According to the Centers for Disease Control, almost half of all Americans have hypertension, or high blood pressure.

However, only a small proportion are managing it, which is concerning considering that high blood pressure poses a significant risk to overall health. Uncontrolled hypertension is a direct risk factor for heart attack and stroke, worsening diabetes, and even dementia.

In addition to medication, your diet plays an important role in controlling high blood pressure.

Studies show that the DASH (Dietary Approaches to Stop Hypertension) diet is one of the best dietary approaches to follow to lower blood pressure. The DASH diet was designed for the specific goal of management of high blood pressure and has been studied extensively over the past two decades. It includes low-sodium dietary approaches with a high intake of fruits, vegetables, whole grains, low-fat dairy, fish, poultry and healthy fats like extra virgin olive oil, nuts and seeds. Some studies show that adherence to the diet may be just as effective as medication in controlling blood pressure.

In addition to the DASH diet protocol, the following foods have been found to effectively reduce blood pressure.

Foods that lower blood pressure

Avocado

Potassium is a mineral found in plants and directly benefits blood pressure. A 2023 study found that consuming avocados, a fruit high in potassium, five or more times per week led to a 17% decrease in hypertension. That’s because potassium can mitigate the effects of sodium, sending sodium out of the body through urine instead of staying in the body to damage vessels.

Beets

A study in the Journal of Hypertension found that consuming about 1 cup of nitrate-rich beet juice could help reduce blood pressure. Nitrate converts to nitric oxide, which in turn helps improve the function of blood vessels by widening the vessels allowing greater blood flow.

Beet-Citrus Blast Smoothie by Frances Largeman-Roth, RDN

Lemons

Multiple studies have linked lemons and lemon juice to improvements in hypertension. Benefits are derived from minerals in lemons and citric acid found in all citrus fruits.

Dark chocolate

Dark chocolate has been found to help reduce blood pressure via its high content of flavonoids. A 2021 study assessing flavonoid intake and its impact on gut microbiome found that participants with the highest consumption of flavonoid-rich foods such as dark chocolate (as well as red wine, berries and tea) had the lowest systolic blood pressure.

Coffee

A 2023 study in the journal Nutrients found that three or more cups of coffee a day may help lower blood pressure. The study found that these benefits are most likely due to the compounds found in the coffee bean. However, other studies have associated moderate (2 cups or more) coffee consumption with an increased risk of cardiac-related death in individuals with severe hypertension (the risk was not seen in individuals who drank one or fewer cups daily). If you love coffee, consider your personal risk factors before diving into multiple cups a day. Determining how well you metabolize caffeine (a nutrigenomics test can help with this) and assessing how severe your hypertension is may help guide how much coffee your body can handle safely.

Almonds

A 2014 study compared two groups of individuals. One group consumed their typical diet, while another added 50 grams (about ½ cup) of almonds a day for one month. After the study, the almond-eating group had greater amounts of antioxidants in the blood, better blood flow and lower blood pressure. In addition to almonds, pistachio, and walnut consumption has also been associated with lower blood pressure.

Dark Chocolate Almond Bark with Cherries and Ginger by Anna Thomas

Celery

Studies show that celery consumption may help reduce inflammation and oxidative stress leading to a reduction in cardiac risk factors, such as high blood pressure.

Spinach

Similar to beets, spinach is a nitrate powerhouse. Studies show that just 1 cup of leafy greens daily, like spinach (as well as kale, swiss chard, arugula, collard greens and bok choy), can significantly reduce the risk for heart disease. These studies often cite improvements in blood pressure as a critical component.

Apples

Like dark chocolate, apples (specifically their peels) are abundant in flavonoids, which have been shown to improve blood pressure. Studies show that the more deeply hued the peel is, the more flavonoids the apple contains.

Wild salmon

Lean proteins play a role in reducing blood pressure, and wild salmon is one of the best options to consider due to its high content of omega-3 fatty acids. One study found that having 3 grams of omega 3’s a day (approximately a 4-5 ounce piece of salmon) could help lower blood pressure, and having more, the authors noted, may provide even more benefit for someone with hypertension. Other sources of omega 3’s include chia and flax seeds and walnuts.

Lemon-Garlic Salmon with Asparagus by Jess Dang

Extra virgin olive oil

A 2020 study in the journal Nutrients referred to olive oil as “ the optimal fat choice in the management protocols for hypertension in both healthy and cardiovascular disease patients.” Olive oil is high in polyphenols and oleic acid, which may help reduce overall risk factors, like blood pressure, for heart disease.

Yogurt

A 2021 study found that yogurt could help reduce blood pressure due to its high concentration of micronutrients calcium, magnesium and potassium, which are all associated with a lower risk of hypertension.

Pumpkin seeds

This fall snack should be a year-round treat if you have high blood pressure. Pumpkin seeds are high in magnesium, a mineral found to help in controlling blood pressure. A 2019 animal study found that rats with 4% pumpkin seeds or pulp had 20% lower blood pressure than rats on the control diet.

Butternut Squash and Pumpkin Seed Yogurt Parfait by Frances Largeman-Roth, RDN

Cinnamon

Add some blood pressure-friendly ingredients to your spice cabinet. A 2021 randomized controlled trial found significant reductions in systolic blood pressure when 1500 mg of cinnamon was added to the diet for 90 days. In addition to cinnamon, other roots like turmeric and ginger may also play a beneficial role in blood pressure management.

Oregano

Oregano is an excellent addition to eggs, sauces, dressings and poultry. It’s also great for your blood pressure. A 2021 study analyzed herbs and spices combined with blood pressure response. The study found that individuals that consumed the most herbs and spices had lower blood pressure readings 24 hours later.

Garlic

Love garlic? So do your arterial walls. One study found that individuals with lower blood pressure levels were more likely to have garlic in their diet.

Greek Sheet Pan Chicken by Pamela Salzman

Blueberries

The compound that gives blueberries their deep hue is the same one demonstrated in studies to lower blood pressure. Authors noted that the benefits to blood pressure were seen just two hours after eating blueberries.

Foods to avoid for high blood pressure

Limiting certain foods may also help in controlling high blood pressure.

First, individuals with hypertension are recommended to limit sodium intake to about 1500 mg or less per day. That’s the equivalent of a little over ½ tsp. You can manage this by limiting your intake of processed and ultra-processed foods and processed red meat products.

You can also look for low-sodium versions of canned foods such as soup, cheese, bread, tomato juice, pickles, condiments, frozen foods and deli meats. You should also limit consumption of products with added sugar, such as sugar-sweetened beverages, baked desserts and candy. Finally, since even moderate alcohol consumption was found to be a significant risk factor for hypertension, you may want to limit it or avoid it altogether.

In addition to diet, regular physical activity, adequate sleep, stress management and weight loss, as well as limiting alcohol and quitting smoking, can also go a long way in controlling high blood pressure.

This article was originally published on TODAY.com