February 2022 Issue

Editor’s Spot: Fresh Look at Hypertension
By Judy Riddle
Today’s Dietitian
Vol. 24, No. 2, P. 5

If you provide nutrition counseling to patients, some of them may have told you that their blood pressure increased soon after the start of the pandemic and the nationwide shutdown in March 2020. Their reality is in keeping with recent nationwide study findings published in the American Heart Association’s journal Circulation, in which researchers analyzed health data from 2018 to 2020 for nearly 500,000 people with an average age of 46. During the study period, women showed increases in diastolic and systolic measurements; older adults experienced increases in systolic readings; and younger adults had increases in diastolic blood pressure. About 92 news outlets and various social media platforms (eg, Facebook, Twitter, Reddit, blogs) reported the study findings, reaching millions of people.

The study didn’t identify what caused the rise in blood pressure, but suggested it wasn’t weight related. The lead study author surmised that the undue stress of the pandemic led to a decline in mental and emotional health, greater alcohol consumption, unhealthful eating habits, lack of exercise, poor sleep, and decreased medication adherence—each contributing to a spike in blood pressure. After all, the sudden lockdowns and social distancing mandates forced many people into unemployment and isolation. Those who remained employed had to quickly develop different work strategies to stay financially afloat, parents working at home also had to monitor children learning remotely, and those who had to work in a public setting each day lived in fear of contracting COVID-19. And even today, with the vaccines and boosters, COVID-19 continues to rage with the introduction of new variants and increases in cases, hospitalizations, and deaths. No wonder our blood pressure is high!

Dietitians know that hypertension already was a serious problem before the pandemic, as it affects almost one-half of US adults. Left undiagnosed, or poorly managed, hypertension can lead to heart attack, stroke, heart failure, kidney disease, vision loss, and other conditions. However, lifestyle changes that include low-sodium eating patterns chock full of fruits, vegetables, whole grains, and healthful fats, as well as regular physical activity and medications, can control blood pressure and keep it in a healthy range.

But while the blood pressure increases in the study were unrelated to weight, there’s much debate on whether hypertension is associated with weight—specifically obesity—and how best to manage it.

In this month’s cover story, “Hypertension & Body Weight,” on page 20, Today’s Dietitian explores the controversy and provides an overview of the American Heart Association’s recently released scientific statement recommending doctors focus less on lifestyle modifications (eg, diet and exercise) and more on weight loss medications and bariatric surgery to best treat obesity hypertension.

Also in this issue are articles on RD farmers and sustainability, seafood innovations, counseling Hispanic clients, and combating pandemic-driven food insecurity in older adults. Please enjoy the issue!

— Judith Riddle, Editor