Difference between revisions of "Eat to Lower Blood Pressure"

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High blood pressure (medically known as hypertension) is a serious health problem that can lead to heart attacks, stroke, organ damage, and other illnesses. It is complicated by obesity, but hypertension and obesity can be controlled (and prevented!) through diet, and an active lifestyle with plenty of exercise. By eating the right foods, you can take the first steps toward lower blood pressure and an overall healthier life. To lower your blood pressure, try to eat according to the Dietary Approaches to Stop Hypertension (DASH) diet (similar to a Mediterranean diet). The DASH diet is high in vegetables, fruits, low-fat dairy products, whole grains, essential fats and lean proteins. It is also low in sodium, added-sugars, and unnecessary fats.<ref>http://www.uptodate.com/contents/diet-in-the-treatment-and-prevention-of-hypertension?source=see_link</ref><ref>http://www.mayoclinic.com/health/dash-diet/HI00047</ref> The DASH diet is recommended by many doctors for watching out for cardiovascular health, including when you're taking blood pressure medication.

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High blood pressure (medically known as hypertension) is a serious health problem that can lead to heart attacks, stroke, organ damage, and other illnesses. It is complicated by obesity, but hypertension and obesity can be controlled (and prevented!) through diet, and an active lifestyle with plenty of exercise. By eating the right foods, you can take the first steps toward lower blood pressure and an overall healthier life. To lower your blood pressure, try to eat according to the Dietary Approaches to Stop Hypertension (DASH) diet (similar to a Mediterranean diet). The DASH diet is high in vegetables, fruits, low-fat dairy products, whole grains, essential fats and lean proteins. It is also low in sodium, added-sugars, and unnecessary fats.<ref name="rf1">http://www.uptodate.com/contents/diet-in-the-treatment-and-prevention-of-hypertension?source=see_link</ref><ref name="rf2">http://www.mayoclinic.com/health/dash-diet/HI00047</ref> The DASH diet is recommended by many doctors for watching out for cardiovascular health, including when you're taking blood pressure medication.

[[Category:Cardiovascular Health and Blood Pressure]]

== Steps ==

=== Eliminating Unhealthy Foods ===

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#Limit salt intake. Sodium can significantly affect how high your blood pressure is. Salt is the first element of your diet you will need to tackle to lower your blood pressure. Talk to your doctor about the amount of salt you should eat: the human body needs a small amount of salt; so eliminating it entirely can cause health problems.<ref>http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974</ref> Most adults can consume up to 2,300 mg of sodium a day without significant health risks.<ref>http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456</ref>But, many food products have several hundred mg of sodium in one small serving. The total can grow astronomically; so read labels and avoid extra salt.

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#Limit salt intake. Sodium can significantly affect how high your blood pressure is. Salt is the first element of your diet you will need to tackle to lower your blood pressure. Talk to your doctor about the amount of salt you should eat: the human body needs a small amount of salt; so eliminating it entirely can cause health problems.<ref name="rf3">http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974</ref> Most adults can consume up to 2,300 mg of sodium a day without significant health risks.<ref name="rf4">http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456</ref>But, many food products have several hundred mg of sodium in one small serving. The total can grow astronomically; so read labels and avoid extra salt.

#*If your blood pressure is high, your doctor might recommend you eat 1,500 mg of sodium a day. That's about half a teaspoon of salt.

#*You might be advised to keep your sodium intake below 1,500 mg if you have been diagnosed with kidney disease or diabetes.

#*Your doctor might advise you to watch your sodium if you are from a high-risk population. All women over 65 and men over 45 are at an increased risk of high blood pressure. Black men and women are prone to high blood pressure and serious complications.

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#Avoid processed foods. Most of the salt and sugar you consume comes from processed foods, such as soup, chips, bread, many cereals, cakes/donuts — and mackerel/sardines, canned meats, cured meats as well as lunch meats, plus pork that has "water added". Prepared frozen foods, restaurant or any other meal you can buy "to go" is likely to be packed with sodium. North Americans eat almost twice as much salt as they should, and ¾ of that salt comes from processed foods.<ref>http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Processed-Foods-Where-is-all-that-salt-coming-from_UCM_426950_Article.jsp</ref> Foods that do not appear salty are still high sodium if they have been processed and are not marked "low sodium."

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#Avoid processed foods. Most of the salt and sugar you consume comes from processed foods, such as soup, chips, bread, many cereals, cakes/donuts — and mackerel/sardines, canned meats, cured meats as well as lunch meats, plus pork that has "water added". Prepared frozen foods, restaurant or any other meal you can buy "to go" is likely to be packed with sodium. North Americans eat almost twice as much salt as they should, and ¾ of that salt comes from processed foods.<ref name="rf5">http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Processed-Foods-Where-is-all-that-salt-coming-from_UCM_426950_Article.jsp</ref> Foods that do not appear salty are still high sodium if they have been processed and are not marked "low sodium."

#*Cooking fresh food from unprocessed ingredients is the biggest step toward cutting salt from your diet.

#Cut out sweets or eat five or fewer lowered sugar sweets a week. 100% unsweetened cocoa powder stirred into natural peanut butter or sprinkled over fruit with stevia makes a great snack. Eating fewer sweets is a question of lowering your sugar craving. Limited sugar will provide you with special treats and fewer health problems, as you eat it sparingly. Gradually lower sweetness of treats. Try out desserts that are sweetened with fruit, applesauce or fruit juice. Make a [[Make a Fruit and Yogurt Smoothie|smoothie]], juice, or [[Make Mango and Yogurt Drink (Mango Lassi)|mango lassi]] for a dessert. Lowering sugar in fruit ices, sorbets, and lemonade creates a healthier option.

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#*Cocoa has antioxidant flavanols that you can take advantage of by eating a small amount (up to 1 ounce [28 grams]) per day of dark chocolate. It reduces cell damage, helps lower blood pressure and improves vascular function.<ref>[http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/healthy-chocolate/faq-20058044 MayoClinic.org Healthy Lifestyle, Nutrition and Healthy Eating: "Healthy Chocolate"]</ref>.

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#*Cocoa has antioxidant flavanols that you can take advantage of by eating a small amount (up to 1 ounce [28 grams]) per day of dark chocolate. It reduces cell damage, helps lower blood pressure and improves vascular function.<ref name="rf6">[http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/healthy-chocolate/faq-20058044 MayoClinic.org Healthy Lifestyle, Nutrition and Healthy Eating: "Healthy Chocolate"]</ref>.

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#*Baked or poached fruit can be an elegant dessert for company. Poach pears or other seasonal fruit in juice, and serve with a dollop of yogurt<ref>http://www.dictionary.com/browse/yogurt</ref> or a garnish of fresh fruit and citrus zest (shredded peelings).

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#*Baked or poached fruit can be an elegant dessert for company. Poach pears or other seasonal fruit in juice, and serve with a dollop of yogurt<ref name="rf7">http://www.dictionary.com/browse/yogurt</ref> or a garnish of fresh fruit and citrus zest (shredded peelings).

#*Baking low sugar/low salt granola bars and nutty cookies at home can provide you with healthy sweet snacks throughout the week.

#*Use applesauce in place of shortening in cookies and loaf cake.

#*Use plain or unsweetened flavored protein powder in place of flour in biscuits, waffles and pancakes, plain for thickening sauce or chili-con-carne.

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#*Cut down on sugary drinks of all kinds (try stevia or stevia blends; it's an acquired taste so be patient). If you have a sweet drink, such as a soda (even sugar-free), it still counts toward your five or fewer sweets. Try to cut carbonated sodas/pops and sugary fruit drinks out of your diet entirely: it is probably the top source of added sugar in your diet.<ref>http://blog.heart.org/soda-debate-bubbling-across-the-country/</ref>

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#*Cut down on sugary drinks of all kinds (try stevia or stevia blends; it's an acquired taste so be patient). If you have a sweet drink, such as a soda (even sugar-free), it still counts toward your five or fewer sweets. Try to cut carbonated sodas/pops and sugary fruit drinks out of your diet entirely: it is probably the top source of added sugar in your diet.<ref name="rf8">http://blog.heart.org/soda-debate-bubbling-across-the-country/</ref>

=== The DASH Diet ===

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#Eat six to eight servings of whole grains per week. Eat whole grains rather than refined grains. Whole grains have more of the nutrients and fiber you need.<ref~~>http:~~/~~/www.mayoclinic.com/health/dash-diet/HI00047</ref~~> They also tend to be more flavorful than refined grains, which you will appreciate as you start limiting your salt intake. Substitute brown rice (it must be cooked slowly) for white rice, whole-wheat pasta for regular pasta, and whole-grain bread for white bread.

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#Eat six to eight servings of whole grains per week. Eat whole grains rather than refined grains. Whole grains have more of the nutrients and fiber you need.<ref name="rf2" /> They also tend to be more flavorful than refined grains, which you will appreciate as you start limiting your salt intake. Substitute brown rice (it must be cooked slowly) for white rice, whole-wheat pasta for regular pasta, and whole-grain bread for white bread.

#*Experiment with a variety of grains. Eliminate white flour. Use quinoa, bulgur, oats, amaranth, and barley, all good sources of whole grains.

#Eat four to five servings of vegetables a day. Vegetables provide you with the vitamins you need to lower your blood pressure, as well as valuable dietary fiber, and minerals such as potassium and magnesium. To increase the amount of vegetables in your diet, incorporate them into your main dish instead of only eating them on the side. Hearty, flavorful vegetables such as sweet potato (with low added sugar) and squash (sliced and sautéed, mashed) provide an excellent main dish. Don't be afraid to buy large amounts of vegetables at once: you can freeze the ones you don't use.

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#*Eat the skins of fruits and veggies. Much of the flavor and the nutrients of vegetables are found in the skin. Just make sure you clean them thoroughly.

#*Save the stalks. Freeze any part of the vegetable you don't eat in a bag. When the bag is full, boil it with onion and garlic for a few hours to make a [[Make Vegetable Stock|vegetable stock]]. Strain out the vegetables, add a tiny pinch of salt and some lemon juice or vinegar, and use it as a broth.

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#Eat four to five small servings of fruit. Fruit is mouthwatering, delicious and is full of vitamins, minerals, and antioxidants. Fruit can be a snack, a dessert, and can also be treated like a vegetable and served with green salad, fried, or cooked into a sauce. Low-fat yogurt<ref>https://en.wikipedia.org/wiki/Yogurt</ref> with fruit and some nuts makes an excellent breakfast. Try eating fruits in season, when they are sweetest, or buy them frozen for smoothies and cooking.

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#Eat four to five small servings of fruit. Fruit is mouthwatering, delicious and is full of vitamins, minerals, and antioxidants. Fruit can be a snack, a dessert, and can also be treated like a vegetable and served with green salad, fried, or cooked into a sauce. Low-fat yogurt<ref name="rf9">https://en.wikipedia.org/wiki/Yogurt</ref> with fruit and some nuts makes an excellent breakfast. Try eating fruits in season, when they are sweetest, or buy them frozen for smoothies and cooking.

#*Eat the fruit peel for extra fiber and roughage. Apples, pears, plums, and even fuzzy peaches can be eaten with the peel on.

#*Like vegetables, fruits can be frozen when they are overripe and enjoyed later.

#*Juice can count as a serving of fruit. Buy 100 percent fruit juice with no sugar added.

#*Grapefruit juice and other citrus juices can interfere with certain medications, so be sure to check with your health care provider before increasing consumption.

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#Eat six or fewer servings of lean protein per week. Meat gives you protein, vitamins, and minerals. Opt for poultry and fish over beef. Fish such as salmon, herring, and tuna are high in omega-3 fatty acids (and consider taking a purified/concentrated omega-3 oil capsule high in DHA and EHA), and can help lower your cholesterol. Broil, bake, grill, poach, or roast your meat instead of frying it. Avoid sandwich meats and sausages unless they are marked "low sodium" or "no sodium." Some servings of sandwich meat contain more than a quarter of your daily recommended sodium.<ref>http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Meat-Poultry-and-Fish_UCM_306002_Article.jsp</ref>

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#Eat six or fewer servings of lean protein per week. Meat gives you protein, vitamins, and minerals. Opt for poultry and fish over beef. Fish such as salmon, herring, and tuna are high in omega-3 fatty acids (and consider taking a purified/concentrated omega-3 oil capsule high in DHA and EHA), and can help lower your cholesterol. Broil, bake, grill, poach, or roast your meat instead of frying it. Avoid sandwich meats and sausages unless they are marked "low sodium" or "no sodium." Some servings of sandwich meat contain more than a quarter of your daily recommended sodium.<ref name="rf10">http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Meat-Poultry-and-Fish_UCM_306002_Article.jsp</ref>

#*The meat you buy should be marked "lean" or "extra lean," and poultry should be skinless.

#*Vegetarians can follow the DASH diet by combining the "meat" and "nuts, seeds, and legumes" categories, and eating that many servings of nuts, seeds and legumes.

#*Even if you aren't a vegetarian, try substituting soybean-based products, such as tofu and tempeh, for meat dishes. They contain all the amino acids you need to form a complete protein.

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#Eat two to three small servings of dairy. Milk, plain yogurt, and real cheese can give you calcium, vitamin D, and protein. They can also be high-sodium and high-fat, so don't eat too much of them. Yoghurt is not high sodium, can be bought fat-free, and contains probiotics that are good for your digestion. Buy plain yogurt with no added sugar and add fruit. Yoghurt is good on its own and can also be substituted for cream/sour cream.<ref>http://www.healthyeating.org/Milk-Dairy/Nutrients-in-Milk-Cheese-Yogurt/Yogurt-Nutrition.aspx</ref>

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#Eat two to three small servings of dairy. Milk, plain yogurt, and real cheese can give you calcium, vitamin D, and protein. They can also be high-sodium and high-fat, so don't eat too much of them. Yoghurt is not high sodium, can be bought fat-free, and contains probiotics that are good for your digestion. Buy plain yogurt with no added sugar and add fruit. Yoghurt is good on its own and can also be substituted for cream/sour cream.<ref name="rf11">http://www.healthyeating.org/Milk-Dairy/Nutrients-in-Milk-Cheese-Yogurt/Yogurt-Nutrition.aspx</ref>

#*Put yogurt on your tacos or chili instead of sour cream.

#*Stir some yogurt into your soup for a creamy finish.

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#Eat four to six servings of nuts, seeds, and legumes a week. Nuts, seeds, and legumes have omega-3 fatty acids, protein, fiber, minerals and phytochemicals. They can also be high in calories and fats, which is why they are recommended for weekly rather than daily consumption. A serving size might be 1/3 cup of nuts, 1/2 cup of cooked legumes, 2 tablespoons of natural peanut butter or seeds.

#*Vegetarians should combine this category with the "meats" servings and eat 10 – 16 servings of nuts, seeds, and legumes a week.

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#*Eat tofu, tempeh, or rice and beans to get a complete protein.<ref~~>http:~~/~~/www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456</ref~~>

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#*Eat tofu, tempeh, or rice and beans to get a complete protein.<ref name="rf4" />

#*Try topping your yogurt with different kinds of nuts and seeds instead of buying a sugary granola. Almonds, walnuts/pecans, peanuts, cashews, and sesame/chia, shelled pumpkin seeds and flax seeds are all delicious snacks.

#*Experiment with different beans. If you normally eat peas, try kidney beans, black-eyed peas, or lentils.

#Limit fats and oils to two to three servings a day. Fat is good for your immune system, but it's easy to eat too much of it. A serving of fat is small: 1 tablespoon of mayonnaise or 1 teaspoon of margarine will do it. Avoid over consumption of meat, butter, cheese, whole milk, cream, and eggs. Avoid margarine/oleo, lard, shortenings, and palm and coconut oil. Eliminate trans fat, which used in processed foods for smoothness and flavor, fried foods (such as breaded fish, meat, and donuts) and commercially baked goods.

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#*Read labels to cut down on trans fats.<ref>http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/SimpleCookingwithHeart/Healthy-Cooking-Oils-101_UCM_445179_Article.jsp</ref>

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#*Read labels to cut down on trans fats.<ref name="rf12">http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/SimpleCookingwithHeart/Healthy-Cooking-Oils-101_UCM_445179_Article.jsp</ref>

#*Cook with olive oil, canola oil, vegetable oil, sesame oil, and peanut oil. Olive oil and toasted sesame oil are both excellent in salad dressing. Stir oil and vinegar (apple cider vinegar, wine vinegar, lemon juice) for quick, cheap salad dressing. Add a pinch of black pepper, garlic, paprika or stevia for extra flavor.

=== Tracking Your Food ===

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#Adjust your serving size. Servings can be difficult to calculate, and vary wildly depending on the product. A piece of toast might be one serving of grains, but a bowl of cereal could be easily double the recommended serving size. To calculate servings, find food you use frequently and measure out your typical serving size. Then calculate how many servings it actually is. From there, you can adjust your daily intake.<ref>http://www.consumerreports.org/cro/news/2014/12/cereal-portion-control-matters/index.htm</ref>

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#Adjust your serving size. Servings can be difficult to calculate, and vary wildly depending on the product. A piece of toast might be one serving of grains, but a bowl of cereal could be easily double the recommended serving size. To calculate servings, find food you use frequently and measure out your typical serving size. Then calculate how many servings it actually is. From there, you can adjust your daily intake.<ref name="rf13">http://www.consumerreports.org/cro/news/2014/12/cereal-portion-control-matters/index.htm</ref>

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#*If you find you are over-serving, consider buying smaller dishes. You are far likelier to overestimate how much food you need if you are serving into large dishes.<ref~~>http://www.consumerreports.org/cro/news/2014/12/cereal-portion-control-matters/index.htm<~~/~~ref~~>

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#*If you find you are over-serving, consider buying smaller dishes. You are far likelier to overestimate how much food you need if you are serving into large dishes.<ref name="rf13" />

#*Consider investing in a small kitchen scale, which will allow you measure by weight rather than volume. This is especially helpful for determining servings of cereal and pasta.

#[[Keep a Food Diary|Keep a diary of everything you eat]]. By recording all the food you consume, you will be able to easily evaluate the problem areas in your diet. Tracking what you eat will also help you shop smarter at the grocery store and be pickier when eating out at restaurants. Set a goal for yourself and follow it with your diary. Your doctor may also be interested in reviewing your consumption when you visit.

#*Take a picture of your meal with your cell phone to use it to write down what you ate, later.

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#*Tracking your consumption is not necessary for some people. If you have not been advised to watch your blood pressure, lose weight, or track your food, talk to a doctor or therapist before you begin tracking.<ref>http://www.mayoclinic.org/diseases-conditions/eating-disorders/basics/symptoms/con-20033575</ref>

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#*Tracking your consumption is not necessary for some people. If you have not been advised to watch your blood pressure, lose weight, or track your food, talk to a doctor or therapist before you begin tracking.<ref name="rf14">http://www.mayoclinic.org/diseases-conditions/eating-disorders/basics/symptoms/con-20033575</ref>

#Cook from scratch. The easiest and cheapest way to eat well is to cook at home. Make time on your days off to cook ahead for busy days. Make foods like rice and beans, soup, and baked vegetables in large batches and store in the fridge. Freeze the leftovers. Label any food you freeze, to ensure you eat it before it loses flavor. Many community centers offer free cooking lessons: see what is available in your area.

#*Make as many parts of your meal from scratch as you can. For instance, if you are going to make spaghetti, don't buy a canned sauce. Buy tomatoes or canned tomatoes, add onions, and garlic, and make a delicious sauce at home in minutes (let it simmer for best results).

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#Stock up on healthy foods. To build a low-salt, healthy, welcoming kitchen, buy groceries that will contribute to your health goals. Buy fresh, local, in-season food if you can afford it. If you have SNAP, or food stamps, see if you can use them at your local farmer's market. You can double the value of your SNAP benefits by spending them at farmers markets.<ref>http://www.fns.usda.gov/ebt/learn-about-snap-benefits-farmers-markets</ref> Buy as many one-ingredient items as possible: fruits, vegetables, flour, raw meat.

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#Stock up on healthy foods. To build a low-salt, healthy, welcoming kitchen, buy groceries that will contribute to your health goals. Buy fresh, local, in-season food if you can afford it. If you have SNAP, or food stamps, see if you can use them at your local farmer's market. You can double the value of your SNAP benefits by spending them at farmers markets.<ref name="rf15">http://www.fns.usda.gov/ebt/learn-about-snap-benefits-farmers-markets</ref> Buy as many one-ingredient items as possible: fruits, vegetables, flour, raw meat.

#*Don't forget to read the label when you buy processed food. Check for labels that read "low sodium" or "sodium free." Compare different products, and buy the ones with the lowest amount of sodium.

#*Foods that read "no salt added" or "unsalted" are not necessarily salt-free.

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== Warnings ==

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*"Hypertensive crisis": Caution, blood pressure of 180/110 or higher, may require emergency, urgent care. Rest and relax for a few minutes and take your blood pressure again. If it is still very high, call 911 for emergency transport to a hospital. You should '''not''' drive or operate dangerous equipment. A hypertensive crisis can lead to a loss of consciousness, stroke, heart attack or kidney damage.<ref>[http://www.webmd.com/hypertension-high-blood-pressure/ss/slideshow-hypertension-overview#5 WebMD.com -- "Hypertensive Crisis," slide 5]</ref>

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*"Hypertensive crisis": Caution, blood pressure of 180/110 or higher, may require emergency, urgent care. Rest and relax for a few minutes and take your blood pressure again. If it is still very high, call 911 for emergency transport to a hospital. You should '''not''' drive or operate dangerous equipment. A hypertensive crisis can lead to a loss of consciousness, stroke, heart attack or kidney damage.<ref name="rf16">[http://www.webmd.com/hypertension-high-blood-pressure/ss/slideshow-hypertension-overview#5 WebMD.com -- "Hypertensive Crisis," slide 5]</ref>

**The personal symptoms of a hypertensive crisis might be unnoticed, or could include any of the following: severe headache, anxiety, nosebleed, and shortness of breath (or no symptoms).

*High blood pressure causes and contributes to severe, killer illnesses:

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Difference between revisions of "Eat to Lower Blood Pressure"

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-High blood pressure (medically known as hypertension) is a serious health problem that can lead to heart attacks, stroke, organ damage, and other illnesses. It is complicated by obesity, but hypertension and obesity can be controlled (and prevented!) through diet, and an active lifestyle with plenty of exercise. By eating the right foods, you can take the first steps toward lower blood pressure and an overall healthier life. To lower your blood pressure, try to eat according to the Dietary Approaches to Stop Hypertension (DASH) diet (similar to a Mediterranean diet). The DASH diet is high in vegetables, fruits, low-fat dairy products, whole grains, essential fats and lean proteins. It is also low in sodium, added-sugars, and unnecessary fats.<ref>http://www.uptodate.com/contents/diet-in-the-treatment-and-prevention-of-hypertension?source=see_link</ref><ref>http://www.mayoclinic.com/health/dash-diet/HI00047</ref> The DASH diet is recommended by many doctors for watching out for cardiovascular health, including when you're taking blood pressure medication.
+High blood pressure (medically known as hypertension) is a serious health problem that can lead to heart attacks, stroke, organ damage, and other illnesses. It is complicated by obesity, but hypertension and obesity can be controlled (and prevented!) through diet, and an active lifestyle with plenty of exercise. By eating the right foods, you can take the first steps toward lower blood pressure and an overall healthier life. To lower your blood pressure, try to eat according to the Dietary Approaches to Stop Hypertension (DASH) diet (similar to a Mediterranean diet). The DASH diet is high in vegetables, fruits, low-fat dairy products, whole grains, essential fats and lean proteins. It is also low in sodium, added-sugars, and unnecessary fats.<ref name="rf1">http://www.uptodate.com/contents/diet-in-the-treatment-and-prevention-of-hypertension?source=see_link</ref><ref name="rf2">http://www.mayoclinic.com/health/dash-diet/HI00047</ref> The DASH diet is recommended by many doctors for watching out for cardiovascular health, including when you're taking blood pressure medication.
 [[Category:Cardiovascular Health and Blood Pressure]]
 == Steps ==
 === Eliminating Unhealthy Foods ===
-#Limit salt intake. Sodium can significantly affect how high your blood pressure is. Salt is the first element of your diet you will need to tackle to lower your blood pressure. Talk to your doctor about the amount of salt you should eat: the human body needs a small amount of salt; so eliminating it entirely can cause health problems.<ref>http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974</ref> Most adults can consume up to 2,300 mg of sodium a day without significant health risks.<ref>http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456</ref>But, many food products have several hundred mg of sodium in one small serving. The total can grow astronomically; so read labels and avoid extra salt.
+#Limit salt intake. Sodium can significantly affect how high your blood pressure is. Salt is the first element of your diet you will need to tackle to lower your blood pressure. Talk to your doctor about the amount of salt you should eat: the human body needs a small amount of salt; so eliminating it entirely can cause health problems.<ref name="rf3">http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974</ref> Most adults can consume up to 2,300 mg of sodium a day without significant health risks.<ref name="rf4">http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456</ref>But, many food products have several hundred mg of sodium in one small serving. The total can grow astronomically; so read labels and avoid extra salt.
 #*If your blood pressure is high, your doctor might recommend you eat 1,500 mg of sodium a day. That's about half a teaspoon of salt.
 #*You might be advised to keep your sodium intake below 1,500 mg if you have been diagnosed with kidney disease or diabetes.
 #*Your doctor might advise you to watch your sodium if you are from a high-risk population. All women over 65 and men over 45 are at an increased risk of high blood pressure. Black men and women are prone to high blood pressure and serious complications.
-#Avoid processed foods. Most of the salt and sugar you consume comes from processed foods, such as soup, chips, bread, many cereals, cakes/donuts — and mackerel/sardines, canned meats, cured meats as well as lunch meats, plus pork that has "water added". Prepared frozen foods, restaurant or any other meal you can buy "to go" is likely to be packed with sodium. North Americans eat almost twice as much salt as they should, and ¾ of that salt comes from processed  foods.<ref>http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Processed-Foods-Where-is-all-that-salt-coming-from_UCM_426950_Article.jsp</ref> Foods that do not appear salty are still high sodium if they have been processed and are not marked "low sodium."
+#Avoid processed foods. Most of the salt and sugar you consume comes from processed foods, such as soup, chips, bread, many cereals, cakes/donuts — and mackerel/sardines, canned meats, cured meats as well as lunch meats, plus pork that has "water added". Prepared frozen foods, restaurant or any other meal you can buy "to go" is likely to be packed with sodium. North Americans eat almost twice as much salt as they should, and ¾ of that salt comes from processed  foods.<ref name="rf5">http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Processed-Foods-Where-is-all-that-salt-coming-from_UCM_426950_Article.jsp</ref> Foods that do not appear salty are still high sodium if they have been processed and are not marked "low sodium."
 #*Cooking fresh food from unprocessed ingredients is the biggest step toward cutting salt from your diet.
 #Cut out sweets or eat five or fewer lowered sugar sweets a week. 100% unsweetened cocoa powder stirred into natural peanut butter or sprinkled over fruit with stevia makes a great snack. Eating fewer sweets is a question of lowering your sugar craving. Limited sugar will provide you with special treats and fewer health problems, as you eat it sparingly. Gradually lower sweetness of treats. Try out desserts that are sweetened with fruit, applesauce or fruit juice. Make a [[Make a Fruit and Yogurt Smoothie|smoothie]], juice, or [[Make Mango and Yogurt Drink (Mango Lassi)|mango lassi]] for a dessert. Lowering sugar in fruit ices, sorbets, and lemonade creates a healthier option.
-#*Cocoa has antioxidant flavanols that you can take advantage of by eating a small amount (up to 1 ounce [28 grams]) per day of dark chocolate. It reduces cell damage, helps lower blood pressure and improves vascular function.<ref>[http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/healthy-chocolate/faq-20058044 MayoClinic.org Healthy Lifestyle, Nutrition and Healthy Eating: "Healthy Chocolate"]</ref>.
+#*Cocoa has antioxidant flavanols that you can take advantage of by eating a small amount (up to 1 ounce [28 grams]) per day of dark chocolate. It reduces cell damage, helps lower blood pressure and improves vascular function.<ref name="rf6">[http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/healthy-chocolate/faq-20058044 MayoClinic.org Healthy Lifestyle, Nutrition and Healthy Eating: "Healthy Chocolate"]</ref>.
-#*Baked or poached fruit can be an elegant dessert for company. Poach pears or other seasonal fruit in juice, and serve with a dollop of yogurt<ref>http://www.dictionary.com/browse/yogurt</ref> or a garnish of fresh fruit and citrus zest (shredded peelings).
+#*Baked or poached fruit can be an elegant dessert for company. Poach pears or other seasonal fruit in juice, and serve with a dollop of yogurt<ref name="rf7">http://www.dictionary.com/browse/yogurt</ref> or a garnish of fresh fruit and citrus zest (shredded peelings).
 #*Baking low sugar/low salt granola bars and nutty cookies at home can provide you with healthy sweet snacks throughout the week.
 #*Use applesauce in place of shortening in cookies and loaf cake.
 #*Use plain or unsweetened flavored protein powder in place of flour in biscuits, waffles and pancakes, plain for thickening sauce or chili-con-carne.
-#*Cut down on sugary drinks of all kinds (try stevia or stevia blends; it's an acquired taste so be patient). If you have a sweet drink, such as a soda (even sugar-free), it still counts toward your five or fewer sweets. Try to cut carbonated sodas/pops and sugary fruit drinks out of your diet entirely: it is probably the top source of added sugar in your diet.<ref>http://blog.heart.org/soda-debate-bubbling-across-the-country/</ref>
+#*Cut down on sugary drinks of all kinds (try stevia or stevia blends; it's an acquired taste so be patient). If you have a sweet drink, such as a soda (even sugar-free), it still counts toward your five or fewer sweets. Try to cut carbonated sodas/pops and sugary fruit drinks out of your diet entirely: it is probably the top source of added sugar in your diet.<ref name="rf8">http://blog.heart.org/soda-debate-bubbling-across-the-country/</ref>
 === The DASH Diet ===
-#Eat six to eight servings of whole grains per week. Eat whole grains rather than refined grains. Whole grains have more of the nutrients and fiber you need.<ref>http://www.mayoclinic.com/health/dash-diet/HI00047</ref> They also tend to be more flavorful than refined grains, which you will appreciate as you start limiting your salt intake. Substitute brown rice (it must be cooked slowly) for white rice, whole-wheat pasta for regular pasta, and whole-grain bread for white bread.
+#Eat six to eight servings of whole grains per week. Eat whole grains rather than refined grains. Whole grains have more of the nutrients and fiber you need.<ref name="rf2" /> They also tend to be more flavorful than refined grains, which you will appreciate as you start limiting your salt intake. Substitute brown rice (it must be cooked slowly) for white rice, whole-wheat pasta for regular pasta, and whole-grain bread for white bread.
 #*Experiment with a variety of grains. Eliminate white flour. Use quinoa, bulgur, oats, amaranth, and barley, all good sources of whole grains.
 #Eat four to five servings of vegetables a day. Vegetables provide you with the vitamins you need to lower your blood pressure, as well as valuable dietary fiber, and minerals such as potassium and magnesium. To increase the amount of vegetables in your diet, incorporate them into your main dish instead of only eating them on the side. Hearty, flavorful vegetables such as sweet potato (with low added sugar) and squash (sliced and sautéed, mashed) provide an excellent main dish. Don't be afraid to buy large amounts of vegetables at once: you can freeze the ones you don't use.
@@ Line 27: / Line 27: @@
 #*Eat the skins of fruits and veggies. Much of the flavor and the nutrients of vegetables are found in the skin. Just make sure you clean them thoroughly.
 #*Save the stalks. Freeze any part of the vegetable you don't eat in a bag. When the bag is full, boil it with onion and garlic for a few hours to make a [[Make Vegetable Stock|vegetable stock]]. Strain out the vegetables, add a tiny pinch of salt and some lemon juice or vinegar, and use it as a broth.
-#Eat four to five small servings of fruit. Fruit is mouthwatering, delicious and is full of vitamins, minerals, and antioxidants. Fruit can be a snack, a dessert, and can also be treated like a vegetable and served with green salad, fried, or cooked into a sauce. Low-fat yogurt<ref>https://en.wikipedia.org/wiki/Yogurt</ref> with fruit and some nuts makes an excellent breakfast. Try eating fruits in season, when they are sweetest, or buy them frozen for smoothies and cooking.
+#Eat four to five small servings of fruit. Fruit is mouthwatering, delicious and is full of vitamins, minerals, and antioxidants. Fruit can be a snack, a dessert, and can also be treated like a vegetable and served with green salad, fried, or cooked into a sauce. Low-fat yogurt<ref name="rf9">https://en.wikipedia.org/wiki/Yogurt</ref> with fruit and some nuts makes an excellent breakfast. Try eating fruits in season, when they are sweetest, or buy them frozen for smoothies and cooking.
 #*Eat the fruit peel for extra fiber and roughage. Apples, pears, plums, and even fuzzy peaches can be eaten with the peel on.
 #*Like vegetables, fruits can be frozen when they are overripe and enjoyed later.
 #*Juice can count as a serving of fruit. Buy 100 percent fruit juice with no sugar added.
 #*Grapefruit juice and other citrus juices can interfere with certain medications, so be sure to check with your health care provider before increasing consumption.
-#Eat six or fewer servings of lean protein per week. Meat gives you protein, vitamins, and minerals. Opt for poultry and fish over beef. Fish such as salmon, herring, and tuna are high in omega-3 fatty acids (and consider taking a purified/concentrated omega-3 oil capsule high in DHA and EHA), and can help lower your cholesterol. Broil, bake, grill, poach, or roast your meat instead of frying it. Avoid sandwich meats and sausages unless they are marked "low sodium" or "no sodium." Some servings of sandwich meat contain more than a quarter of your daily recommended sodium.<ref>http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Meat-Poultry-and-Fish_UCM_306002_Article.jsp</ref>
+#Eat six or fewer servings of lean protein per week. Meat gives you protein, vitamins, and minerals. Opt for poultry and fish over beef. Fish such as salmon, herring, and tuna are high in omega-3 fatty acids (and consider taking a purified/concentrated omega-3 oil capsule high in DHA and EHA), and can help lower your cholesterol. Broil, bake, grill, poach, or roast your meat instead of frying it. Avoid sandwich meats and sausages unless they are marked "low sodium" or "no sodium." Some servings of sandwich meat contain more than a quarter of your daily recommended sodium.<ref name="rf10">http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Meat-Poultry-and-Fish_UCM_306002_Article.jsp</ref>
 #*The meat you buy should be marked "lean" or "extra lean," and poultry should be skinless.
 #*Vegetarians can follow the DASH diet by combining the "meat" and "nuts, seeds, and legumes" categories, and eating that many servings of nuts, seeds and legumes.
 #*Even if you aren't a vegetarian, try substituting soybean-based products, such as tofu and tempeh, for meat dishes. They contain all the amino acids you need to form a complete protein.
-#Eat two to three small servings of dairy. Milk, plain yogurt, and real cheese can give you calcium, vitamin D, and protein. They can also be high-sodium and high-fat, so don't eat too much of them. Yoghurt is not high sodium, can be bought fat-free, and contains probiotics that are good for your digestion. Buy plain yogurt with no added sugar and add fruit. Yoghurt is good on its own and can also be substituted for cream/sour cream.<ref>http://www.healthyeating.org/Milk-Dairy/Nutrients-in-Milk-Cheese-Yogurt/Yogurt-Nutrition.aspx</ref>
+#Eat two to three small servings of dairy. Milk, plain yogurt, and real cheese can give you calcium, vitamin D, and protein. They can also be high-sodium and high-fat, so don't eat too much of them. Yoghurt is not high sodium, can be bought fat-free, and contains probiotics that are good for your digestion. Buy plain yogurt with no added sugar and add fruit. Yoghurt is good on its own and can also be substituted for cream/sour cream.<ref name="rf11">http://www.healthyeating.org/Milk-Dairy/Nutrients-in-Milk-Cheese-Yogurt/Yogurt-Nutrition.aspx</ref>
 #*Put yogurt on your tacos or chili instead of sour cream.
 #*Stir some yogurt into your soup for a creamy finish.
@@ Line 44: / Line 44: @@
 #Eat four to six servings of nuts, seeds, and legumes a week. Nuts, seeds, and legumes have omega-3 fatty acids, protein, fiber, minerals and phytochemicals. They can also be high in calories and fats, which is why they are recommended for weekly rather than daily consumption. A serving size might be 1/3 cup of nuts, 1/2 cup of cooked legumes, 2 tablespoons of natural peanut butter or seeds.
 #*Vegetarians should combine this category with the "meats" servings and eat 10 – 16 servings of nuts, seeds, and legumes a week.
-#*Eat tofu, tempeh, or rice and beans to get a complete protein.<ref>http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456</ref>
+#*Eat tofu, tempeh, or rice and beans to get a complete protein.<ref name="rf4" />
 #*Try topping your yogurt with different kinds of nuts and seeds instead of buying a sugary granola. Almonds, walnuts/pecans, peanuts, cashews, and sesame/chia, shelled pumpkin seeds and flax seeds are all delicious snacks.
 #*Experiment with different beans. If you normally eat peas, try kidney beans, black-eyed peas, or lentils.
 #Limit fats and oils to two to three servings a day. Fat is good for your immune system, but it's easy to eat too much of it. A serving of fat is small: 1 tablespoon of mayonnaise or 1 teaspoon of margarine will do it. Avoid over consumption of meat, butter, cheese, whole milk, cream, and eggs. Avoid margarine/oleo, lard, shortenings, and palm and coconut oil. Eliminate trans fat, which used in processed foods for smoothness and flavor, fried foods (such as breaded fish, meat, and donuts) and commercially baked goods.
-#*Read labels to cut down on trans fats.<ref>http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/SimpleCookingwithHeart/Healthy-Cooking-Oils-101_UCM_445179_Article.jsp</ref>
+#*Read labels to cut down on trans fats.<ref name="rf12">http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/SimpleCookingwithHeart/Healthy-Cooking-Oils-101_UCM_445179_Article.jsp</ref>
 #*Cook with olive oil, canola oil, vegetable oil, sesame oil, and peanut oil. Olive oil and toasted sesame oil are both excellent in salad dressing. Stir oil and vinegar (apple cider vinegar, wine vinegar, lemon juice) for quick, cheap salad dressing. Add a pinch of black pepper, garlic, paprika or stevia for extra flavor.
 === Tracking Your Food ===
-#Adjust your serving size. Servings can be difficult to calculate, and vary wildly depending on the product. A piece of toast might be one serving of grains, but a bowl of cereal could be easily double the recommended serving size. To calculate servings, find food you use frequently and measure out your typical serving size. Then calculate how many servings it actually is. From there, you can adjust your daily intake.<ref>http://www.consumerreports.org/cro/news/2014/12/cereal-portion-control-matters/index.htm</ref>
+#Adjust your serving size. Servings can be difficult to calculate, and vary wildly depending on the product. A piece of toast might be one serving of grains, but a bowl of cereal could be easily double the recommended serving size. To calculate servings, find food you use frequently and measure out your typical serving size. Then calculate how many servings it actually is. From there, you can adjust your daily intake.<ref name="rf13">http://www.consumerreports.org/cro/news/2014/12/cereal-portion-control-matters/index.htm</ref>
-#*If you find you are over-serving, consider buying smaller dishes. You are far likelier to overestimate how much food you need if you are serving into large dishes.<ref>http://www.consumerreports.org/cro/news/2014/12/cereal-portion-control-matters/index.htm</ref>
+#*If you find you are over-serving, consider buying smaller dishes. You are far likelier to overestimate how much food you need if you are serving into large dishes.<ref name="rf13" />
 #*Consider investing in a small kitchen scale, which will allow you measure by weight rather than volume. This is especially helpful for determining servings of cereal and pasta.
 #[[Keep a Food Diary|Keep a diary of everything you eat]]. By recording all the food you consume, you will be able to easily evaluate the problem areas in your diet. Tracking what you eat will also help you shop smarter at the grocery store and be pickier when eating out at restaurants. Set a goal for yourself and follow it with your diary. Your doctor may also be interested in reviewing your consumption when you visit.
 #*Take a picture of your meal with your cell phone to use it to write down what you ate, later.
-#*Tracking your consumption is not necessary for some people. If you have not been advised to watch your blood pressure, lose weight, or track your food, talk to a doctor or therapist before you begin tracking.<ref>http://www.mayoclinic.org/diseases-conditions/eating-disorders/basics/symptoms/con-20033575</ref>
+#*Tracking your consumption is not necessary for some people. If you have not been advised to watch your blood pressure, lose weight, or track your food, talk to a doctor or therapist before you begin tracking.<ref name="rf14">http://www.mayoclinic.org/diseases-conditions/eating-disorders/basics/symptoms/con-20033575</ref>
 #Cook from scratch. The easiest and cheapest way to eat well is to cook at home. Make time on your days off to cook ahead for busy days. Make foods like rice and beans, soup, and baked vegetables in large batches and store in the fridge. Freeze the leftovers. Label any food you freeze, to ensure you eat it before it loses flavor. Many community centers offer free cooking lessons: see what is available in your area.
 #*Make as many parts of your meal from scratch as you can. For instance, if you are going to make spaghetti, don't buy a canned sauce. Buy tomatoes or canned tomatoes, add onions, and garlic, and make a delicious sauce at home in minutes (let it simmer for best results).
-#Stock up on healthy foods. To build a low-salt, healthy, welcoming kitchen, buy groceries that will contribute to your health goals. Buy fresh, local, in-season food if you can afford it. If you have SNAP, or food stamps, see if you can use them at your local farmer's market. You can double the value of your SNAP benefits by spending them at farmers markets.<ref>http://www.fns.usda.gov/ebt/learn-about-snap-benefits-farmers-markets</ref> Buy as many one-ingredient items as possible: fruits, vegetables, flour, raw meat.
+#Stock up on healthy foods. To build a low-salt, healthy, welcoming kitchen, buy groceries that will contribute to your health goals. Buy fresh, local, in-season food if you can afford it. If you have SNAP, or food stamps, see if you can use them at your local farmer's market. You can double the value of your SNAP benefits by spending them at farmers markets.<ref name="rf15">http://www.fns.usda.gov/ebt/learn-about-snap-benefits-farmers-markets</ref> Buy as many one-ingredient items as possible: fruits, vegetables, flour, raw meat.
 #*Don't forget to read the label when you buy processed food. Check for labels that read "low sodium" or "sodium free." Compare different products, and buy the ones with the lowest amount of sodium.
 #*Foods that read "no salt added" or "unsalted" are not necessarily salt-free.
@@ Line 72: / Line 72: @@
 == Warnings ==
-*"Hypertensive crisis": Caution, blood pressure of 180/110 or higher, may require emergency, urgent care. Rest and relax for a few minutes and take your blood pressure again. If it is still very high, call 911 for emergency transport to a hospital. You should '''not''' drive or operate dangerous equipment. A hypertensive crisis can lead to a loss of consciousness, stroke, heart attack or kidney damage.<ref>[http://www.webmd.com/hypertension-high-blood-pressure/ss/slideshow-hypertension-overview#5 WebMD.com -- "Hypertensive Crisis," slide 5]</ref>
+*"Hypertensive crisis": Caution, blood pressure of 180/110 or higher, may require emergency, urgent care. Rest and relax for a few minutes and take your blood pressure again. If it is still very high, call 911 for emergency transport to a hospital. You should '''not''' drive or operate dangerous equipment. A hypertensive crisis can lead to a loss of consciousness, stroke, heart attack or kidney damage.<ref name="rf16">[http://www.webmd.com/hypertension-high-blood-pressure/ss/slideshow-hypertension-overview#5 WebMD.com -- "Hypertensive Crisis," slide 5]</ref>
 **The personal symptoms of a hypertensive crisis might be unnoticed, or could include any of the following: severe headache, anxiety, nosebleed, and shortness of breath (or no symptoms).
 *High blood pressure causes and contributes to severe, killer illnesses:

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