QUESTION: My doctor said that I have "borderline" high blood pressure. He suggested that I change my diet and begin an exercise program to see if it would come down some before putting me on medication. Would you please tell me some of the foods that should be emphasized and those that should be de-emphasized in terms of controlling blood pressure. I sure do not want to take any medication. Thank you.

ANSWER: I am pleased that your doctor suggested making some changes in your lifestyle before beginning medication. This is surely the best approach, especially where the blood pressure is only borderline high.There is some evidence to suggest that diet plays a role in hypertension. For instance, sodium has been implicated as a factor in hypertension for some time. Probably one-third to one-half of all hypertensive people are "sodium-sensitive" and must restrict sodium to reduce their blood pressure. More recent research has mentioned a need for both calcium and potassium. In one study, a calcium-rich diet reduced blood pressure in 44 percent of the hypertensive subjects.

Potassium is also critical for proper heart and blood vessel function, and preliminary evidence suggests that increasing potassium and calcium, along with reducing sodium, may be an effective way to lower blood pressure. There is probably no need to take calcium and potassium supplements, but foods high in these minerals are nutritious and could healthfully be added to anyone's diet.

Decreasing fats in the diet may also help decrease moderate hypertension. However, this effect may come as a result of a decrease in body fat associated with a low-fat diet. Some researchers even think that mono- or polyunsaturated fats are better in terms of blood pressure than saturated fats. In any case, decreasing fats and eating less saturated fats is probably better for you.

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