Vegan Diets and High Blood Pressure

High blood pressure, commonly known as hypertension, is a widespread concern. Many dietary patterns are associated with lowering blood pressure, including the DASH diet and plant-based diets.

This article reviews why high blood pressure is a concern, and whether vegan diets could help prevent high blood pressure.

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What is High Blood Pressure?

The heart pumps blood throughout the body via arteries, which carry blood away from the heart, and veins, which return blood to the heart. The pressure within these blood vessels is called blood pressure.

Blood pressure fluctuates depending on the volume of blood in the body, the width of arteries or veins, and other factors. Smaller or narrower arteries, or those that don’t stretch well, leads to increased pressure because it’s harder for blood to pass through.

There are cutoffs for blood pressure measurements, above which a doctor could diagnose high blood pressure ¹.

High blood pressure is known as a “silent killer” because many people don’t experience signs or symptoms to indicate and issue. Even without symptoms, high blood pressure can cause harm ¹.

Why is High Blood Pressure a Problem?

High blood pressure is a concern because it can damage arteries, the heart, and kidneys. The following is a simplified overview of how this damage occurs.

High Blood Pressure Damages Arteries

Over time, high blood pressure damages arteries. The body attempts to repair this damage in a similar way to how it heals a cut, with a scab.

However, scabs within the artery wall can grow, narrowing the artery over time. This increases blood pressure further, due to the reduced width for blood to flow through.

This process, known as atherosclerosis, can eventually lead to heart attacks and strokes ².

High Blood Pressure Damages the Heart

High blood pressure also harms the heart. When blood pressure is high, the heart must pump harder to move blood around.

Over time, this can lead to enlargement of the heart, which can further limit the heart’s ability to pump blood. Eventually, this type of heart damage can lead to a diagnosis of heart failure ².

Other Complications due to High Blood Pressure

Having high blood pressure can also damage the kidneys. These organs have very delicate blood vessels that are highly susceptible to damage from high pressure ².

Overall, high blood pressure has many unpleasant consequences and can lead to fatal outcomes if left uncontrolled ¹.

Can Diet Decrease the Risk of High Blood Pressure?

The DASH diet, short for “Dietary Approaches to Stop Hypertension,” is a well-established diet protocol for blood pressure management ³^,⁴.

The DASH diet emphasizes daily consumption of vegetables, fruits, grains, low-fat dairy, lean meats, nuts and seeds. It also encourages consuming plant-based proteins, and unsaturated fats. Research supports its effectiveness in reducing blood pressure and this diet may have additional health benefits ³^,⁴^,⁵.

Research also shows that plant-based diets, centered on whole foods, can help prevent and manage high blood pressure ⁶^,⁷^,⁸. Furthermore, research supports that vegetarians tend to have lower blood pressure compared to omnivores ⁹.

It seems that diet can definitely impact blood pressure and certain dietary changes, like a DASH diet or plant-based diet, may lower blood pressure ¹⁰.

Always speak with your doctor before making diet or lifestyle changes.

DASH Diet vs Vegan Diet to Manage High Blood Pressure

There is a lot of overlap between the DASH diet and a whole foods vegan diet. Both diets emphasize intake of vegetables, fruits, nuts, seeds and whole grains, and these foods are generally associated with lowered blood pressure.

While the DASH diet suggests consuming legumes 4-5 times per week, a plant-based diet typically includes legumes daily. Research shows that legumes, including beans, peas, chickpeas, and lentils, are beneficial for lowering blood pressure ¹¹.

A plant-based diet generally excludes meat and fish, which are associated with an increased risk of high blood pressure, although high-quality research is limited ¹². Fish intake is not typically linked to high blood pressure, although some studies suggest a weak association ¹³.

Overall, reducing meat consumption appears to benefit high blood pressure, especially considering the evidence supporting a lower prevalence of high blood pressure among vegetarians and vegans ⁷^{, 9,}¹².

One study found people on a high-diary, high vegetable and fruit diet, compared to those on just a high vegetable and fruit diet with low-dairy, had similar reductions in blood pressure ¹⁴. This suggests increasing fruit and vegetable intake was beneficial even without consuming dairy products, which are emphasized on the DASH diet but avoided on a plant-based diet.

More research studies on fully plant-based diets vs the DASH diet are needed, but current research suggests both approaches are beneficial for blood pressure management.

The Dairy Debate: Is Dairy Good or Bad for Blood Pressure?

Several studies suggest that consuming dairy, particularly low-fat dairy, is beneficial for blood pressure, and dairy consumption is a key component of the DASH diet ³^, ¹²^, ¹⁵. However, a closer look at the research suggests that this benefit may stem from nutrients in dairy such as calcium, potassium and magnesium ¹⁵^,¹⁶^,¹⁷.

Consuming adequate amounts of these nutrients has been found to lower blood pressure and adequate calcium intake seems particularly important ¹⁶^,¹⁷. Dairy provides large amounts of calcium, and this could help explain why dairy consumption lowers blood pressure.

Given that research shows plant-based diets, including vegan diets, are beneficial for blood pressure, consuming dairy shouldn’t be necessary to lower blood pressure ⁶^,⁷^,¹⁶. For those who avoid dairy for ethical reasons (vegans), a balanced diet that focuses on whole foods and adequate calcium, is likely sufficient.

Plant-based diets are typically high in potassium and magnesium, so those additional nutrients aren’t a huge focus. On the other hand, calcium intake is often significantly lower on a plant-based or vegan diet, and getting adequate intake is challenging.

Salt Intake and High Blood Pressure

A significant amount of research suggests salt/sodium intake affects blood pressure, with blood pressure rising or falling in response to changes in salt intake ¹⁸.

For decades, population health initiatives have advocated for reducing sodium intake. Current guidelines typically recommend adults consume less than 2300 mg of sodium per day ¹⁹.

However, current worldwide average sodium intake levels are estimated about almost double the recommendation, at about 4300 mg per day ¹⁹.

There are many limitations with the research on sodium intake and blood pressure including: ²⁰

Most studies are short-term
Research on low (2300 mg per day) vs. moderate (3000 – 5000 mg per day) sodium intake levels is lacking
Most research compares highest vs. lowest sodium intake levels
Dietary quality of high vs. low sodium intakes can vary significantly

After factoring in limitations, newer reports suggest that, based on the best current evidence, a moderate sodium intake levels of 3000 – 5000 mg per day is reasonable for adults ^{20, 21}.

Sodium Intake Research

Based on the newest reports, current findings suggest: ^{20, 21}

Achieving a population-wide sodium reduction to below 2300 mg per day is unlikely to occur, even with intensive counselling.
Numerous studies from around the world have reported increased mortality associated with low sodium intakes (intakes below 3000 mg per day).
When analyzing the overall data, a J-shaped relationship between sodium intake and cardiovascular disease is observed, with lowest risk associated with a moderate sodium intake of 3000-5000 mg per day. This contradicts previous assumptions of a linear relationship where lower intakes were always associated with lower risk of cardiovascular events or mortality.
Higher potassium intakes and generally higher-quality diets can mitigate the association between sodium intake and cardiovascular events. Therefore, a focus on higher-quality diets, including adequate potassium intake, is likely a more effective target for population health initiatives.
Only about 50-60% of the population is salt sensitive, meaning blood pressure in about half the population doesn’t respond to changes in salt intake.

Until large clinical trials with long-term follow-up are available, it seems there are many limitations to current guidelines on reducing salt intake.

I typically prefer an approach to nutrition that focuses on what we can add to our diets and meals, rather than focusing on avoiding or limiting foods. With this approach, focusing on including more vegetables, fruits, whole grains, legumes, nuts and seeds, as well as consuming adequate calcium and potassium, might be a good approach for reducing the risk of high blood pressure.

Other Lifestyle Changes to Prevent High Blood Pressure

While this article focuses on dietary changes related to blood pressure, various other lifestyle changes are associated with blood pressure.

Consider factors such as smoking, stress levels, alcohol intake, and physical activity when exploring ways to prevent or manage high blood pressure and decrease risk of cardiovascular disease in general ¹.

Summary: Vegan Diets to Prevent High Blood Pressure

High blood pressure is often considered a “silent killer” as many people don’t experience symptoms even if high blood pressure is causing harm to the body.

There are many dietary factors associated with reducing blood pressure. The DASH diet as well as a plant-based diet both include beneficial blood pressure lowering components including legumes, vegetables, fruits, nuts, seeds and grains.

Calcium, potassium and magnesium are also important for blood pressure, so ensuring adequate intake is likely a good goal. Potassium and magnesium are typically easy to consume on a vegan diet whereas calcium is more challenging.

Speak with your doctor before making any changes to your diet.

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