Foods for Lower Blood Pressure, Graded by Evidence

High blood pressure affects nearly half of US adults, according to the Centers for Disease Control and Prevention, and many don't know they have it. Diet is one of the most effective ways to lower it, sometimes enough to reduce or delay the need for medication. But claims about individual "blood pressure foods" vary widely in quality. The approaches below are grouped by how strong the evidence is, from changes backed by large trials to popular ideas with only limited support. Anyone being treated for high blood pressure should talk to their doctor before changing their diet significantly or stopping medication.

Strong evidence

The DASH eating pattern. DASH stands for Dietary Approaches to Stop Hypertension. In a landmark trial published in the New England Journal of Medicine in 1997, a diet rich in fruit, vegetables and low-fat dairy, with whole grains, fish, poultry, nuts and beans, and limited red meat, sweets and sugary drinks, lowered blood pressure within weeks, with the largest effect in people who already had high blood pressure. It remains one of the most recommended eating patterns by heart and blood pressure organizations.

Cutting sodium. A follow-up trial, DASH-Sodium, published in 2001, found that combining the DASH diet with lower sodium intake reduced blood pressure more than either alone. The American Heart Association recommends no more than 2,300 milligrams of sodium a day, moving toward an ideal limit of 1,500 milligrams for most adults, especially those with high blood pressure. Most sodium comes not from the salt shaker but from processed and restaurant foods, including bread, cured meats, cheese, soups, sauces, pizza and sandwiches. Reading labels and cooking at home more often make the biggest difference.

More potassium. Potassium helps the body excrete sodium and relaxes blood vessel walls. Good food sources include bananas, oranges, potatoes and sweet potatoes, beans and lentils, spinach and other leafy greens, tomatoes, avocados, yogurt and salmon. Diets high in potassium are associated with lower blood pressure. Potassium supplements and salt substitutes containing potassium are not safe for everyone, particularly people with kidney disease or those taking certain blood pressure medicines, so check with a doctor first.

Less alcohol. Drinking more than moderate amounts raises blood pressure, and cutting back lowers it. Guidelines from the American Heart Association and American College of Cardiology suggest limiting or avoiding alcohol for people with high blood pressure.

Weight loss, if needed. Losing excess weight is among the most effective lifestyle changes. Guidelines suggest blood pressure tends to drop by around 1 point for every kilogram lost in people with overweight.

Moderate evidence

Beetroot and leafy greens. Beets, spinach, arugula and other leafy vegetables are rich in nitrates, which the body converts to nitric oxide, a molecule that relaxes blood vessels. Several studies and meta-analyses have found that beetroot juice can modestly lower blood pressure, at least in the short term. Whole vegetables have the added benefit of fiber and potassium.

Low-fat dairy. Dairy is part of the DASH diet, and some studies link dairy intake to lower blood pressure, perhaps through calcium, potassium and other nutrients. Plain yogurt and milk fit better than salty cheeses.

Nuts, seeds and legumes. These provide magnesium, potassium, fiber and healthy fats. Choose unsalted versions.

Oily fish. Salmon, mackerel and sardines provide omega-3 fats. Reviews suggest a modest effect on blood pressure, along with wider heart benefits.

Limited or mixed evidence

Garlic. Some trials of garlic supplements have found modest reductions in blood pressure, but studies vary in quality and in the products used. Cooking with garlic is fine, but it is not a replacement for proven treatments.

Hibiscus tea, dark chocolate and berries. Small studies suggest possible small effects. Dark chocolate in particular is calorie-dense, so the downsides can outweigh any benefit.

Single "superfoods." No individual food will lower blood pressure on its own. The overall pattern of eating matters far more than any one ingredient.

Putting it into practice

Aim for vegetables or fruit at every meal, filling about half the plate.
Season with herbs, spices, citrus and vinegar instead of salt.
Compare labels and choose lower-sodium bread, soups, sauces and canned goods.
Swap processed meats for fresh chicken, fish, beans or eggs.
Rinse canned beans and vegetables, which removes some of the sodium.
Limit restaurant and takeout meals, which are often very high in salt.

A day of DASH-style eating

Breakfast might be oatmeal topped with banana and a spoonful of unsalted nuts, with a glass of low-fat milk. Lunch could be a large salad with beans, leafy greens, tomatoes and a simple olive oil dressing, plus a piece of fruit. An afternoon snack of plain yogurt with berries keeps hunger at bay. Dinner might be baked salmon or chicken with a baked potato and two vegetable sides, seasoned with herbs and lemon rather than salt.

Beyond food

Regular physical activity, good sleep, not smoking and managing stress also help. Measuring blood pressure at home with a validated upper-arm monitor, at the same times each day, gives you and your doctor a clearer picture than occasional clinic readings. High blood pressure usually causes no symptoms, so checks matter even when you feel well.