High blood pressure (hypertension)
A chronic rise in the pressure of blood in the arteries (140/90 mmHg or more in the clinic), a major risk factor for stroke, heart attack and kidney failure, often without symptoms.
Blood pressure is expressed as two numbers: the systolic (pressure when the heart contracts) over the diastolic (pressure between two beats). High blood pressure is diagnosed from 140/90 mmHg in the clinic (135/85 with home monitoring).
It is nicknamed the “silent killer” because it is generally symptomless: you can have dangerous blood pressure and feel nothing for years while it damages your arteries, heart, kidneys, brain and eyes.
An original angle (beyond salt): the “less salt” lever is real but partial and overstated for many people. Several factors count as much or more:
- The sodium/potassium ratio: increasing potassium (vegetables, fruit, pulses) is often more effective than just cutting sodium
- Weight: losing a few kilos lowers blood pressure significantly
- Physical activity: regular exercise makes arteries more supple
- Alcohol and chronic stress
- Sleep: sleep apnoea is a frequent and underdiagnosed cause of resistant high blood pressure
The DASH diet (rich in fruit, vegetables and low-fat dairy, low in sodium) has been shown to lower blood pressure by amounts comparable to some medications.
A caveat: “salt sensitivity” varies; some people see their blood pressure fall when they cut sodium, others barely. Hence individual responses, and the value of home monitoring to see what works for you.