What foods and drinks can help lower blood pressure in adults with hypertension or at risk of developing hypertension?

Foods and Drinks That Lower Blood Pressure

Adults with hypertension or at risk should prioritize the DASH diet (rich in fruits, vegetables, and low-fat dairy), reduce sodium to <5g daily, increase potassium intake to 3500-5000mg daily through food, and limit alcohol—these dietary changes can reduce systolic blood pressure by 5-11 mm Hg. 1, 2

Primary Dietary Interventions (Strongest Evidence)

The DASH Diet Pattern

The DASH diet produces the most substantial blood pressure reduction of any dietary intervention, lowering systolic BP by approximately 11 mm Hg in hypertensive adults and 3 mm Hg in normotensive adults. 1, 2 This effect is particularly pronounced in Black Americans. 1

Specific DASH diet components include:

• 5-9 servings of fruits and vegetables daily 1
• 2-4 servings of low-fat dairy products daily 1
• Whole grains, poultry, fish, and nuts 1
• Reduced red meat, sweets, and sugar-containing beverages 1

The diet naturally provides high levels of potassium, magnesium, calcium, and fiber without requiring individual nutrient counting. 1

Sodium Reduction

Limit sodium intake to less than 5g daily (approximately 2g of elemental sodium), which produces a 5-6 mm Hg reduction in systolic BP in hypertensive individuals and 2-3 mm Hg in normotensive individuals. 1, 2

Practical sodium reduction strategies:

• Avoid adding salt during cooking and at the table 1
• Eliminate high-salt processed foods including soy sauce, fast foods, processed breads and cereals 1
• Recognize that 75% of dietary sodium comes from processed foods and restaurant meals, not home salt shakers 1

The effect is dose-dependent—even modest reductions of 1000mg daily provide benefit. 1, 2

Potassium-Rich Foods

Consume 3500-5000mg of potassium daily through dietary sources, which reduces systolic BP by 4-5 mm Hg. 1, 2

Best food sources of potassium include:

• Fruits and vegetables (4-5 servings provide 1500-3000mg) 1
• Low-fat dairy products 1
• Beans and legumes 1, 3
• Selected fish and meats 1
• Nuts, seeds, and soy products 1
• Avocados and tofu 1

Critical contraindication: Do not increase potassium if you have advanced chronic kidney disease or take medications that reduce potassium excretion (ACE inhibitors, ARBs, potassium-sparing diuretics). 1, 2

Potassium-Enriched Salt Substitutes

Consider potassium-enriched salt substitutes as an alternative to regular salt, which provides dual benefit by reducing sodium while increasing potassium intake. 1 The WHO 2023 Global Report on Hypertension identifies this as an affordable strategy, with trials showing 40% reduction in cardiovascular events. 1

Alcohol Limitation

Limit alcohol to maximum 2 standard drinks daily for men and 1 for women, which reduces systolic BP by approximately 4 mm Hg. 1, 2 Heavy alcohol intake (≥3 drinks daily) is consistently associated with elevated blood pressure. 1

Additional Beneficial Foods and Nutrients

Calcium and Magnesium Sources

Foods high in calcium and magnesium provide additional BP-lowering benefit, though the effect is smaller than potassium. 1, 4

Key sources include:

• Dark green leafy vegetables (magnesium) 3
• Low-fat dairy products (calcium) 1, 3
• Beans and legumes (both minerals) 3

Other Dietary Patterns with Evidence

Alternative effective dietary patterns include:

• Mediterranean diet (substantial BP reduction) 1, 5
• Vegetarian and vegan diets (lower hypertension prevalence than omnivores) 1, 5
• Low-carbohydrate and high-protein diets (demonstrated BP lowering) 1

Combining Interventions for Maximum Effect

The combination of dietary interventions produces substantially greater BP reduction than any single intervention. 2 For example:

• DASH diet plus sodium reduction produces larger reductions than either alone 1
• Weight loss combined with sodium reduction nearly doubles the BP-lowering effect 1
• Multiple lifestyle modifications together produce approximately 4 mm Hg net reduction compared to usual care 2

Clinical Application Algorithm

For Stage 1 Hypertension (130-139/80-89 mm Hg):

• Begin with DASH diet, sodium reduction to <5g daily, and potassium increase to 3500-5000mg daily 2
• Add weight loss if overweight (1 mm Hg reduction per kg lost) 2
• These interventions may prevent need for medications 2

For Stage 2 Hypertension (≥140/90 mm Hg):

• Implement all dietary interventions immediately 2
• Recognize that pharmacological therapy will generally be required in addition to diet 2
• Dietary changes can facilitate medication dose reduction over time 2

Important Warnings and Pitfalls

Common pitfalls to avoid:

• Do not increase potassium supplementation without checking kidney function and medication list 1, 2
• Avoid supplements marketed for athletic performance or sexual enhancement, as these may increase BP 2, 6
• Monitor BP when starting any new supplement 2, 6
• Recognize that most dietary sodium comes from processed foods, not home cooking—patient education must focus on food selection, not just salt shaker removal 1

Maintenance challenges:

• Sustained dietary change is difficult but achievable with behavioral interventions and nutritionist counseling 1
• Even modest improvements in diet provide benefit—perfection is not required 1
• Websites and books provide practical DASH diet implementation guidance 1