My Doctor said I have HYPERTENSION… Now What?

● What is hypertension?
o Hypertension is a constant excessive force against the artery walls.

● How does hypertension affect my body?

o Hypertension can cause damage to the heart, brain, kidneys and eyes.

● Can kids get hypertension?

o Yes! Although hypertension is not as common in kids as it is in adults, studies show
that hypertension is linked more closely to being overweight than it is to age.

What can I do to control my hypertension?

Maintain a healthy weight: Controlling our weight and avoiding being overweight are
the most effective lifestyle approach to reduce the risk of hypertension.

Eat a balanced diet: A healthy eating plan can both reduce the risk of developing high
blood pressure and lower a blood pressure that is already too high.

Watch your sodium intake: The body only needs a small amount of sodium
(around 500 mg) to function properly. It is estimated that the average American
child eats about 6,000 to 10,000 mg of sodium per day. If your diet is high in
sodium, follow the guidelines on this handout and the advice of your Doctor and/or
Registered Dietitian to lower it.

Make sure you are getting enough minerals: An adequate intake of calcium,
potassium, and magnesium exerts a hypotensive (blood pressure lowering) effect. Eating
foods rich in these minerals may help prevent hypertension, particularly in those who are
at risk.

Limit alcohol consumption: Drinking alcohol can raise blood pressure and harm your
liver, brain, and heart. Alcoholic drinks also contain calories, which matters if you are
trying to lose weight.

Do not smoke! In addition to other dangers, smoking can adversely affect blood
pressure.
 What Should I Know About Sodium?
Sodium is an essential dietary nutrient.

Your body needs a small amount of sodium to help with important jobs in the body like
maintaining water balance, contracting muscles, and conducting nerve impulses.

Approximately 75% of dietary sodium is added to food during processing. Only 11% of
dietary salt comes from a foods natural content.

The American Heart Association and the National High Blood Pressure Education Program
recommend a daily intake of 1500 mg of sodium to help control blood pressure.

Tips to Reduce Sodium

ALWAYS read the label carefully! Try to choose products with less than 200 mg of
sodium PER SERVING.

Limit salty foods such as pickles, cured meats, salted snacks, and canned soups.
Choose fresh products instead.

Try to stay away from products (especially snacks) with visible salt such as salted pretzels,
potato chips and popcorn. Instead choose the low sodium (or reduced fat) versions of these
snacks.

Fast food is high in sodium as well as fat, and cholesterol. If you eat out, do so in moderation
(try to limit to 1 time per week). When you do eat out, ask that your order be prepared without
added salt.

Seasonings and condiments can be high in sodium. Some of these products

include garlic and onion salt, monosodium glutamate (MSG, often found in Chinese
food) and condiments such as soy sauce, steak sauce, ketchup, and BBQ sauce.

Season without salt and instead experiment with different spices and herbs to try
out different flavors on a dish.

Salt Substitutes: These products may be used in place of regular table salt
Brand SODIUM per teaspoon POTASSIUM per teaspoon
Nu-Salt ® 0 mg 530 mg
No Salt ® 0 mg 2600 mg
Morton ® Salt Substitute 0 mg 2440 mg
Morton ® Lite Salt ™ Mixture 1160 mg 1400 mg
Morton ® Regular Table Salt 2240 mg 0 mg
*Before trying salt substitutes, you should check with your doctor, especially if you have high blood pressure. These
contain potassium chloride and may be harmful for those with certain medical conditions.
 Reading the Food Label
● Reading food labels is the only way to be sure of the sodium content of foods. The
sodium content must be listed on the package - it is usually on the nutrition information
panel. Make it a habit to always READ THE LABEL!

● Ingredients are listed in decreasing order by weight - if salt or sodium appears on the
ingredient list at all, make sure it is near the end of the list of ingredients.

● Use the Percent Daily Value (%DV) as a tool to determine the sodium content of foods
in one serving. When comparing and choosing foods, pick the food with the lower
present daily value of sodium.

o 5% DV or less: sodium content per serving is low

o 20% DV or more: sodium content per serving is high

Some ingredients that are high in sodium include:

● Baking soda ● Brine
● Disodium phosphate ● Salt
● Garlic salt ● Monosodium glutamate (MSG)
● Onion Salt ● Sodium propionate

What the Label Really Means:

If the Label Says… It Means…
Sodium free or salt free… …. Less than 5mg of sodium per serving
Very low sodium… …. Less than 35 mg of sodium per serving
Low sodium…. …Less than 140 mg of sodium per serving
*Reduced sodium… …At least 25% less sodium than the original product
*Light in sodium… …At least 50% less sodium than the original product
*Unsalted or No added salt… …No ADDITIONAL salt added during processing

*These products are NOT always LOW in sodium. They are simply advertising that the salt content of these products are
lower than the salt content in the original. It’s important to ALWAYS READ THE LABEL in order to identify the actually
sodium content in foods and to NOT rely on indications such as these!
 Eat a Balanced Diet
● For an overall eating plan to reduce your blood pressure, consider DASH, which stands
for “Dietary Approaches to Stop Hypertension.”

● The DASH eating plan stresses a dietary pattern that is low in saturated fat,
cholesterol, and total fat. The DASH plan is rich in fruits, vegetables and low-fat dairy
products. It is high in potassium, calcium, magnesium, protein and fiber. It includes
whole grains, lean meats like poultry and fish, and nuts and beans. The DASH eating
plan limits the intake of fats, red meats, sweets, and sugar-sweetened beverages.

Tips for Adjusting to the DASH Eating Plan

● Get added nutrients such as the B vitamins by choosing whole grain foods, including
whole wheat bread or whole grain cereals.

● Have two servings of fruits and/or vegetables at each meal, or have fruits as snacks.
Change the variety gradually.

● Move meat away from the center of the plate, and serve it as a side. Try casseroles,
pasta, or stir-fry dishes. Have two or more meatless meals a week and when you do
have meat choose leaner sources of meat.

What about Minerals?

Calcium
● Calcium helps lower blood pressure.
● Include calcium rich foods like milk, cheese, and yogurt and always try
to choose a lower fat dairy product.

Potassium
● Potassium helps protect against hypertension by increasing sodium loss.
● Get your potassium from fruits, vegetables and low-fat dairy products (such
as milk and yogurt).

Magnesium
● Get magnesium from foods such as nuts, legumes, unrefined grains,
green vegetables, and dairy products.
● It may help prevent hypertension, especially if you are at risk!
 Nutrient Rich Food Choices
Food Group High Sodium Foods
Fruit None
Canned vegetables with added
Vegetables salt, dill pickle, olives, sauerkraut,
potato chips/French fries
Buttermilk, regular and processed
Dairy cheese, cottage cheese
Salted wheat crackers, quick
Grains breads, prepacked and processed
mixes for potatoes, rice, pasta and
stuffing
Smoked, cured or salted meat, fish
Meats or poultry, canned entrees, frozen
breaded meats and dinners (ie.
Frozen burritos and pizza), deli
meats, jerky
*A majority of sodium comes from processing, in which potassium is lost and sodium is added. In general,
processed foods contain a high amount of sodium and should be reduced or avoided!
Low Sodium Foods
All fruits, dried fruits
Fresh and frozen vegetables
without sauces, instant mashed
potatoes, fresh potatoes
Milk, yogurt, low-sodium cheese,
cream cheese, ricotta cheese,
mozzarella
Whole grains, plain rice and pasta,
low-sodium corn and flour tortilla,
muffins, most ready-to-eat cereals
Fresh or frozen beef, lamb, pork,
poultry, and fish, eggs, dry peas
and beans, low-sodium peanut
butter, skinless turkey and chicken

High Calcium Foods

Dairy: Milk, yogurt, cheddar cheese, Swiss cheese, cottage cheese, pudding, ice cream
Vegetables: Cauliflower, Brussels sprouts, rutabaga, kale, mustard greens, spinach, broccoli,
green beans,
Other: tofu, sardines (with bones), almonds, flour tortilla, calcium fortified foods and beverages
(such as some cereals and orange juice)

High Potassium foods

Fruits: apricots, avocado, banana, cantaloupe, grapefruit juice, honeydew, kiwifruit, orange,
orange juice, prune juice, strawberries
Vegetables: asparagus, artichoke, broccoli, cauliflower, carrots, beans, celery, potato, sweet
potato, squash, tomato, tomato juice, vegetable juice
Cereal & Breads: bran, quinoa, rye, Bran Flakes, Raisin Bran, barley, amaranth
Nuts: Almonds, brazil nuts, cashews, chestnuts, pecans, peanuts, walnuts

High Magnesium Foods

Fruits & Vegetables: Avocado, banana, black-eyed peas, chickpeas, kidney beans, lentils,
raisins, spinach
Grains: barley, wheat flour, granola, millet oats, whole wheat pasta, high bran cereals, Raisin
Bran, whole grain oats
Nuts & Seeds: Pumpkin seeds, sesame seeds, almonds, cashews, hazel nuts, brazil nuts,
peanuts, pistachio nuts, macadamia nuts (dried nuts contain more Mg than roasted)
 Maintain a Healthy Weight
● Being overweight or obese increases your risk of developing high blood
pressure, high cholesterol, or coronary artery disease.

● When you gain too much weight, your blood pressure goes up. When you
lose the extra pounds and return to a healthier weight, your blood pressure
goes down. Losing even just 10 pounds can lower your blood pressure!

Tips to Achieve & Maintain a Healthy Weight

● If you need to lose weight, it is important to do so slowly. Do not lose more than 1/2
pound to 2 pounds a week.

● There is no magic formula for weight loss. You have to eat fewer calories than you use
up in daily activities. The amount of calories you burn daily depends on your body size
and your physical activity. Get moving by walking, riding your bike, or playing sports at
least 4-5 times per week.

● One pound of body fat equals 3,500 calories. So, to lose one pound a
week you need to decrease your caloric intake by 500 calories a day or burn
500 calories more than you usually do a day. It is best to work out some
combination of both eating less and being more physically active.

● Eat regularly & eat slowly – 3 meals and 1-2 snacks per day. This will
prevent you from getting too hungry and overeating.

● Avoid or limit sugar sweetened beverages (including juice, soda, iced tea, etc.). Limit it
to no more than 6-12 oz/day. Eat fewer cookies, pies, cakes, candy, and other sweets.
Instead drink 6-8 cups of water per day and choose fresh or dried fruit to satisfy that
sweet tooth.

● Limit dining out or having fast food. Though when you do go out, treat yourself to foods
that are lower in fat such as grilled or steamed foods.

● Eat more high fiber foods such as, fruits and vegetables. Aim for 5 servings every day
and choose whole grains such as whole-wheat pasta, whole grain breads and cereals
and brown rice.

● Choose low-fat dairy products and lean proteins.

 What about Fast Food?

● Try to limit your intake of fast food to once or twice a month. Fast food is very high
in total fat, saturated fat, cholesterol and sodium.

● If you are going to be eating out at a fast food restaurant try to make better choices.
Remember you can reduce your sodium intake even when you’re eating out.
Moderation is the goal!

● Here are some examples of lower sodium choices when eating out.

Sodium Content of a Fast Food Meal

Restaurant High Sodium Food item Na+ Lower Sodium Alternative Na+
Quarter Pounder with cheese 1240mg Quarter Pounder 770 mg
Large French Fries 350mg *Side salad 10 mg
BBQ sauce (1 pack) 250 mg Sweet & Sour sauce 140 mg
McDonalds
32 oz Vanilla shake 810 mg Van low fat ice cream cone 75mg
Total: 2650mg Total: 995mg
Percent Daily Value: 110% Percent Daily Value: 41%
Burrito Supreme (steak) 1260 mg Soft Taco Supreme (reg, beef) 630 mg
Nachos Bell Grande 1300 mg Cinnamon Twists 150 mg
Taco bell Guacamole 100 mg Sour cream 15 mg
Total: 2660 mg Total: 795 mg
Percent Daily Value: 111% Percent Daily Value: 33%
Original Whopper (no cheese, no
Original Whopper with Cheese 1420 mg 790 mg
pickles)
Medium French Fries 640 mg French Fries (no salt) 380 mg
Burger King Chili 1040 mg *Side Garden Salad 15 mg
Small chocolate shake 310 mg Orange juice 25 mg
Total: 3410 mg Total: 1210 mg
Percent Daily Value: 142% Percent Daily Value: 50%

*Side salad does not include salad dressing. Salad dressings provide an additional 440-730mg of
sodium per package (2oz). Oil and vinegar contain 0mg of sodium per tablespoon!
McDonald's Nutrition Facts Available at:
http://nutrition.mcdonalds.com/usnutritionexchange/nutritionfacts.pdf
Taco Bell Nutrition Calculator: Available at: https://www.tacobell.com/food/nutrition/info
https://fastfoodnutrition.org/taco-bell
Burger King Nutrition Facts. Available at: https://www.bk.com/pdfs/nutrition.pdf
https://fastfoodnutrition.org/burger-king
 A DASH-ing Way to Lower your Blood Pressure

 Whole grains provide

 Try whole grain bread
 Choose fresh fruits and eat
a variety.
 Many fruits are high in
potassium like bananas,
oranges, and tomatoes.
fiber and energy to
your meals.  Choose low-fat dairy
products.
and pasta, brown rice
 A great source of
or quinoa. calcium, vitamin D and
protein.

 Reach for lean proteins like

poultry, fish and nuts to reduce
 Choose fresh vegetables your intake of saturated fats.
over canned.
 Limit your intake of red meat to
 Have a variety of vegetables 1-2x per week.
to get a good source of
vitamins and minerals.

Remember:
Limit your intake of
salt, sweets and
sugar-sweetened
beverages.
 Food Group Servings A Serving Size What to Choose What to Lose
per day Low sodium choices High sodium foods
White, wheat, rye pumpernickel, & other Sweet rolls; biscuits, & cornbread;
types of regular and unsalted breads; quick or instant oatmeal; salted
English muffins, sandwich buns, & dinner crackers, & other salted snack
Bread, 1 slice of bread (1oz) = 130 mg
rolls may substitute 2 slices of bread. items; macaroni and cheese mix;
Cereal, Rice, ½ cup of cooked cereal = 100 –450mg
6-11 Cooked cereals such as Cream of Wheat, seasoned rice and noodle mixes,
& Pasta 1 ounce ready-to-eat cereal
rice, farina, or ready-to-eat low-sodium canned spaghetti, frozen rice or
cereals such as puffed wheat; unsalted pasta dishes
cracker, unsalted popcorn; macaroni, rice,
spaghetti, & potatoes
½ cup of chopped raw= Fresh, frozen, or low-sodium canned Olives, pickles, sauerkraut, frozen
Vegetables
3-5 ½ cooked vegetables = 9 mg vegetables and vegetable juice vegetables with butter or sauces, &
1 cup of raw leafy = all regular canned vegetables
1 piece of fruit or melon Fresh, frozen, or canned fruits and fruit Fruit packed in heavy syrup
wedge = juices (use juices in moderation!)
Fruits 2-4 2 mg
¾ cup of juice =
½ cup of canned fruit =
Milk, cream, sour cream, and nondairy Processed cheese slices and
creamer; buttermilk and yogurt; cream spreads, limit regular (natural)
1 cup of milk or yogurt = cheese, cottage cheese, low-sodium cheese to no more than 2 ounces
Milk, Yogurt,
2-4 ½ cup milk or yogurt = 120 mg cheese. per day.
& Cheese
1½ to 2 ounces of cheese =
*Always choose low or reduced fat dairy
products!
Fresh or frozen meat, poultry, & fish; low or Salted, smoked, canned, spiced,
reduced sodium canned tuna or salmon; and pickled meats, poultry, and
3 ounces of cooked lean meat, fish, or peanut butter; eggs. *Low fat peanut butter fish; bacon; ham; sausage;
Meat,
poultry = 25 mg per oz is preferred and egg consumption should scrapple; regular canned tuna or
Poultry, Fish, 2-3
1 egg = 70mg be limited to 2-3 times per week. salmon; luncheon meats, such as
Eggs, & nuts
2 tbsp peanut butter = 150 – 190 mg bologna or salami and hot dogs;
pre-breaded frozen meats, fish,
and poultry.
Regular butter or margarine; unsalted butter Bacon grease, salt pork,
Fats, Oils, & Use 1 teaspoon of stick butter = 50 mg or margarine; cooking oils and shortenings; commercially prepared sauces,
Sweets sparingly! unsalted gravies, cream sauces, salad gravies, and salad dressings
dressings, and mayonnaise
https://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf
 For More Information

For information on Lowering your blood pressure visit:

● NHLBI. Your Guide to Lowering Your Blood Pressure. Available at: <
http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_low/hbp_low.pdf>
Accessed December 29, 2017
● The Nemours Foundation. Kids Health for Parents: Hypertension. Available at:
http:kidshealth.org/parent/medical/heart/hypertension.html Accessed December
29, 2017.
● American Heart Association. High Blood Pressure in Children. Available at:
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandSy
mptomsRisks/High-Blood-Pressure-in-
Children_UCM_301868_Article.jsp#.Wkaew0w-KCQ Accessed December 29,
2017.
● American Heart Association. 2017 Hypertension Guidelines. Available at:
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/High-Blood-
Pressure-or-Hypertension_UCM_002020_SubHomePage.jsp Accessed
December 29, 2017

For information about the DASH diet, visit:

● NHLBI. Facts about the DASH Eating Plan. Available at:
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf Accessed
December 29, 2017.

For more information about how micronutrients affect your blood pressure, visit:
● National Dairy Counsel. Dairy and Blood Pressure. Available at:
https://www.nationaldairycouncil.org/content/2015/science-summary-dairy-and-
blood-pressure Accessed December 29, 2017.