli, red peppers, lettuce, etc.) and then as the last item what small side of meat do they want to have with it. This “inside-out” order focus most of the creative energy on the plant food items and the meat gets short shrift. In this way the plant dishes usually wind up being the “fancier” dish of the meal and so has a better chance to be the best tasting. Also since it takes up the most room on the plate it is what people will get used to filling up on rather than looking at meat as the thing they fill up on.




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  13. I like the last sentence in the Sacks and Kass paper: However, the low BPs of vegetarians are so striking
    that efforts must be expended to determine why they
    occur.




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    1. A lot of effort has been expended by previous researchers, wonder when anyone will “spill the beans” and let the general public know? Yes, it would be much easier if the “fence” of few billion-dollar industries wasn’t muddying up the water. Someday wellness has to take over, or we follow the Romans.




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  14. In my experience, blood pressure is most correlated with weight and overeating (I’ve probably averaged a lower than average sodium intake, especially after being diagnosed with hypertension). Probably vegans have less hypertension because they tend to be slimmer than omnivores or flexitarians–to which group I long belonged. Since getting really serious about my BP, I’ve cut back my animal products consumption from 15% or so of total calories to well under 5%–probably 2% or so. That worked, though it took some time. I’ve found that 2-3 tbsp.of flax seed helps, and lately a couple tsp. of cocoa also seems to make a difference. Haven’t tried hibiscus tea yet, though plan to. I’ve been able to lower my BP meds from 3 pills to 1/2 pill/day.The only thing holding me up is my overweight–which I expect to get under control eventually. For me this has been a matter of avoiding falling into pleasure traps (e.g., nuts, chocolate) and watching oil consumption (I’ve cut it in half, and plan on further reducing). From eating 4 oz. of nuts/seeds a day and having 3-4 tbsp. of cooking oil or salad oil, I’ve gone to 2 oz. of nuts/seeds and 2 tbsp. of oil. From doing 50 g. of dark chocolate a day, I’m now down to 20g. (not having it every day helps). It seems that we crave or expect “goodies” which are off the diet, and psychologically need to indulge ourselves, but I can say that my indulgences today are much more healthful than in the past. Naturally, I don’t count the flax seeds as an “indulgence”–they are a necessity.

    Things which usually raise BP, besides salt: alcohol and many other drugs, tobacco, coffee (temporarily) and probably black tea. I used to over-consume all of these, but am pretty moderate now or abstemious. Overeating and not getting enough sleep. Needing to urinate and talking while getting your BP tested (too many nurses ask the patient questions while taking a reading). White Coat Hypertension–a reality for many people–which can vary widely from readings taken at home. Aerobic exercise–which can temporarily raise BP, but usually lowers it long-term. Being stressed out. Conversely, sitting all day probably also raises BP (for sure it’s not a healthy habit). Some weight lifting and isometric exercises. I would think Yoga would be beneficial, as would meditation or breathing exercises.

    Dr. Greger says we should aim for 110/70,and I think he is right–provided we can attain this naturally, without pills. But the AHA recently relaxed its guidelines for those over 60, who used to be treated above 140/90, but now are recommended to be treated at 150/90. Perhaps the side effects of HT medication are worse than we’ve been told? I’m now 120-130/70 or so, and so I’m inclined to wean myself totally off the medication so long as I stay below 140 systolic (diastolic has never been much of a problem). An honest 140/75 without pills is probably more healthful than 125/70 with pills, though that’s just my hunch. The main thing to realize is what Dr. Greger says, that the meds just cover up the problem and don’t address the underlying causes.




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    1. New here huh? You don’t need oil or any sugar-at all. Nuts are brilliantly good for almost everything. Any food that is not whole (white flour, sugar, oil the main offenders and compose bulk of all processed foods) is suspect and likely to be linked to poor health and longevity outcomes. Also generally speaking, but the main thrust of the research discussed here; almost every whole plant food exhibits health promoting properties, whereas practically every single product of animal origin carries with it higher rates of sickness, disease, toxicity, dementia, and mortality.

      Stick around watch another 50 or 60 videos, read the articles. Several years of reports right here-pushing 1,500+ indexed topics. Check out the local search and topic list. Best.




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      1. For some reason, my posting above led both you and Brux to think I am either naively unscientific or inexperienced with veganism or whole plant foods. I was macrobiotic in the 70’s. True, I later departed from this diet, partly due to social pressure, but have leaned towards vegetarianism–or at least pesco-vegetarianism for more than 40 years. I left the SAD around 1970. I’m hardly a newbie, and have watched probably a hundred videos here and also have waded through all of Plant Positives videos on YT. I am familiar with most of the arguments, and generally agree with the whole plant people.

        Addressing your particular comments. Yes, we don’t “need” either oil or sugar…though many healthy people without hypertension do consume some. A good example would be the Sardinians and some Greeks–both of whom live in Blue Zones. I believe they eat some olive oil. I’ve gone sugarless for many years (sugar is the bete-noire of the Macrobiotic diet), and virtually the only sugar I ever eat is contained in 80%+ cacao dark chocolate (it is difficult to eat pure chocolate). In any event, I don’t believe in absolutes. I can assure you that sugar is neither the cause of my overweight, nor my hypertension. Oil may be somewhat of a factor, and again, I don’t use it gratuitously but in small amts. for sauteeing vegetables. But oil does make the food tastier, which is not exactly what I need–so I’m cognizant of oil’s danger. Still, when the Mediterranean diet often uses four tbsp. of olive oil per day, I think I should be able to get by with two. That would still be less than what most people get. Nuts are brilliant, but in my case probably a bigger temptation, and hence a danger. I’ve been known to gobble more than a cup of walnuts or almonds. That’s 800 calories or more. We see that everybody is different; some would never eat this many nuts! White flour I never use, and in fact eat almost all grains in whole form–I rarely even have a pumpernickel bread.




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        1. Fair enough, sorry for the mis-read. I eat a lot of nuts. But I don’t count. WFPB is a bit new to me although I did go semi-fruitarian with 80/10/10 a few years back. Been studying nutrition and integrative medicine and natural healing off and on for a dozen years or more. WFPB has had the biggest impact on me and I don’t see ever straying. As a “new convert” can be a bit zealous. Cheers.




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          1. I understand the zeal and approve it. I also appreciate your fervor.

            You probably don’t count calories because you’re not overweight–I’m guessing. My problem is that I eat constantly, albeit mostly calorie-sparse foods. In other words, I don’t restrict myself to three meals, or even three with two snacks…the ‘snacks’ have sort of taken over, as sprawling suburbs can take over all space between two cities. Part of the problem is that I’m quite sedentary when not exercising. I think overeating is often tied in with being sedentary (in my case usually at the computer). We must remember to get up and do things. At least I have worked myself up to ten hours/week of moderate aerobic exercise and if I’m lucky, an hour of resistance training. That has helped a lot to keep my weight from being in the obese range (though I’m close),and has kept my BP somewhat well behaved.

            Despite the exhortations to eat more protein as we age, I seem to be tending in the opposite direction, moving from a macronutrient ratio of about 50-15-35 (carb-protein-fat) to something like 60-10-30 (it is easy to get 30% of calories from fat with the amt. of nuts/seeds and chocolate I eat). Going to 80-10-10 would be a bit of a challenge, but I’m already there as regards protein. I’d just have to cut down nuts, etc. drastically. I already eat gobs of fruit, and it contributes the largest caloric share of any food group–by far. It was comforting to see that fruits got a clean bill of health in one of Dr. Greger’s recent videos.




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            1. I was just under the BMI threshold for “overweight”, started WFPB and dropped 20# in a few months without counting. I do measure my weight almost every day and keep a chart (great little program does the work), but I don’t count any calories or grams or ratios because I haven’t found it necessary. I look at lables when eating something that comes with one, just to see that there are no surprises or hidden ingredients. Was eating four or five times daily, job change has me down to three plus snacks. Am active, but not aerobically working out yet. Get a mile or two of walking accumulation throughout the day. Cheers!




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    2. >> In my experience, blood pressure is most correlated with weight and overeating

      Sure, blame the victim There are many many people who have high BP that are skinny as a rail, my dad is one of them.
      This kind of post is a big problem with this website, and it kind of undermines all the scientific
      work and tone Dr Gregor and others work towards when someone comes in and makes statements
      like this that are unqualified, from their experience. We have science because “from someone’s
      experience” has been found not to work. From my experience I feel lucky when I wear my
      favorite underwear with the holes in it! ;-)

      >> Probably vegans have less hypertension because they tend to be slimmer than omnivores or flexitarians

      Probably? There are overweight vegans too, and there are vegans with high blood pressure.
      When are people going to really read and listen to the comments, remarks and articles here instead
      of reading into them what they want to hear or believe? Even the strict diet of rice, fruit and veggies
      that was talked about in some of these videos only helped about 60% of people.

      You wonder why people don’t switch to veganism, because they cannot. You have to give up eating
      as you know it, which everything in one’s life is habituated against, plus when you are addicted to bad
      American/processed foods it is like kicking heroin.

      I guess it is my problem and I should just ignore posts that are unscientific or even wrong, but I
      sure with the owners and moderators of this sight would be quicker to comment on certain things
      that are said here instead of tacitly approving it by saying nothing.

      Just a comment tag that something has or has not been determined yet, and I don’t think
      overeating is the cause of high BP, or else it would not be the difficult thing to deal with that
      it in fact is.




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      1. I don’t understand your vitriolic response, Brux. By naming overweight as one of the chief contributors to hypertension I am only repeating the conventional (scientific) wisdom. Many authorities state that simply reducing one’s weight by 10% can have profound effects on blood pressure. Sure, there are “many people” skinny as a rail with hypertension, but this is not the most common pattern. In my case I have taken daily readings at home for three years and my BP is strongly correlated with my weight. I am not saying that weight is the sole determiner, and in fact listed many other factors. I don’t think even a vegan diet–even a whole plant foods diet–eaten to excess would be healthful. Still, I think it would be better than other diets eaten to excess, and would have beneficial effect on BP. I also think that a vegan whole foods diet leads to weight loss compared with other diets. I do accept the findings shared at this site and am not pushing any “agenda” counter to this site, which I consider most helpful. But I do take issue with two things you said: that calling out overeating as a problem is “blaming the victim” and that people cannot switch to veganism because they are addicted to the SAD, which is addictive like heroin. In both cases this is a choice (I do believe we have free will, else why bother with sites like this?). I doubt the SAD is so addictive, as there are many millions of people who choose alternatively. Certainly many people realize its harms.




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          1. some people don’t like facts, it gets in the way of political correctness, if obesity is a risk factor so be it.




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  15. My partner and I have been vegan for over 5 years now, and lately have been gravitating towards a higher carb, whole foods diet (still vegan). My blood pressure has been consistently perfect over the years (105-110/65-70ish), but my partner’s systolic pressure is consistently in the low 130s now (down from the high 140s when we were eating more fat and junk food). His diastolic is in the low 70s, so the gap between the two is quite large! I know isolated systolic hypertension is of concern in meat-eaters, but what to make of this when one has been plant-based for 5 years? We’ve only gravitated towards a healthier plant-based diet recently, mind you, so perhaps his number will keep decreasing, but if it doesn’t, should we be concerned? Perhaps I’ll discuss adding ground flaxseed to his diet with him.




    0
    1. I suggest trying flax and incorporating more of the other foods Dr. Greger mentioned at the end of the video, as they have been found to help reduce blood pressure. Watch out for high salt intake and make sure to incorporate other lifestyle factors such as physical activity. If you’ve only gravitated toward a healthful diet of late I’d give it some time. Interesting how once the “junk” was avoided blood pressure came down. Keep up with that! Let us know if anything worked and of course it’s always a good idea to check in with his doctor.




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  16. Thanks so much for this video! I took my mother to the hospital last night for high blood pressure. She decided at the hospital that she would rather go vegan than add another medication (her doctor’s plan). I can’t wait to show this to her. The video on amla powder helped her avoid metformin (it works wonderfully), so she trusts the information here.

    I started getting a migraine at the hospital last night, but fortunately I carry some ginger powder with me now (instead of Imitrex). I learned about it here. These videos make a real difference in people’s lives.




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    1. Great result. I’m quite hoping to get my mom to adjust her ways such _before_ an emergency trip. I did get her to make a vegan spaghetti sauce and whole wheat pasta one night. But she had a pork roast the next weekend (i visit most weekends). Every little bit helps I suppose. Glad you had a good result, hope she gets results quickly to reinforce the ideas and changes.




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    2. Change takes baby steps. Be careful with dropping the diabetes meds all of a sudden.

      It’s probably a good idea to encourage your mother to watch blood pressure and blood sugar at home. Lots of people keep a diary.

      Lots of people don’t like metformin because it makes their tummy upset. I have heart that this side effect usually subsides in a few weeks.

      What she is going through must be scary… she isn’t alone.

      Support and love and compassion and what not.




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      1. Thanks. She actually started the amla instead of even starting the metformin, and it’s working great.

        She is keeping track of her BP. I’m afraid that with an improved diet that her medication might push it too low, so she is watching it closely.




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  17. Acknowledgments
    OK- I like the texture of ground flax and do add it to frozen banana/fruit smoothies, whole grain pancakes.
    Read the publication (appears well done).
    Do need to temper with the following Acknowledgments from publication:

    We gratefully acknowledge the continued encouragement of Kelley
    Fitzpatrick and the Flax Council of Canada. We thank Canada Bread,
    the Canadian International Grain Institute (Winnipeg, Canada), and the
    Food Development Centre (Portage La Prairie, Canada) in preparing
    the foods for this trial. The flaxseed or wheat was provided by Glanbia
    Nutritionals Inc. We also thank J. Alejandro Austria for distributing
    food to patients during this trial, and the Office for Clinical Research at
    St Boniface Hospital for their help in the conduct of this trial.

    Sources of Funding

    The work was supported through grants from Flax2015, the Canola
    Council of Canada, the Agri-food Research and Development
    Initiative, and the Canadian Institutes for Health Research. Indirect
    research support was obtained from St Boniface Hospital Foundation.




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  18. My son is 24 and has hypertension, partially hereditary and partially lifestyle. I have forwarded many of your videos to him in an effort to help him change the bad habits he picked up in college. Thanks for all you do to improve our health!




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  19. I checked my BP today. It was 109/71. I’m so excited coz that’s the lowest it’s been in years. For years on the paleo diet, my systolic bp was constantly in the 130’s. I’m sure the 20 lbs I’ve lost this year due to increased exercise has helped though. I wish I’d checked it 2-3 mths ago when I was still eating meat to see the impact independent of the weight loss. A month ago it was ~118/78 (after cutting meat but before cutting eggs & dairy). I cut back on eggs and dairy about 2 weeks ago. I can’t wait to check changes in my lipid panel in 2-3 mths, now that I’m at 100% plant-based.




    0
    1. Depends how high your BP is whether you need to buy coffin just yet. Several things could cause elevated BP even on a WFV diet.

      Sodium (salt)
      lack of exercise
      overweight/overeating (try to get your BMI down below 28 if you are overweight/obese)
      Coffee/alcohol/tobacco/other drugs
      Chronic kidney disease

      My own BP dropped sufficiently so that I was able to cut down on meds after going vegan–this happened in a few months, but prior to that I was 90-95% vegan. It can take a lot of time. How long have you been WFV?




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    2. A lot of people have that problem, and the promises of the WFPB people really ring hollow when you see both the people it does not help or the people who are not WFPB and live a long time. Things are not so simple as people are desperate for them to be.




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  20. I solved my blood pressure problems by getting the right information about EXACTLY what hbp is……..what causes it?…….had hbp for 10 years and used drugs to control it…..until …..i read an article on minerals and the effects on the body if you dont get them……………CALCIUM was ths answer to my hbp problems……..i was told by alternatve medicine doctors that i either had a) the beginings of kidney failure…..no…had them checked and they were ok….or B) a major calcium deficiecy in my body……..i took the supplements for 3 months and i dont have hbp anymore………its under control……which is much better than artificially controlling the problem with drugs…..




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  21. WHAT IF NOTHING WORKS?
    I’ve been WFPB for about 7 years. Breakfast is often fruit, unsweetened almond milk, raw regular rolled oats, with some powdered ginger or cinnamon. Lunch is veggies and beans or veg soup and salad. Dinner is the same. Eat lots of kale, little oil, little salt, little sugar. If I snack, it’s European rye with home made blackberry jam, or Mary’s gone crackers with hummus, or … sometimes biscotti with a bit of chocolate on the bottom. I’m 5’1″. I used to weigh over 180, but lost 40 lbs when I changed to low SOS plant based – but have trouble losing the next 20 lbs or so. Here’s my question: I STILL have high blood pressure. I stopped taking the meds when, after a long fast (25 days), I got the BP down to 120s – 130s, but it’s up again – often 150s – 160s (diastolic is 60s-80s). I just started using a CPAP machine a couple of weeks ago and hoping that helps, but I’m really puzzled that my high bp has been so resistant. Kidneys test okay; I do an hour of Pilates 3X week, meditate… Any ideas?




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  22. High blood pressure pills almost killed my father. They got it too low apparently. Its a scary thing to watch a family member go through.




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  23. I am new to the WFPBD. My mother struggles with hypertension and I just found out I have prehypertension. I decided to adopt this lifestyle firstly to encourage her to make changes but I soon realised, after taking my blood pressure, that I may need as much help as she does.
    Thank you so much Dr. Greger (and your team), for making all of this research available. I am looking forward for better health for hopefully both my mother and I.




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  24. Shalom! I have been diagnosed with Hypertension I used to be vegan three years ago, I am taking Norvasc 5 mg. I am trying to go back vegan, I have cut out ALL Starch and Meat and Pork. I been watching your videos on YouTube. Can Plant Based Vegan reverse Hypertension and High Blood Pressure and Heart Disease. I am taking a Vitamin C Herbal Powder by Markus Rothkranz I am walking and doing exercise and drinking lots of water.




    0
    1. >> Markus Rothkranz

      Why do people fall for this scams on the Internet. So you are thinking that you were fine 3 years ago, and in eating something in your last 3 years worth of diet it made you develop hypertension? What do you suppose that would be? Did you have some kind of particularly unhealthy diet. If you have this hypothesis that would be what to look at an analyze. Is it possible to get high blood pressure in 3 years because of diet? Maybe? Do you have genetic predisposition? Did you have a lot of stress or some health problems? Did you activity level change? I troubleshoot systems for a living and we always ask … what changed? I think going around looking for magic cures from unqualified people is not optimal. What does your doctor say? When you read about hypertension they do not even know what causes it, and the authorities argue about everything. It is the perfect health space for scammers to suck people in with a semi-logical story and get them to try things that may not really help, or be indicated, or may even keep you from trying something that might work? Not a good answer I know, but even the rice doctor Kempner’s routine did not work for 30% of patients. So many things in life are not just about diet.




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      1. I began to be stress and not exercising, my doctor said I have hypertension I think also I started back eating processed acid based foods, I used to use Dr. Sebi’s Products that really helped with weight loss, when I was juicing and making smoothies and eating plant based only I was much healthier. I don’t want to be on medicine what so ever so today I made wild rice with homemade gravy using Teff Flour. And I did not get any ingestion perfect digestive feeling.




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    2. Daveeda: I’m sorry to hear you are having trouble with hypertension, high blood pressure and heart disease. As you saw in this video and other videos on this site, you have a good chance of fixing your problems on a whole plant food diet. So, this means no meat, dairy and eggs. Also, leaving out the highly processed plant foods like oils. Also, you may consider leaving out salt or cutting way back. On the happy side, you get to include LOTS of food from beans, grains, vegetables, fruit and fungus/mushrooms.
      .
      I don’t think you want to cut out starch. Starch may be your best friend! You could check out the book The Starch Solution, which is consistent with the information here on NutritionFacts and includes recipes in the back of the book. Another great option for you would be the book “Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure” by Esselstyn. It also has recipes at the back of the book. Or if you would like some free guidance on-line, I can point you to a program that will give you 21 days of meal plans and extra help on implementing it all.
      .
      The thing to remember is that diet can do wonders for many people, but it is not a magic pill. It is easier to prevent a health problem in the first place than to try to reverse the problem after you have it. So, while it is very worth giving a healthy diet a try, no one can promise results. But I can’t think of a downside to trying. In general, the worst that would happen is that you prevent other diseases from complicating your life even further. With your exercise also happening, I think you are heading in the right direction!
      .
      One important point to make for someone in your situation is that if you are on certain types of medications for the high blood pressure, you will need to work closely with your doctor because sometime diet works very well, very fast. To be safe, you would have to know when to get off your medications right away.
      .
      Hope that helps.




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  25. I used to have HBP. When I went vegetarian, it went into prehypertensive. Now that I’ve been on a plant-based diet for about 6 months, my latest result was 117/80!




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  26. i think a good blood pressure monitor can helps a lot,im 41 ,i still it every day. Echo80 :Echo Blood Pressure(BP) measure and monitor for adult,pediatric, and neonatal. It most stores 300 records of common user and 358 of ambulatory Blood Pressure data. Every record includes the detailed measure time, systolic blood pressure,diastolic blood pressure, mean blood pressure, pulse rate, error message and record number..

    here is their email just in case:sales@meditech.cn




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  27. Please advise if it is good to take a baby aspirin daily. I hear this repeatedly. And if we should be taking it, who should take it and at what age? Thanks!




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  28. Dear Dr. Gregor, I’m a vegan for the past 9 month and was a vegetarian for 20 years. I’m on blood pressure meds. I would like to get off these medication. I eat a good diet and add a Tablespoon of flax seeds in my smoothie every day. What eles can I do? Thank you. Kayli




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  29. I was wondering what role heredity plays in high blood pressure. I have been on a plant based diet for 4 years and live a very active lifestyle (lots of cardio and yoga 2x a week). Over the past five months I have significantly cut out processed foods and try to stick with a whole foods plant based diet. I have also recently (4 weeks ago) cut out alcohol.
    Still on my BP meds (5mg of lisinopril and still 125/82), what else can I do?
    Does heredity play that big of a role as well?




    0
      1. I don’t add salt too often, but I’m sure it could be better. That’s one place I could start. I’ve thought about keeping a diet journal. Maybe that would help me keep track of my salt intake.




        0
        1. Jeffrey D: I think a diary is an excellent idea! Some other ideas:
          .
          Dr. Greger’s book, How Not To Die, has an entire chapter specifically on high blood pressure. Seeing all that information in one place may give you a list of tweaks you could do to what sounds like a pretty healthy diet.
          .
          If you give a no-added-salt, whole plant food diet a real try and you still don’t get results, you might consider doing a phone consultation with Dr. Michael Klaper, a well respected WFPB doctor who I think has been successful helping people with problems like this.
          .
          If you start to tweak your diet in ways that you expect to affect your blood pressure, I’ve seen experts recommend that you work closely with a doctor because sometimes the diet changes are so effective, blood pressure can drop very quickly and medications have to be adjusted just as quickly.
          .
          I’m not as familiar with high blood pressure as other issues, but if high blood pressure is at related in some people with obesity, and if you have a weight problem, I have some really great weight loss suggestions. Just let me know if you want my grand list of weight loss resources and ideas.
          .
          I’m not an expert, so you can take all this for what it’s worth. I hope I gave some ideas to help.




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  30. As
    a pescavegan who likes a little fish (no more than twice a week) I read
    this carefully. Would it not be fair to emphasize the risk from seafood
    alone was (only) a 5% increase (HR = 1.05) compared to a (large) 30%
    increase (HR = 1.3) for the meat eating group and “Seafood was
    associated with an increased risk of hypertension in HPFS and NHS II,
    but not NHS.” – so in two groups but NOT at all in the latter group NHS =
    “Nurses’ Health Study of n = 62 273 women. Thus it is somewhat
    contentious as there are contradictory results across three cohorts.
    Your quote of the pooled food type result (HR = 1.3 = 30% increased
    risk) is strongly biased by the meat (non-fish) eating groups. But
    still, “In contrast to our hypothesis, we found a weak but significant
    trend toward an increased risk of hypertension with increasing seafood
    consumption.” – Yeah, a 5% increased risk. But come on, this is a very
    small increase, and again, it was NOT found in one group of 62,000 (!!)
    nurses…but was in another group of 89,000 nurses (not surprisingly as
    greater N means more stat “power” – more chance of getting a
    statistically significant result). Quibbles aside…what of the
    advantages of eating some fish?? Can you say what they are? As you might
    say…”I MEAN HEY! LET’S GET SOME PERSPECTIVE HERE!!!”. :v!




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  31. In your recent facebook post on this you wrote:
    “Consumption of any
    animal flesh [red meat, poultry or seafood] at least 1 serving/day was
    associated with an increased hypertension risk” in three large Harvard
    studies (Pubmed link). How might a plant-based diet benefit for blood pressure? Click below to find out:”

    As a pescavegan who likes a little fish (no more than twice a week) I read
    this carefully. Would it not be fair to emphasize the risk from seafood
    alone was (only) a 5% increase (HR = 1.05) compared to a (large) 30%
    increase (HR = 1.3) for the meat eating group and “Seafood was
    associated with an increased risk of hypertension in HPFS and NHS II,
    but not NHS.” – so in two groups but NOT at all in the latter group NHS =
    “Nurses’ Health Study of n = 62 273 women. Thus it is somewhat
    contentious as there are contradictory results across three cohorts.
    Your quote of the pooled food type result (HR = 1.3 = 30% increased
    risk) is strongly biased by the meat (non-fish) eating groups. But
    still, “In contrast to our hypothesis, we found a weak but significant
    trend toward an increased risk of hypertension with increasing seafood
    consumption.” – Yeah, a 5% increased risk. But come on, this is a very
    small increase, and again, it was NOT found in one group of 62,000 (!!)
    nurses…but was in another group of 89,000 nurses (not surprisingly as
    greater N means more stat “power” – more chance of getting a
    statistically significant result). Quibbles aside…what of the
    advantages of eating some fish?? Can you say what they are? As you might
    say…”I MEAN HEY! LET’S GET SOME PERSPECTIVE HERE!!!”. :) Any comment please?




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  32. After a lifetime of being overweight I watched the Forks over Knives video & decided to go for it. So for 4+ years I’ve been WFPB (no oil). Basically off of 5 (all) prescriptions in 3 weeks, 3 just for blood pressure, but I had lost only about 12-15 pounds! After 4 years BMI went from 44 to 25. Blood work greatly improved in 1st 3 months: Total Cholesterol 220-> 150 (now 115), Triglycerides 172 -> 114 (now 81), Glucose 106 -> 88 (now 79) , without prescriptions.

    What I need is a search engine that already assumes I’ve been WFPB for 4+ years. When I search on current websites and search for my energy, sleeping, breathing & thinking problems, I’m in an endless loop of how WFPB (no oil) diets would help. Thanks!




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    1. Newme: Congratulations on how much progress you have made so far! You are indeed a new you. :-) I have some information about healthy weight loss on a whole plant food based diet. I hope this helps.

      The nice thing about your situation is that you already understand half the battle. I’m guessing from your post that you already understand about the importance of a whole plant food diet and have at least a sense of how to implement it. That’s half the learning curve. The other half is understanding the concept of calorie density and how to apply it to weight loss so that you don’t get hungry and you still get all the nutrients you need.
      .
      Dr. Greger covers calorie density (http://nutritionfacts.org/video/eating-more-to-weigh-less/ ), but not in enough detail in my opinion for someone who wants to apply it for the first time. Doug Lisle, one of the experts in the Forks Over Knives documentary, gives a great ‘calorie density 101’ talk officially called: How To Lose Weight Without Losing Your Mind. I have watched the following talk from Doug Lisle several times and think very highly of it. And it’s free!!! And it’s entertaining! https://www.youtube.com/watch?v=xAdqLB6bTuQ
      .
      As good as Doug Lisle’s talk is, it pretty much just gives you a solid understanding of the concept, but not enough practical information in my opinion. For starting to get the practical information, I recommend a talk from Jeff Novick,Calorie Density: “How to Eat More, Weigh Less, and Live Longer,” http://www.jeffnovick.com/RD/Calorie_Density.html If talks aren’t your thing, the following article from Jeff covers a lot of the same information: http://www.jeffnovick.com/RD/Articles/Entries/2012/5/20_A_Common_Sense_Approach_To_Sound_Nutrition.html
      Be sure to pay attention to the charts.
      .
      Chef AJ tells people who want to lose weight to eat “left of the red line”, where I believe the red line is on a diagram of hers representing is about 650 (or so) calories per pound. And “left of the red line” is all the whole plant foods which are below 650 calories per pound. The above article from Jeff Novick gives you a good sense of which foods are “left of the red line” by food category. But if you want to look up the calorie density of specific foods, you can find many foods on the following site: http://nutritiondata.self.com/ Most foods on that site have the option of choose an ‘ounce’ as a size. Then you can multiply by 16 to get the calories per pound.
      .
      It would be perfectly respectable if you are one of those people who are just not interested in the theory. You just want to dive right in and want straight how-to information. If you would rather not think about any of that (or start with the theory and then move onto this step), I have one more suggestion that Dr. Greger also recommends in his book, How Not To Die. Consider going through the free program from PCRM (Physician’s Committee For Responsible Medicine) called 21 Day Kickstart. The program will “hold your hand” for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions.
      http://www.pcrm.org/kickstartHome/
      (Click the green “Register Now” button.)
      At the end of the program, you will have a very good practical knowledge about how to eat with healthy and “low” (normal for most people) calorie density.
      .
      Another recommendation that Dr. Greger and I share is to get Jeff Novick’s Fast Food videos for tasty, affordable, fast and healthy calorie density recipes. Also, on-line and free is a YouTube series of recipes/cooking shows called something like Chef AJ and The Dietician. I know that Chef AJ will not steer you wrong in terms of weight loss and providing accurate nutrition information.
      .
      How’s that for some tips? If you give these ideas a try, please report back and let us know how it went.




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  33. I already posted this but I think I put it in the wrong place..anyway I have been on a plant based diet for 4 years and although I have lost weight and my Type 2 diabetes has gone I cannot get far with my Blood Pressure . It stubbornly stays high (ranges between 139 – 160 and 80 – 92.) I am on Ramapril; Diltiazem; Metropolol-l and Warfarin. I was diagnosed with Afib 4 years ago but have had no recurrences of thwe symptoms since. I have tried all the suggestions Dr Greger advises in his amazing book “How not to die” but I cannot seem to get any good results. Maybe I’m one of the few who gets no success from a plant based diet – where hypertension is involved?




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    1. First of all, congratulations on your successes!! Weight loss and control of the Diabetes!! I am sorry you haven’t been able to get your blood pressure in target range. I don’t know if I would say that you might be one of those people who do not see success where HTN is involved, because your blood pressure may be much worse if you weren’t following a plant based diet. There are some conditions that require medicinal support inspire of a plant based diet. I would be persistent in asking your medical provider to get your pressure in target and investigate the underlying cause. Don’t give up!!




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      1. Oh I won’t give up on the plant based lifestyle…I’m just looking for perhaps tweaks to the diet which might help to lower the HBP. My blood pressure hasn’t really changed in the 4 years since I’ve been on the PBD despite the fact that my doctor has commented on the improvement I’ve experienced in the condition of my heart and arteries.
        Anyway thanks for your comments.
        Mac




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        1. Mac: I’m sure you already tried this, since you have read Dr. Greger’s book. But I just have to ask, have you looked at your sodium intake???




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          1. Thea: One of the first things I concentrated on. Cut out salt for cooking and substituted spices and herbs. Been doing that for about 6 months. If it made any changes they weren’t statistically obvious. I’m kind of beat.
            Mac




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            1. Well dang. I’m sorry you aren’t getting any luck in that area. It sure does sound like you’ve tried everything.
              .
              Wait, one more question: Could you have “white coat syndrome?” Could your pressure go up just because you are in the doctor’s office? If you are measuring it yourself, could the pressure be going up just because you are worried about the pressure??? Just an idea.

              .
              It sounds like you are eating so healthy and doing so well, I wonder if this is really a problem for you? I’m not an expert and don’t know. I’m just wondering if this is something you need to worry about. Best of luck to you.




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    2. High blood pressure, like most things in life is multifactorial. Typically we see people’s blood pressure go down with a few pounds lost but this is not universal. Anything that causes the blood vessels to constrict will increase blood pressure like smoking and caffeine. Sometimes long standing problems will cause structural damage that may require the heart to beat harder to perfuse the end organs of the body. Vascular lesions leading to the kidneys can restrict blood flow causing the kidneys to release hormones that tell the heart to pump harder to maintain perfusion. Very often if a patient continues to have hypertension that doesn’t respond to diet, weight loss, etc.. a more intense work up is sometime warranted to make sure no other structural reason is causing the increased blood pressure. These are things to discuss with your personal physician.




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  34. I have been on strict plant based diet for ~ 4 years. (I will be 82 soon). Blood work showed very great improvement (like HDL of 130 and LDL. of 72, e.t.c. BUT absolutely no reduction in severe hypertension- which requires at least 3 BP meds. Using everything you and others have recommended for reducing BP naturally. No reduction at all (and I measure my BP at least 4x/day. Did I start PB diet too late? I’m totally puzzled!




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    1. Hello Peter,
      Thank you for your question, and I’m sorry it seems to have taken a long time for us to reply. I am a family doctor with a private practice in lifestyle medicine and also a volunteer moderator for this website. First, congratulations on eating a healthy diet, which has lowered your cholesterol, and your risk of death and disability from various causes. (See this video: https://www.youtube.com/watch?feature=player_embedded&v=30gEiweaAVQ#at=1345).

      Regarding your hypertension, and your need for 3 blood pressure medications: You need to be on a very low salt diet — preferably under 500 mg of sodium per day. This is not at all easy to do.

      You need to make sure you don’t have “secondary hypertension” — i.e. hypertension due to another known cause. The most common of these are: obstructive sleep apnea, diabetes, thyroid imbalance, kidney disease, hyperparathyroidism. So, I recommend that you see your primary doctor, or an internist. With a few simple lab tests, and an overnight sleep study, they can check for these conditions.

      I hope this helps.
      Dr. Jon
      PhysicianAssistedWellness.com




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      1. I am doing everything suggested by Michael Gregor and many other sites. My salt intake is absolute minimum since I normally use KCl as salt substitute. For last 40 years (I will be 82 in September) secondary causes have been eliminated. Sleep study showed no sleep apnea, A1C test normal, HDL as high as 130, chlolesterol particle size large (type A). One thing I may have not mentioned is that I have extreme bradycardia for at least 50 years without any symptoms even at the lowest ever reading of 32 bpm (normally in low 40’s and 50’s) which causes other physicians to great concern, but I feel totally normal. From daily measurements of BP (at least 4 times a day) the BP and PR do not seem to be correlated. I am totally puzzled why switching to strict plant based diet had absolutely NO impact on my BP. Currently taking large doses of vitamin K2 with D3 and will do complete blood work and a calcium scan. You don’t need to answer this e- mail unless you have additional suggestions on how to lower my BP.

        Respectfully, Peter Sivgals @ sivi.socal.rr.com




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  35. Hi this is Daniela, a moderator on Nutritionfacts. I am a Naturopathic PhD and as I saw your exchange with Dr. Jon, I endeavored a few more thoughts:
    1. Environmental factors such as heavy metal toxicity with Lead and/or Cadmium may be a factor in chronic hypertension and this should be ruled out.
    2. We ruled out obesity and sodium chloride intake due to your lifestyle. Sucrose and other processed sugars were also found to be a factor and hopefully your consumption here is also low.
    3. Next are caffeine and alcohol that were found to play a role and maybe again that is not the case.
    4. Food allergies should also be considered, as studies show good response in hypertensive individuals with atopic allergies, when the allergen was removed via an elimination diet followed by an individual food challenge
    As for diet, in addition to a plant based diet, it was shown the specific consumption of onions, garlic, whole oats, flax seed, with its high content of EPA/DHA and pomegranate juice (unsweetened, fresh or from concentrate) were beneficial.
    As far as supplementation, you may want to consider first plant based sources rich in the following nutrients: calcium, magnesium and vitamin C; also bioflavonoids such as rutin found in citrus, buckwheat and asparagus, quercetin (https://nutritionfacts.org/topics/quercetin/) and hesperidin (https://nutritionfacts.org/topics/hesperidin/) all known not only for cancer protection but also to lower high blood pressure. Tomato juice, rich in lycopene was also found to lower blood pressure, go for low salt versions though. One other beneficial nutrient is L-Arginine, with blood pressure regulation properties, as it may be converted to nitric oxide, a potent vasodilator (https://nutritionfacts.org/topics/arginine/) and finally folic acid, B6 and thiamine (B1), which usually come in rich supply from beans, avocado, pistachios, broccoli, spinach and dark leafy greens.
    I hope this helps, have a great day, Daniela




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    1. To Daniela Sozanski

      I have bee doing everything you have suggested except for heavy metal test. In graduate school and post graduate, I did research in properties of multitude of Rare Earth metals. Will request a heavy metal scan. As I recall, my blood pressure problems started soon thereafter when I was re-called to Active Duty with USAF. Thank you for your response.




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  36. I am 76 years old have hypertension BP was very high 210/110 at one point my Dr put me on 20mg Auro Olmesartan. My farther and sister both had Hypertension. I’m vegan diet for 10 years eat mostly plant based diet. I have ordered Dr Gergers book to read I do follow on Nutrition Facts and I am doing two tablespoons of ground flax seeds also drinking Hibiscus Tea today my BP was good at 122/63 but the problem I’m having is with diarrhea. Is their anything else I can take to solve my problem.




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  37. Dear Dr. Greger,
    I have valued and continue to value your contribution to the diet and health literature and the education process. I often refer people to NFO and I love the fact you provide references.

    As I’m exploring the role of diet on blood pressure, I have been going back to some of the original sources you have cited. In the one by Donaldson (1926) you quote: “In College students in California on a lacto-ovo vegetarian diet, increases in systolic and diastolic BP were recorded 11 days after meat was added to the usual diet”

    Can you help me find this quote? In the article, it speaks of FIVE subjects studied for SIXTEEN days. I suspect you are citing a different article than the one shown. Kindly help me see what I’m missing. Thanks.




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  38. In addition, in Sacks 1995 article quoted from I am having difficulty finding the quote:

    “The diet design goals were to create patters that would (a) have the blood pressure lowering-benefits of a vegetarian diet, yet contain enough animal products to make them palatable to nonvegetarians”

    in the article. Can you please assist me. I think this is a powerful quote, but I’m just missing it. Thank you for your assistance — please share with the page, column, and paragraph so I can find this quote.

    With much appreciation,




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  39. Dr. Michael Greger

    So, I’ve been on a plant based diet for a year and 5 months, definitely the best decision I’ve made in 29 years of living. The only issue is genetically having high blood pressure. I can’t tell you how many hypertension pills I was taking, from Lisinopril, Almodipine, and Clonidine. Now, don’t get me wrong it has lower my blood pressure significantly, I went from 170/112 to 115/87. But I feel like it’s draining all my energy, and I feel very light headed after 2-3 hrs of taking them. I want my blood pressure to decrease naturally, so I watched your videos on “how to help hypertension with a diet” even if you already have high blood pressure, and it’s still in the 140/100 stages, even after I took all the advice that was given in the video. I drink rice with 2-3 tablespoons of flax seeds everyday, I also drink 2-4 cups of hibiscus tea, and I also consume a very low sodium diet. I just need some advice, and maybe a diet plan if possible.

    Thank you,
    Sincerely,
    Anthony Santiago

    Age – 29
    Weight – 132.6
    Height – 5’4
    Diet – plant based diet (Vegan) 1yr 5months




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  40. Hi Anthony,

    I am a volunteer for Dr. Greger. Thanks so much for your question.

    You seem to be doing incredibly well. I understand that you would like to make your blood pressure optimal though. Good for you.

    The only recommendations I can make are to absolutely minimize your intake of processed foods, and increase the number of fruits and vegetables. Avoid oils, added sugars, and processed foods. Increase your intake of dark green leafy vegetables.

    I wish you all the best! Just make sure you communicate with your physician to appropriately titrate your blood pressure medications.




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    1. What do you think I have been doing for last 4 years? Even vegan diet is not the always a healthy one since sugar, oil (as long as it is not derived from animals) and salt is allowed. My resting PR is in the low 40’s and my HDL is as high as 130. I do strength exercises at 24 hr Fitness at least 5 days a week and pushing around 300 lbs which is not bad for one who will soon be 82. Nothing, absolutely nothing has lowered my BP except hypertension drugs (and the only drugs) which I take as needed. (I measure my BP at least 4 times each day to avoid systolic BP > 180mm). Of course, I have constant battles with Cardiologists and other physicians who do not like their patients taking medications on “as needed bases.” Nor do they recognize that any measurement that is 2 or even 3 Standard Deviations away from the mean may be OK. (I specifically am referring to my PR which has often been as low as 32 bpm with absolutely no symptoms whatsoever).




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  41. I was asked to come here for some advice. I am almost 5’8 , early 40’s and weigh about 170lb.
    Vegetarian most of my life , vegan the past 7 years and I would say 95% WFPB. I am very careful about what I eat and dont cook with oil. I may eat some oil or salt if I eat outside. I am a fairly active person – exercise atleast 6 days a week. My exercise is walking and some running . I am training for a half marathon in Nov. i am also a triathlete

    I have a fairly stressful job and a mother of 2 teens . I try and meditate atleast once a day to calm my mind and body . I am grateful for life otherwise!

    Coming back to my issue – my blood pressure. I have tried to manage it with diet and exercise but I just cannot seem to . My bloodpressure hovers around 125-130/90-100. I lost about 12 lb recently eating starches and thinking I could reduce the blood pressure but it really hasnt. That has really sent me on a downward spin especially since I lead a very healthy life. I dont really want to take medication but it looks like I may have to succumb to it.

    I really wanted to see if you had anything that I could do that I am not. I recently started drinking decaf which I also quit today. I am not sure why I cannot bring down my BP when so many people have had success with WFPB.




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  42. Well first of all, congratulations on all the healthy changes you have made. Keep it up. No matter what your blood pressure is, there will be positive health benefits from everything you are doing.
    I feel for you personally too. My husband and I are both marathon runners and triathletes and eat plant based diets. Even with our healthy lifestyles, my husband has to take blood pressure medication. I felt like a failure as a nurse wife that I couldn’t fix it for him with diet and exercise alone. Medications may be overused some, but they do have needed therapeutic benefits too and they are needed sometimes. Don’t beat yourself up if you have to take medication. You are doing some amazing things for your health. Most medications only lower your blood pressure by about 10 points. So if you need medication, you would probably only need a single low dose one. You know a lot of patients need 3 or MORE medications to control their blood pressure? They have blood pressures of 150 or higher and it takes multiple medications to get it down to where blood pressure is now.

    Does your doctor want to start you on medication? If you blood pressure is running 125/90, a lot of people would love to have a blood pressure that good. 100 is high for the bottom number. Usually 140/90 is what we don’t want to be above.

    Another thought, do you check your blood pressures at home or are these readings in the Drs office? It might be worthwhile to check it at home at different times during the day. Just make sure your blood pressure monitor is calibrated correctly. Your Drs. office should be able to calibrate it for you. If you have a little “white coat syndrome” in the Drs. office, your home readings may be better. Regardless of where you are checking it, there are a few things that can make your blood pressure readings falsely elevated- if you have a full bladder, if you have just eaten, if you have recently had caffeine, if you are talking while the cuff is running, if you are not sitting with your back supported, if your arm is below the level of your heart or not supported, or even if your legs are crossed when the cuff is running. Those can all falsely elevate your blood pressure by about 10 points. Some Drs. offices aren’t good about checking these things to make sure they get accurate readings.

    I know Dr. Greger recommends hibiscus tea (it’s caffeine free) for lowering blood pressure. Have you ever given that a try? This video explains it.
    https://nutritionfacts.org/video/hibiscus-tea-vs-plant-based-diets-for-hypertension/

    Here is a few other videos Dr. Greger has made about blood pressure that you might enjoy.
    https://nutritionfacts.org/video/high-blood-pressure-may-be-a-choice/
    https://nutritionfacts.org/video/how-not-to-die-from-high-blood-pressure/

    Good luck to you and keep up all those healthy things you are doing!
    Kelly
    Nutritionfacts.org Moderator




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    1. Thank you Nurse Kelly for your insight. Yes I drink hibiscus tea everyday . I take my readings at home with a withings blood pressure monitor. I am going to take it in to the doctors so I can check along with them.

      I am still not happy about taking the medication! I So many people that go WFPB stop taking medication just by going WFPB and I am not sure why mine is not coming down even being WFPB. Not fair :) Is there any other way to tell whether i could have secondary blood pressure from something levels. All my lab levels are great .




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  43. What do you know about Dr Marlene Merritt, LAc, DOM(NM), MS Nutritionn, and her natural Nutritional treatment plan for high blood pressher? Her book is “The Blood Pressure Solution.”




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  44. Margie- There are so many books published by doctors, often marketed effectively, but to evaluate you need to look at what research has shown about the causes and effective treatment of blood pressure. Why not look these videos over, then you can better evaluate if this book has merit and based on research or just a publication on a popular topic written to attract your interest but not to teach you anything new? Here’s where to look for updated, reliable information about blood pressure:
    https://nutritionfacts.org/topics/blood-pressure/
    https://nutritionfacts.org/video/whole-grains-may-work-as-well-as-drugs/
    https://nutritionfacts.org/video/uprooting-the-leading-causes-of-death/
    https://nutritionfacts.org/video/high-blood-pressure-may-be-a-choice/
    https://nutritionfacts.org/video/how-to-treat-high-blood-pressure-with-diet/
    https://nutritionfacts.org/video/hibiscus-tea-vs-plant-based-diets-for-hypertension/

    I hope that’s helpful.




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  45. More of a question really and yes I have been on this site before and also read Dr. Greger’s book. I have been plant based, low sodium and lowfat for 15 months now and my blood pressure is still the same 140/80 on bp meds. I also have dropped 22 lbs and work out 4 – 5 days a week for an hour at a time, also walk everywhere. I tried all the remedies: eg. eating celery, apples, watching processed food which I eat very little of. Is it possible that I may never lower my bp due to years of eating poorly? It’s so frustrating but now I am starting to wonder if genetics play a part. Thank you all and Dr. Greg very much! :)




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    1. Hello Patricia,
      Thank you for your question. I am a family doctor with a private practice in lifestyle medicine and also a volunteer moderator for this website. First, congratulations on all the great changes you’ve made!! What you’ve done is not easy, and shows you are really dedicated to improving your health.

      To better understand your situation, I would want to know your current height and weight, to determine if you are still overweight, despite losing 22 pounds — because excess weight can certainly contribute to high blood pressure. Also, exactly what is your sodium intake? Many people’s blood pressure is very sensitive to sodium intake; for these folks, they should aim to get their sodium intake extremely low — i.e. less than 1000 mg per day, or even better, less than 500 mg per day.

      If you have a normal body mass index (BMI 20-25), and your sodium intake is really low, and you get 4-5 hours per week of aerobic exercise, there’s not a whole lot more you can do. I doubt that your “years of eating poorly” would continue to keep your blood pressure high if you have a normal BMI.

      The last issue you raise about role of genetics is important, but even with “bad genes”, many chronic illnesses including hypertension will still respond to a good (plant-based diet). Here is a video by Dr. G about how diet alters gene expression: https://nutritionfacts.org/video/plant-based-diets-and-cellular-stress-defenses/.

      One last point to consider: sometimes hypertension is secondary to another medical problem such as renal artery stenosis, or pheochromocytoma. If you are sure you’ve max’d out with diet and exercise, it may be worth going to a good internist or family physician who can check for these unusual causes of “secondary hypertension”.

      I hope this helps.
      Dr. Jon
      PhysicianAssistedWellness.com
      Volunteer moderator for NutritionFacts.org




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