When treating hypertension, doctors rarely pay attention to stress—but that's a mistake. Stress hormones, such as epinephrine and norepinephrine, make the heart beat faster and blood vessels constrict, significantly raising blood pressure.

The stress response can be triggered by driving in traffic...waiting in long lines...or arguing with a family member, friend or colleague. Many studies have demonstrated that emotional stress can contribute to high blood pressure.

Solution: Allocate time each day to elicit the relaxation response. This is a quiet state that can be brought forth by meditation or breathing exercises. Start with five or 10 minutes several days a week, and gradually increase it to 20 minutes daily.

For optimal benefit, add a "minirelaxation" exercise whenever you feel stress building.

Examples: Count slowly from 10 to zero, inhaling and exhaling slowly with each number. Or sit quietly and focus on your breathing for one minute. With every inhalation, repeat "I am" to yourself. 'S7ith each exhalation, repeat "at peace."

Important: Activities that people often perceive as "relaxing," such as watching TV, do not have a quieting effect on the mind and body.

LOW-PRESSURE EATING

Most people know the basics of a healthful diet—unsaturated fats, whole grains, low-fat dairy and at least five servings of fruits and vegetables daily. But there's more.

In the landmark Dietary Approaches to Stop Hypertension (DASH) study, 459 men and women with high blood pressure were divided into three groups-one group followed the typical American diet...one added more fruits and vegetables... and the third followed a diet designed specifically for the program.

The DASH diet contained four daily servings of fruits, four servings of vegetables, two to three servings of low-fat dairy foods and a moderate intake of fish, poultry and nuts, along with a decreased intake of saturated and total fats. Blood pressure dropped most significantly in the DASH group—by an average of 11.4 mm/ Hg systolic and 5.5 mm/Hg diastolic.

Researchers are unsure why the DASH diet helps control blood pressure so effectively, but they speculate that it may be the potassium, calcium and magnesium that it contains...the antioxidant compounds...and/or the fiber.

Also, most people still are consuming too much salt. The usual recommendation for daily sodium intake is 2,400 mg (approximately one-half teaspoon of salt) or less, but most Americans consume 3,300 mg or more daily.

For the 50% of people who are salt sensitive (they experience an increase in their blood pressure after eating salty foods), even 2,400 mg daily is too high

A later DASH study found that cutting sodium intake back to 1,500 mg daily reduced blood pressure by 72 mn/Hg systolic and 6 mm/Hg diastolic.

Surprisingly, only 75o/o of an average person's sodium intake comes from the salt shaker. Processed foods are the biggest source.

To detect sources of hidden sodium, it's crucial to read food labels. A snack should have no more than 200 mg per serving and a meal entr6e no more than 500 mg. Less is even better. Unexpected sodium sources…

  • Processed foods labeled "healthy" or "lean." A serving may be low in calories, cholesterol and saturated fat but include up to half your daily sodium quota.
  • Packaged meats and soy-based meat substitutes.
  • Canned foods, including beans, tomatoes and other vegetables as well as tuna (even if it's packed in water).
  • Breakfast cereals, including some "heart healthy," high-fiber or whole-grain varieties.

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