Hypertension is the most common cardiovascular disease, and it can induce other major diseases, and its harm should not be underestimated.
With the development of mainland society, the incidence of the disease is still increasing, and more and more young people are suffering from the disease. This is also mentioned in the latest "Guidelines for the Prevention and Treatment of Hypertension in China". Mr. Gao was only 27 years old when he was approached by high blood pressure. He is a company employee, and in order to relieve stress, he has also developed a lot of bad habits.
In addition to staying up late, a common problem among young people, he also likes to relieve stress by eating, such as oily and spicy food is his favorite, and these heavy foods are usually high in oil and salt.
His long-term unhealthy diet and irregular work and rest have left him obese and lacking in energy. At the time of the visit, the patient kept frowning and said that he had a terrible headache when he came together this morning.
After inquiry, I learned that his headache lasted for half a month, and he felt dizzy every day when he got up, and he was very dizzy today. Blood pressure detection: 170/100mmHg, BMI: 34Kg/㎡. The patient did not have the habit of regularly measuring blood pressure at home, and considering that his current symptoms were severe and the diagnosis was clear, he was admitted to the hospital for further diagnosis and treatment.
Thyroid ultrasound, renal artery ultrasound, and adrenal ultrasound were completed, and no obvious abnormalities were found, ruling out secondary hypertension. The head CT was improved, and no obvious abnormalities were found, and special types of hypertension such as hypertensive encephalopathy and intracranial hemorrhage were ruled out. Improve ambulatory blood pressure: average blood pressure 160/90mmHg, maximum systolic blood pressure 200mmHg, minimum 130mmHg, maximum diastolic blood pressure 100mmHg, minimum 70mmHg;
Health education: regular work and rest, low-salt and low-fat diet, weight control, amlodipine benazepril twice a day, one tablet at a time, two weeks later. But a week later, the patient came, and it turned out that his blood pressure was back and forth, and it was never controlled below the standard level.
Mr. Gao is also very aggrieved, he takes medicine on time every day, and his diet is properly managed, why can't his blood pressure go down? For example, recently cumin is in season, and he has eaten a lot. The patient wonders, isn't it enough to eat less salt to reduce sodium intake, and what does it have to do with other foods?
Many hypertensive patients, including Mr. Gao, who do not control their blood pressure properly, actually have great misunderstandings in dietary management. They think that to control their blood pressure, they just need to put less salt and eat more vegetables. But in fact, in addition to salt, many vegetables in life are rich in sodium, such as fennel, which has a high sodium content, and eating it will definitely affect blood pressure. In this article, we will learn about the onset of hypertension and its dietary contraindications.
1. Why can't patients with high blood pressure eat sodium-rich foods?
Blood acts on the walls of the arteries to create pressure that causes it to flow forward in the arteries, and this pressure is called blood pressure. If blood pressure increases, patients usually experience dizziness, headache and other uncomfortable symptoms, and as the disease progresses, arteriosclerosis and even visceral lesions occur.
Changes in blood pressure are due to changes in ventricular systolic ejection, circulating blood volume, arterial wall compliance, and peripheral arterial resistance. The mechanism of high sodium causing the disease is not fully understood, but most people believe that sodium retention in the body mainly promotes an increase in vascular tone and cardiac output, resulting in an increase in blood pressure. There are three main mechanisms.
- Mechanism 1: Renin-angiotensin-aldosterone system
High salt (sodium) intake activates epithelial sodium channels, which in turn activates the brain system, aldosterone stimulates endogenous digitalis-like factor production, resulting in sympathetic nerve excitation, and aldosterone can also cause oxidative stress with angiotensin II and increase sympathetic nerve efferent.
Angiotensin and aldosterone play an important role in the development of this disease. This is due to the fact that the former has a strong vasoconstrictor effect, while the latter can lead to sodium and water retention, and the two work together to increase the resistance around the artery, increase the blood volume, and ultimately lead to an increase in blood pressure.
- Mechanism 2: Sympathetic-adrenal medullary system
This system is the conduction pathway of the central nervous system to regulate cardiovascular activity, and the sympathetic nerve is mainly pathogenic through two pathways in the onset of hypertension.
The first pathway is to directly act on the heart and blood vessels, causing the heart rate to increase, myocardial contractility to increase, and cardiac output to increase, causing arteriolar vasoconstriction and peripheral resistance, resulting in an increase in blood pressure.
The second pathway is that nerve excitation triggers the release of large amounts of epinephrine and norepinephrine from the adrenal medulla. The former has a cardiotonic effect, while the latter has a vasopressor constriction effect, and the two work together to increase blood pressure.
- Mechanism 3: Vascular endothelial active substance action
The endothelium of blood vessels produces bioactive substances such as nitric oxide and endothelin, both of which play an important role in the onset of hypertension. Endothelin is a highly vasoconstrictor, active peptide that can cause transient hypotensive and heartbeat increases when administered intravenously, followed by a long-lasting and significant vasopressor effect.
Nitric oxide, on the other hand, has the effect of vasodilating and plays a key role in the regulation of local vascular tension and blood flow homeostasis. The study found that nitric oxide levels in the plasma of patients with essential hypertension decreased. In experiments, long-term administration of nitric oxide synthase inhibitors in rats can cause hypertension.
Many scholars believe that when cell membrane ion transport is defective, high salt intake can also cause abnormal sodium metabolism, and then cause a variety of pathological changes to lead to the occurrence of the disease.
It is now recognized that the onset of hypertension is mainly caused by high sodium (salt) intake, which is the main component of salt. Therefore, whether it is in clinical prevention and treatment, or in the usual health education, the importance of low-salt and low-fat diet is emphasized. The Chinese Guidelines for the Prevention and Treatment of Hypertension recommend that sodium intake should not exceed 5g per day.
However, many patients fall into a misunderstanding, that is, salt control is equal to sodium control, but this is not the case. In daily life, in addition to salt, many drinks and foods are rich in sodium, and even many vegetables are also high in sodium. These greens not only do not lower blood pressure, but can even cause blood pressure to rise.
Second, the doctor bluntly said: These 3 kinds of green vegetables for high blood pressure should be eaten less, and be careful of rising blood pressure
Vegetables are rich in fiber and various nutrients, many of which can even improve blood vessels and water and eliminate sodium. Therefore, in the health education of many diseases, everyone will be encouraged to eat more vegetables. But for patients with high blood pressure, although most of the greens can be eaten, it is better to touch the sodium-rich greens less. There are three main types of sodium-rich greens.
First: fennel
Its sodium content is extremely high, up to 186.3mg/100g. Although it has active ingredients such as fatty oils, amino acids, and flavonoids, it has a high sodium content, and if more salt is added during cooking, it is easy to increase the concentration of sodium ions in the blood plasma and cause high blood pressure.
The second type: chrysanthemum
Its sodium content can reach 161.3mg/100g. Today's chrysanthemum is also in season, and its tender taste has won the love of many people. There are also many people who like to eat chrysanthemum salad, and in order to make it more delicious, more salt will be added during the production process. But for people with high blood pressure who like to eat chrysanthemum, this practice can easily lead to excessive sodium intake.
In addition, excessive consumption of chrysanthemum can also cause gastrointestinal burden, indigestion, and diarrhea. In the long run, it may even increase the risk of stomach diseases. Therefore, patients with high blood pressure should eat as little as possible, and put less salt in the preparation.
The third type: Cabbage
Also known as kraft cabbage, it is a type of sugar beet, and its sodium content is 260mg/100g. In addition to an overdose that can lead to an increase in plasma sodium concentration, it also contains a lot of sugar and oxalic acid. Excessive intake of the former can lead to an increase in total cholesterol levels in the blood plasma, increasing the risk of atherosclerosis, narrowing of blood vessels, and even ruptured bleeding.
Oxalic acid, on the other hand, is easy to cause damage to kidney function, because on the one hand, it will cause an increase in blood uric acid, and on the other hand, it is easy to combine with calcium to form stones after entering the human body, which are deposited or embedded in the urinary system. If kidney function is impaired, it is easy to induce exacerbation of hypertension.
The specific mechanism by which the above three types of vegetables raise blood pressure is different. In addition to these 3 kinds of vegetables, are there any other foods in life that we don't know about with high sodium content?
3. What are the other "inconspicuous" sodium-rich foods in life?
Electrolyte water
In supermarkets, common electrolyte water is mainly sodium-rich mineral water and sports drinks. Mineral water is taken from underground mines, which are usually rich in trace elements, gases, etc., which can meet the needs of the population for trace elements.
When people are exerted by a lot of exercise and physical labor, they excrete a lot of sweat, which contains water and electrolytes. Sodium-rich mineral water and sports drinks are products launched to replenish the water and electrolytes lost by the human body, so there is more sodium in them.
Some mineral waters have a high sodium content, even up to 200mg, and are not suitable for people with high blood pressure. Sports drinks are rich in electrolytes but also contain sugar, which can also cause an increase in blood pressure and damage the health of blood vessels.
Bread
It's a very common carbohydrate that is high in sugar, but people wouldn't expect it to be high in sodium.
This is because yeast and salt are usually used in the bread making process, and every 6 g of yeast contains 216 mg of sodium. Yeast is used to make it fluffy, and salt is chewy and tough. And the raw material used to make bread, whole wheat flour itself is rich in sodium.
In fact, common sweet foods such as salad dressings, ketchup, and yoghurt are relatively high in sodium. It is difficult for us to find these sodium-rich foods in life, because the threshold of saltiness in the human body itself is low, only 0.05%, theoretically, every 100 grams of food contains 50mg of sodium, which can be perceived by the taste buds, but these salty tastes are often easily covered by other ingredients in the food, so it is usually difficult to detect.
As the most common cardiovascular disease, the onset of hypertension is closely related to lifestyle habits. In the occurrence and development of hypertension, salt is inextricably related to it, so limiting salt and sodium is a big step to defeat hypertension.
Mr. Gao in the article suffered from high blood pressure due to improper diet, work and rest for a long time, coupled with the influence of genetic factors, and his condition was more serious. The lack of awareness of health management and detailed dietary guidance has led to the disease not being well controlled. In daily life, patients with high blood pressure must strictly control sodium intake, accurately avoid sodium-rich foods, and protect their vascular health.
Bibliography:
[1] Sun Ningling. Beijing:People's Medical Publishing House,2009:280-286.
Chinese Guidelines for the Prevention and Treatment of Hypertension (2018 Revised Edition).Chinese Journal of Cardiology,2019,24(1):24-56.
Experimental study on the pathogenesis of hypertension caused by long-term intake of high-sodium diet•Chinese Journal of Pathophysiology,2001,17(2):143-146.
[4] Fu Qifeng, Zhang Yanli, Xu Shujun, et al., Research Progress on Chemical Composition and Pharmacological Effects of Cumin[J], Traditional Chinese Medicine Information, 2008, 25(5):24-26.