Elevated blood pressure arises from a combination of environmental and genetic factors and the interactions of these factors. A substantial body of evidence from animal studies, epidemiologic studies, meta-analyses, and randomized controlled trials has demonstrated that certain dietary patterns and individual dietary elements play a prominent role in the development of hypertension. Changes in diet can lower blood pressure, prevent the development of hypertension, and reduce the risk of hypertension-related complications. Dietary strategies for the prevention of hypertension include reducing sodium intake, limiting alcohol consumption, increasing potassium intake, and adopting an overall dietary pattern such as the DASH Dietary Approaches to Stop Hypertension diet or a Mediterranean diet. In order to reduce the burden of blood pressure-related complications, efforts that focus on environmental and individual behavioral changes that encourage and promote healthier food choices are warranted. Hypertension exerts a staggering worldwide burden on human quality of life and health care system resources via contribution to increased mortality and risk of cardiovascular diseases such as myocardial infarction, angina pectoris, heart failure, and stroke [ 1, 2 ]. In the US, hypertension is the most common primary diagnosis with 35 million outpatient office visits annually [ 3 ]. Even a small downward shift in the distribution of blood pressure in the general population could have a substantial impact on the risk of cardiovascular disease. Dietary modifications have been widely regarded as a lifestyle modification strategy with enormous potential for preventing hypertension at a cost that is often less than current pharmacologic interventions. Such successful historical interventions are reflected in dietary recommendations advocating weight loss, reduced intake of dietary sodium, and moderation in alcohol consumption, and more recently revised to reflect the blood-pressure lowering effect of potassium supplementation and a dietary eating pattern [ 4 ]. This article reviews the consistency of blood pressure results regarding proven dietary interventions as well as several new dietary targets.
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