Cardiovascular Disease - Hypertension

Practice Guidance Toolkit

Key Nutrition Issues


Hypertension is a major independent risk factor for coronary artery disease (CAD), stroke, chronic kidney disease and heart failure, thus efforts to prevent high blood pressure have the potential to significantly impact the development of these diseases (1,2). Treatment is considered in association with these co-morbidities and often includes health/lifestyle modification/behaviour management related to smoking, diet, physical activity and alcohol intake (1-4). The clinically significant amount of reduction in blood pressure for health benefits, specifically reducing the risk of major cardiovascular events by approximately 10% irrespective of previous diagnosis of cardiovascular disease (CVD) and even at normal or high-normal blood pressure values is 5 mmHg (5).

Hypertension is elevated blood pressure (BP), generally defined as a systolic pressure (SBP) at rest that is 140 mmHg or greater and/or diastolic pressure (DBP) at rest that is 90 mmHg or greater, or both (1-3). The diagnosis of hypertension is based on multiple BP measurements taken on different occasions as described in clinical practice guidelines (2,3). Adults with a high normal blood pressure (130-139/85-89 mmHg) are at a very high risk of developing hypertension (3). The majority of individuals with hypertension have other cardiovascular risk factors such as dyslipidemia, diabetes or impaired glucose tolerance and abdominal obesity (3). Treatment of hypertension must therefore be considered in association with other related conditions (1-3).
This toolkit discusses the following key nutrition issues:
  • the role of dietary patterns (Mediterranean, plant-based, DASH, Portfolio, Nordic, low sodium/salt, pulses and low glycemic index) in individuals with or at risk for hypertension 
  • the role of diets higher in fibre for primary and secondary cardiovascular disease (CVD)
  • the effect of dietary supplements (micronutrients (multivitamin and multimineral, magnesium and potassium supplementation) and nutraceuticals and herbal supplements (beetroot juice, garlic, ginger, hibiscus, inositol, L-arginine, pomegranate juice, spirulina and black licorice) on blood pressure in adults with and without hypertension
  • the effect of omega-3 fatty acid supplements on CVD prevention
  • the effect of flaxseed on markers of CVD
  • effect of caffeine on hypertension. 

Last Updated: 2023-02-10