Nutritional factors in the control of blood pressure and hypertension.

Differing hypertension prevalence rates between certain population and age groups are partially due to differences in the intake of certain nutrients. Blood pressure is positively associated with higher sodium, alcohol, and protein intakes; it is inversely associated with potassium, calcium, and magnesium intakes. Salt may lead to an increase in blood pressure in the presence of salt sensitivity, but there is no inexpensive or easy strategy to identify salt-sensitive patients. Other risk factors for hypertension include obesity and lack of regular physical activity. The best strategy appears to be moderate salt restriction (6-7 g/day) in combination with an optimal compliance of the antihypertensive drug therapy, as well as adoption of the combination diet of the DASH study--a diet rich in fruits and vegetables, and thus rich in potassium. Current evidence does not support the increased intake of Ca2+ or Mg2+ for blood-pressure-lowering purposes only; however, calcium and magnesium may represent important components in the combination diet of the DASH study. It seems that it is the combination of these nutrients that is of crucial importance for the achievement of optimal blood-pressure reduction. Also recommended is a decrease in alcohol consumption and an increase in regular physical activity. Instead of a severe intervention with regard to 1 risk factor alone, positive changes in 5 habits combined--high salt intake, high sodium-to-potassium ratio, alcohol intake, calorie imbalance, and a sedentary life--may be the most realistic and effective strategy to counteract the present hypertension epidemic.