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DASH to Control Your Blood Pressure
Keep track of your numbers and watch your diet for optimal control of blood pressure and sugar

Did you know that controlling your blood pressure is as important as controlling your blood sugar? It is, because high blood pressure (also known as hypertension) will damage both your large and small blood vessels over time. This, in turn, increases the risk for kidney and cardiovascular diseases, diabetic retinopathy and amputation. The good news is that you can take charge of your blood pressure. And you may be surprised to learn that these lifestyle changes will help you manage your blood sugar and cholesterol as well. It all fits together for a healthier you!

Know Your Numbers
Having a blood pressure target is as important as having a target for your blood sugar. The American Diabetes Association recommends a blood pressure goal of 130/80 mm/Hg or less for people with diabetes. If your blood pressure runs high, ask your doctor what you can do together to bring it down. Be assertive. You may want to take a few months to follow the tips below if your blood pressure is only slightly above target. But, if your blood pressure starts out significantly above target, or you can’t seem to get it down over many months, you may need blood pressure medication. Many people need a combination of blood pressure medications to achieve control.

Keep Track at Home
Checking your blood pressure at home is another option you should know about, especially since many factors affect your blood pressure, including time of day, activity, medications, nutrition and emotional stress. Some people even have higher blood pressure at their doctor’s office due to a nervous response known as the “white coat syndrome.” An automatic home blood pressure monitor is easy to use on either the upper arm or wrist. If you use a wrist monitor, make sure to hold your wrist at heart level to improve the accuracy of the results. If the machine has an upper-arm cuff, be sure you have the correct size. Follow the directions carefully to avoid user errors, and get in the habit of taking both the home test results and the monitor to doctor’s appointments. Having these records will give you and your healthcare team a better picture of your blood pressure, and they will check your monitor for accuracy while you’re there.

Build a Healthy Foundation
There are several steps you can take to improve your blood pressure.

• Maintain a healthy weight. If you are overweight, losing as little as 10 pounds can bring down your blood pressure.
• Increase your activity. Your healthcare team should be able to talk with you about the types of physical activity that will work for you.
• If you drink alcohol, do so in moderation. This means one drink per day for women, two for men. One serving of alcohol equals 12 ounces beer, 5 ounces wine or 1 ½ ounces 80 proof spirits.

Reduce Your Sodium Intake
The less sodium you eat, the more you reduce your blood pressure. A daily intake of 2400 mg or less is ideal. At first this might be difficult if you liberally use your salt shaker, but be patient and cut back gradually. At first, food may taste bland. Try cooking with herbs, spices, lemon juice or wine to boost food flavor.

Here are some things you can do to limit your salt intake:

• Take the salt shaker off of your table or fill it with a sodium-free spice blend (but do not use salt substitutes until you discuss it with your diabetes team)
• Do not add salt when you cook
• Buy unsalted versions of snack food
• Look for foods labeled “low sodium” (meaning 140 mg of sodium or less per serving) and “very low sodium” (meaning 35 mg or less sodium per serving)
• Don’t buy foods labeled “reduced sodium”, “less sodium” or “lite” until you check the nutrition label for the exact sodium content

Adopt the DASH Eating Plan
The Dietary Approach to Stop Hypertension (DASH) study showed that the use of the DASH eating plan lowered blood pressure significantly. A follow-up study (DASH-sodium) revealed that combining reduced sodium intake with the DASH eating plan was more effective at lowering blood pressure than reduced sodium intake alone. Here are ways to add DASH to your routine:

• Aim for 5 servings of fruit and 5 servings of vegetables per day
• Select a variety of fruits and vegetables to maximize your nutrient intake
• Consume 3 servings of low fat dairy products or soy-based alternatives per day
• Pick whole grain foods
• Eat more poultry or fish and less red meat
• Have 2 meatless meals per week
• Reduce your fat intake and use plant-based fats whenever possible
• Add 4-5 servings of nuts, seeds and dried beans per week
• Limit sweetened beverages and sweets

The DASH diet is a healthy eating plan, but it may not be right for you if you have kidney disease or gastroparisis (diabetes nerve damage affecting the stomach). Ask your diabetes team how you can fit DASH into your meal plan.

Involve Your Family and Friends
The DASH diet is a healthy way for everyone to eat. So, if you share your meals with family or friends, encourage them to join you on this journey. You will benefit from their support, and they will enjoy some new tasty meals.

Talk to a Dietitian
Making the dietary changes described above can be overwhelming. How do you incorporate them into your current diabetes regime? A Registered Dietitian (RD), especially one who also has the experience with diabetes needed to become a Certified Diabetes Educator (CDE) can help you fit all of the pieces together to make a meal plan that works for you. If you do not have a dietitian on your diabetes team already, ask your doctor for a referral.

Get More Information
For more information about the DASH diet and eating less sodium, including recipes, visit http://www.nhlbi.nih.gov/hbp/treat/treat.htm.

Lynn BaillifAbout the Author
Lynn Baillif has been a registered dietitian for 15 years and a certified diabetes educator for 7 years. She has been a member of the National Federation of the Blind since 1987 when she was a national scholarship winner.