A client with hypertension asks which dietary change would have the GREATEST impact on blood pressure reduction. What is evidence-based?

HYPERTENSION DIETARY MANAGEMENT evidence supports sodium reduction and the DASH (Dietary Approaches to Stop Hypertension) pattern as primary dietary interventions.

Sodium: Sodium causes water retention, increasing blood volume and blood pressure; the current recommendation is <2,300 mg/day for most adults, and the JNC guideline and AHA recommend <1,500 mg/day for those with hypertension; most Americans consume 3,400 mg/day — primarily from processed foods, restaurant meals, and canned goods.

Dash diet components: High: fruits and vegetables (8-10 servings/day); whole grains; low-fat dairy; nuts, seeds, legumes; lean poultry and fish; Low: red meat; sweets and sugar-sweetened beverages; saturated fats; sodium.

Evidence: The DASH diet reduces systolic BP by 8-14 mmHg — comparable to starting a single antihypertensive medication; sodium reduction by 1,000 mg/day reduces systolic BP by approximately 5-6 mmHg.

Additional lifestyle measures: Weight loss (each kg lost reduces BP ~1 mmHg); aerobic exercise (150+ min/week reduces BP 5-8 mmHg); moderate alcohol (<1 drink/day women, <2/day men); smoking cessation.

Pn teaching: Use MyPlate; read nutrition labels for sodium (aim <600 mg per serving for pre-packaged foods); choose fresh over canned; rinse canned foods; minimize restaurant and fast food; cook at home with herbs and spices instead of salt.