Hypertension is one of the leading causes of stroke, heart disease, kidney failure, and premature death in this country. Even those with normal blood pressure (130/85) have an increased risk of heart disease and stroke compared to individuals with optimal blood pressure of 120/82 or less.

High blood pressure is considered a "silent killer" because one-third of the 50 million Americans who have it, don’t know it. As the graying of America progresses, it should be of concern that one out of two Americans over 60 has high blood pressure. If you have high blood pressure or the risk factors associated with hypertension (see table 1), there is some good news to help reduce your risk of this "silent killer."

The National Heart Lung and Blood Institute’s study, "Dietary Approaches to Stop Hypertension," has provided evidence that diet composition alone can significantly decrease blood pressure. This study compared three diets: a control diet similar to that of the "all American diet," a diet high in fruits and vegetables, and the DASH combination diet.

The findings of this study supported the use of a diet (the DASH diet) rich in fruits, vegetables, and low-fat dairy products with reduced total fat, saturated fat, and cholesterol to lower blood pressure in normotensive and hypertensive subjects. In some of the subjects with high blood pressure this diet had a lowering affect similar to that seen with medication. This diet specifically consists of consuming seven to eight grain products daily; four to five servings of vegetables daily; four to five servings of fruit daily; two to three servings of low non-fat dairy products daily; two or fewer meat, fish, or poultry servings daily; four to five servings of nuts, seeds, and legumes per week; and limited intakes of fats and sweets.

Some tips for eating the DASH way include make gradual changes in your eating habits; center your meal around carbohydrates such as pasta, rice, beans, or vegetables; treat meat as one part of the whole meal instead of the focus; use fruit or low-calorie foods such as sugar-free desserts and snacks. When attempting to prevent hypertension or lower blood pressure, make DASH part of a lifestyle change. This change should also include increased physical activity, lower sodium food choices, and maintaining a healthy weight. It is estimated that if a population-wide downward shift in blood pressure similar to that seen with the DASH diet were to occur, there would also be a 15% drop in the incidence of coronary heart disease and a 27% drop in the incidence of stroke.

See the DASH web site for more information on the DASH diet (http://dash.bwh.harvard.edu/).

• Family history of heart disease

• Men and postmenopausal women

• Over 35 years of age

• Have pre-existing conditions such as diabetes, renal disease, or obesity

• Smoking

• Of African-American descent

• High blood cholesterol

• Take oral contraceptives

• Frequently consume alcoholic beverages

• Lead a sedentary lifestyle