Dietary Therapy in Hypertension

A 57-year-old woman presents to an outpatient clinic for evaluation of hypertension. She has no history or symptoms of cardiovascular disease and reports having gained 15 kg over the past 30 years. Her blood pressure is 155/95 mm Hg, her weight 86 kg, her height 165 cm, her body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) 31, and her waist circumference 98 cm. Her serum triglyceride level is 175 mg per deciliter (2.0 mmol per liter), high-density lipoprotein cholesterol 42 mg per deciliter (1.1 mmol per liter), low-density lipoprotein cholesterol 110 mg per deciliter (2.8 mmol per liter), and glucose 85 mg per deciliter (4.7 mmol per liter). Her clinical profile is thus consistent with the metabolic syndrome. 1 She is a nonsmoker, is sedentary, and eats a diet that is high in white bread, processed meats, and snacks and drinks containing sugars and sodium and is low in fruits and vegetables. She is interested in adopting a healthier lifestyle.