High blood pressure is the single biggest modifiable risk factor for poor health in developed countries such as the UK, raising the risk of heart attacks, strokes and a range of other conditions – yet as many as five million adults may be living with it undiagnosed. The only way to know is to have it measured, which is why the British Heart Foundation (BHF) is using May Measurement Month to urge everyone to get checked. Checks are available at GP surgeries, many pharmacies, and some workplaces; the NHS in England has distributed more than 220,000 home monitors to support self-testing. For healthy adults aged 40 to 74, regular checks are recommended, and normal blood pressure is generally considered below 135/85 mmHg when measured at home or below 140/90 mmHg in a clinical setting.
Eight steps to lower blood pressure – and the science behind them
The BHF has released a checklist of eight steps to lower blood pressure, some of which go beyond the usual advice. Most people know that losing weight, cutting down on salt, moderating alcohol and regular exercise help. But the charity’s report also highlights three less familiar areas: the role of potassium, the benefits of dairy, and the power of nitrate-rich foods such as beetroot.
“When you have too much salt in your blood, your body tries to dilute it,” said Dell Stanford, a BHF dietitian. That extra fluid volume raises pressure. Potassium helps counter this by prompting the kidneys to excrete sodium. Foods rich in potassium include bananas, avocados, leafy greens, beef, chicken, oily fish, dairy products, and a wide range of fruits, vegetables, nuts and starchy carbohydrates such as jacket potatoes. The recommended daily intake for adults in the UK is around 3,500 mg (3.5 g). However, the BHF warns against taking potassium tablets unless medically advised – too much can disturb the heart rhythm. Professor Bryan Williams, chair of medicine at University College London, said: “Too much can be harmful.” People with kidney problems are also advised to avoid potassium-based salt substitutes.
Dairy has often been seen as less heart-healthy because of its saturated fat content, but the BHF says it should be included for its blood pressure benefits. Calcium helps lower pressure, possibly by boosting sodium excretion and relaxing blood vessels. Beyond calcium, milk contains dairy peptides that relax blood vessels by blocking production of the hormone angiotensin II – the same mechanism used by ACE inhibitor drugs. “Dairy foods are unique in that you’ve got all of these things going on,” Stanford said. The charity recommends choosing lower-fat options such as semi-skimmed or skimmed milk to avoid the saturated fat that can raise cholesterol and increase heart attack risk.
Beetroot is singled out as a particularly good source of nitrates, which the body converts into nitric oxide – a compound that relaxes and widens blood vessels. (This is the same hormone boosted by the erectile dysfunction drug Viagra.) Other nitrate-rich foods include spinach, kale, celery, strawberries and bananas. “As soon as you’ve got open arteries, the blood pressure will drop,” Stanford said. Studies show that beetroot juice can lower systolic pressure by around 4–5 mmHg, with the effect peaking two to three hours after consumption. The BHF notes that antibacterial mouthwash can reduce this effect because oral bacteria are needed for the conversion of nitrates. Older adults may experience a greater drop due to changes in their oral microbiome. Beetroot juice is not a replacement for prescribed medication.
Weight loss jabs show blood pressure benefits
Beyond lifestyle changes, research presented at the European Congress on Obesity suggests that weight loss injections known as GLP-1 receptor agonists can reduce blood pressure as effectively as starting a specific blood pressure drug. A meta-analysis of 32 large-scale trials, led by Dr Marcel Muskiet at Leiden University Medical Center in The Netherlands, found that people taking the jabs experienced an average reduction in systolic blood pressure of about 5 mmHg. Only about three-quarters of that drop could be attributed to weight loss, indicating the drugs have a direct biological effect on blood pressure. “These findings support a meaningful role for [weight loss injections] in blood pressure management in overweight and obesity,” the researchers said.
Full checklist from the British Heart Foundation
The BHF’s eight steps to blood pressure control are:
Check your blood pressure, regular exercise, five portions of fruit and veg daily, include dairy in your diet, cut down on salt, moderate your drinking, manage weight, and take medicines as prescribed.
In a separate development, a recent investigation found that over 200 plant-based meat substitutes sold in British supermarkets contained mycotoxins – mould toxins typically found in tropical and subtropical regions. While levels were generally below EU guidelines, the widespread “co-occurrence” of multiple mycotoxins in 100% of samples tested raised concerns about cumulative exposure and potential long-term health risks including liver and kidney damage, immune suppression, and cancer. Researchers have called for more established regulations to monitor mycotoxins in these products.