TIME Heart Disease

The Other Reason Canned Food Is Raising Your Blood Pressure

Tinned sardines
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Forget sodium—BPA might be the real canned food villain

If your food or drink comes out of a can, chances are it’s not the healthiest choice for your blood pressure (thanks to all that salt preserving your beans, for example.) But the latest research suggests there may be another reason to avoid canned goods. In a study published in Hypertension, researchers from South Korea found that drinking from cans, many of which have linings that contain the chemical bisphenol A (BPA), can raise blood pressure by 16 times compared to drinking from glass bottles.

The data isn’t the first to implicate BPA as a potential health hazard. Previous studies have connected the chemical, which can be found in plastics, the linings of cans and coating some cash register receipts, to disruptions in reproductive hormones such as estrogen, as well as a higher risk of asthma, obesity and disruptions in brain development in children. Exposure is almost unavoidable. Most studies show that people living in the U.S. have high exposures to BPA, and the chemical has been found in the urine of more than 95% of adults. One study found that eating canned soup for five days in a row can boost BPA levels in the urine by more than 1,000% compared to those eating soup prepared with fresh ingredients.

MORE: Why Receipts and Greasy Fingers Shouldn’t Mix

But those studies have compared different populations of people at different times. The Korean scientists decided to study the same group of 60 older people who drank the same beverages from both cans and glass bottles. Because the same people were being studied, it was unlikely that other factors that can affect BPA concentrations were influencing the results.

Senior author Yun-Chul Hong from the department of preventive medicine and the environmental health center at Seoul National University and his colleague found that the containers the drinkers used made a big difference in their BPA levels. Each was given two servings of soy milk during each of three visits. The milk was served in either two cans, two glass bottles, or one can and one glass bottle. The volunteers’ urine BPA levels were lowest after drinking from the two glass bottles, and highest after consuming milk from the two cans.

This difference translated to a change in 5 mmHg in blood pressure. Hong notes that an increase of 20 mmHg doubles the risk of heart disease, so the rise from BPA exposure is concerning.

MORE: BPA Linked with Obesity in Kids and Teens

“Because hypertension is a well-known risk factor for heart disease, our study showing the link of BPA exposure to elevation in blood pressure strongly suggests that BPA exposure may increase the risk of heart disease,” Hong writes in an email discussing the results.

When doctors evaluate patients for high blood pressure, asking them how many canned products they consume may be worthwhile, since the exposure to BPA from those containers could be pushing their blood pressure higher. “Clinicians and patients, particularly hypertension or heart disease patients, should be aware of the potential clinical problems for blood pressure elevation when consuming canned foods or using plastics containing BPA,” Hong says. And if you have a choice of getting your vegetables from the preserved aisle or the produce aisle, it might be better for your heart to kick the can.

TIME Diet/Nutrition

Put Down the Fruit Juice for Better Blood Pressure

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Sugary juice isn't the same as a helping of whole fruit

Stop sipping juice if you want to keep your blood pressure in check.

All fruit products are not created equal, and a new study published in the journal Appetite shows that drinking sugar-filled fruit juices does a number on your blood pressure.

“Despite a common perception that fruit juice is healthy, fruit juice contains high amounts of naturally occurring sugar without the fibre content of the whole fruit,” the Australian researchers write in their study. That missing fiber helps slow your body’s absorption of the sugar in whole fruit form, which is part of the reason why eating fruit is better than drinking it.

The researchers looked at the association between juice consumption and blood pressure among 160 adults. People were asked to divulge whether they drank sugary fruit juice rarely, occasionally or daily. Those who said they drank fruit juice daily were more likely to have higher blood pressure compared to those who consumed juice occasionally or rarely. The researchers suggest that limiting juice may do the blood vessels some good.

The study size is small, so more research is needed, but don’t wait until then to consume more whole fruit—and less of its liquid form.

TIME Research

Your Home Blood Pressure Monitor Might Be Way Off

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Up to 15% of home machines give the wrong readings, study finds

When one nephrologist at an Ottawa hospital asked a patient to bring in his home blood pressure monitoring machine, he only planned to teach him how to use it. But he noticed something strange. The measurement was 21 units off from the device the doctor uses in his office, a gulf that can mean the difference between normal and high blood pressure.

“That took me aback, because in some patients we are looking at home readings to make our decisions for treatment,” says Dr. Swapnil Hiremath of The Ottawa Hospital. So he decided to check out the machines of all his patients, expecting no more than 1% of the machines to give the wrong reading. Instead, according to a new study he’ll present at American Society of Nephrology’s Kidney Week next month, he and his team found that home blood pressure readings might be off in up to 15% of patients.

The researchers asked 210 patients to bring in their home blood pressure monitors and tested them against the gold-standard in-office machines—known as mercury sphygmomanometers. A full 30% were more than 5 units off in the systolic measurement, or when the heart is contracting, and 8% were off by more than 10. Diastolic blood pressure measurements, when the heart is resting between beats, were even more askew: 32% were off by 5 units, and 9% by more than 10 units.

Depending on the patient, those discrepancies could be enough to influence treatment decisions. Hiremath says he doesn’t know why so many of the readings are off, especially since all the machines are validated by FDA and Health Canada before they appear on the market. “Despite that,” he says, “these errors are happening and we’re getting these variations in readings.”

Hiremath takes three readings to ensure accuracy, and instead of merely encouraging his patients to test their home monitors against the kind used in doctors’ offices, now he all but mandates it. “It’s a resource intensive thing to do,” he says. “There are no easy fixes here.”

TIME Diet/Nutrition

8 Salt-Free Flavor Boosters

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Swap salt for ingredients and spices like cilantro and cinnamon

By now, you probably already know that overdoing it on sodium can lead to high blood pressure and up your risk for stroke. But giving up salt can be tough. One way to slash your intake right away is to check labels on processed foods, and avoid fast food restaurants, the menus of which are often chock full of sodium bomb after sodium bomb. But you can also chip away at your salty total with a little bit of kitchen creativity. Many recipes rely on salt as a way to improve the aroma, reduce bitterness, and balance out the flavors of a dish. But real food whizzes know there are plenty of substitutes that add just as much flavor—and provide some health benefits, too.

HEALTH.COM: 13 Foods That Are Saltier Than You Realized

We went to a few of our favorite chefs as well as some registered dietitians to find out their favorite easy swaps.

1. Parsley

Ah, humble parsley. It’s available fresh in almost every season, and you can use it to add a complex, fresh taste to everything from soups and stews to eggs, says Mark Bittman, author of How to Cook Everything Fast (October 2014).

Pro tip: “Don’t mince it,” Bittman says. “You want to be able to chew it to get the most flavor out of it.”

Health bonus: Parsley is an excellent source of vitamin K, which helps blood clot and keeps your bones strong.

2. Ginger

Ginger is a unique flavor that’s both sweet and spicy. You can use it when searing any protein: fish, chicken, pork, and even beef, says Libby Mills, RD, a spokesperson for the American Academy of Dietetics.

Pro tip: Combine it with garlic for double the flavor—and the health benefits, Mills says.

Health bonus: “Anti-inflammatory compounds called gingerols can bring relief and mobility to those with arthritis. It also protects us from damaging free radicals, so it’s perfect for winter months when you want your immune system at its strongest,” Mills says.

HEALTH.COM: How to Peel Fresh Ginger With a Spoon

3. Basil

Fresh basil is a dream on tomatoes (which people love to salt), sauteed vegetables, or even grilled meat or fish, Bittman says.

Pro tip: “It works best raw, which is why people use it to make pesto. But if you want to use it when cooking, throw it in the pan at the last minute so it doesn’t lose flavor,” Bittman says.

Health bonus: “Basil contains flavonoids, which are powerful antioxidants that protect cells from damage,” Mills says.

HEALTH.COM: 6 Health Benefits of Basil

4. Rosemary

This herb has a very strong, woodsy flavor that works in pasta sauces. Or any time you sautee something, use garlic, oil, and add a few whole sprigs of rosemary, Bittman says.

Pro tip: “The good thing about rosemary one is it keeps for weeks,” Bittman says. “Just put in a baggie and then keep in the fridge.”

Health bonus: Rosemary is an old folk remedy for heartburn. “It’s a delicious way to stimulate the digestion,” Mills says.

5. Cilantro

People have a love-hate relationship with cilantro. Some absolutely adore it, while others say it tastes like soap. Fun fact: Studies show that whether you fall in the love or hate camp depends on your genes. If you can stomach it, cilantro is great for Asian-inspired stir-fries or other rice dishes.

Pro tip: “Cilantro doesn’t keep that well so it’s best to use it pretty soon after you buy it fresh,” Bittman says.

Health bonus: This herb is a powerful antimicrobial. Cilantro leaves have even been found to fight back against salmonella germs.

6. Mint

Mint is great in spaghetti or any chilled grain dish like couscous or quinoa salad because it adds a bright freshness.

Pro tip: Grow it yourself! Mint can easily be grown indoors through the cold winter months, so you can pick it fresh each time you cook.

Health bonus: Mint is an excellent source of vitamin C, which helps the body build important proteins that keep skin healthy and hair shiny, Mills says.

HEALTH.COM: 5 Ways to Use Fresh Mint

7. Cinnamon

Mostly thought of as a sweetener or sugar substitute, you can use cinnamon to reduce sodium by combining it with low-sodium broth when preparing whole grains, like barley, millet, or quinoa.

Pro tip: Use it to make a spicy-sweet chicken rub: combine 1 to 2 teaspoons of chili powder (two if you like it hot), half a teaspoon cinnamon, and 1 tablespoon of cocoa powder. This will give you enough for four to six medium chicken breasts.

Health bonus: What can’t cinnamon do? “Cinnamon has essential oils that are both antiinflammatory and antimicrobial,” Mills explains. “It can also be helpful in reducing PMS symptoms, but it’s most famous for it’s ability to slow stomach emptying and thus reduce the rise of blood sugar after a meal.”

8. Wine

You can use wine to deglaze after sauteeing meat to create a nice pan sauce. “Also, even just enjoying your meal with a glass of wine helps distribute the food flavors in the mouth,” Mills says.

Pro tip: Here’s a step-by-step guide to making a red wine reduction pan sauce.

Health bonus: If you use it in your recipes, much of the alcohol will cook off. But studies have linked a nightly glass of wine to a reduced risk for heart disease. (If you’re not a drinker, this would be no reason to start, but one glass for women and up to two for men would be within healthy reason, Mills adds.)

Discover 8 more salt-free ways to flavor your food at Health.com.

TIME Diet/Nutrition

This Kind of Tea Lowers Blood Pressure Naturally

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The best brew for your heart

Recent research has come down squarely on the side of caffeinated morning beverages, suggesting that coffee can protect against cancer and type 2 diabetes. Tea has enjoyed a healthy reputation for years as a heart-protector, and a study published in the October issue of British Journal of Nutrition suggests it might even help lower blood pressure.

Researchers were intrigued by the inconclusive link in studies so far regarding blood pressure and tea intake, so they analyzed 25 randomized controlled trials—the gold standard of scientific research—to further explore on the association.

They found that in the short term, tea didn’t seem to make a difference for blood pressure. But long-term tea intake did have a significant impact. After 12 weeks of drinking tea, blood pressure was lower by 2.6 mmHg systolic and 2.2 mmHg diastolic. Green tea had the most significant results, while black tea performed the next best.

Those might not seem like big numbers, but small changes in blood pressure can have a significant impact on health, the study authors write. Reducing systolic blood pressure by 2.6 mmHg “would be expected to reduce stroke risk by 8%, coronary artery disease mortality by 5% and all-cause mortality by 4% at a population level,” they write.

Tea is thought to offer endothelial protection by helping blood vessels relax, allowing blood to flow more freely. It’s a high source of antioxidants that have been linked to better cardiovascular health.

The researchers weren’t able to pinpoint the optimal number of cups to drink to get the benefit, but other studies have shown protective effects at 3-4 daily cups. The researchers said they didn’t see a difference in caffeinated tea vs. decaf.

“These are profound effects and must be considered seriously in terms of the potential for dietary modification to modulate the risk of CVD [cardiovascular disease],” the authors write.

Read next: 6 Ways to Lower Your Blood Pressure Naturally

TIME Heart Disease

Serious Salt Confusion: New Research On How Much Salt You Should Eat

New studies question our salt intake Getty Images

Three new studies add to the debate—and confusion—about how much salt we should be eating

Three new papers published in the New England Journal of Medicine look at the cardiovascular risks of salt consumption, with some research saying too much salt is bad for the heart and other research saying there’s a sweet spot between too little and too much that is best. This has led to a range of headlines from “Pour On The Salt?” to “Death By Salt?“—adding to the confusion about whether we need to be cutting our consumption or forgetting about it.

So what to make of it all?

Our bodies need salt, but if we consume it in excess, we increase our risk for hypertension, which can ultimately lead to heart disease. The American Heart Association (AHA) recommends consuming less than 1,500 mg of sodium per day. Here’s what that looks like:

1/4 teaspoon salt = 575 mg sodium
1/2 teaspoon salt = 1,150 mg sodium
3/4 teaspoon salt = 1,725 mg sodium
1 teaspoon salt = 2,300 mg sodium

One of the studies had a particularly interesting finding, showing that people who consumed more than 6,000 mg a day and people who consumed less than 3,000 a day had a greater risk of cardiovascular events and mortality. People consuming a moderate amount in the 3,000-6,000 mg range had the lowest number of heart-related events. (The AHA limit—1,500 mg of sodium—is half the lower-limit of what the moderate group consumed.)

The latest studies likely won’t eliminate the debate, though. In an editorial in the same issue of the journal, Dr. Suzanne Oparil of University of Alabama at Birmingham writes: “Taken together, these three articles highlight the need to collect high-quality evidence on both the risks and benefits of low-sodium diets.”

Still, the AHA stands by its guidelines. “The bulk of the available evidence to date shows reduced sodium intake is associated with reduced blood pressure, which itself is associated with a reduction in cardiovascular event,” AHA president Dr. Elliott Antman said in the statement. “Along with improving overall diet, controlling weight, and increasing physical activity, lowering sodium intake is key to lowering blood pressure in the general population and improving blood pressure control in those with hypertension.”

Some scientists have argued that public-health messaging encouraging people to significantly cut their sodium and salt consumption is overblown or missing the point—that we should focus less on the salt in the shaker and instead encourage people to eat more whole and non-processed food, since most processed food is full of sodium and since most whole foods contain negligible amounts of naturally occurring sodium.

The debate is ongoing, but lightening up your sodium intake—particularly from processed and restaurant food—can’t hurt.



TIME Heart Disease

Mississippi Men Learn About Heart Disease — At the Barber

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Barbershops may be the new doctor's office, at least in Mississippi where African American men are learning about high blood pressure...while they get their hair cut

Barber shops and hair salons are great community hubs where residents gather for both grooming and gossip. So public health experts in the Mississippi Delta have decided to exploit these social meccas to connect with groups that don’t often see health care providers, including African American men.

Heart disease and stroke, for example, disproportionately affect this population of men, partly due to genetics, and partly due to lifestyle behaviors. But in places like the Mississippi Delta region, these men also do not get regular heart disease screenings. They do, however, go to barbershops for trims and to catch up on community news. So the Centers for Disease Control and Prevention (CDC) is funding a barbershop initiative called Brothers (Barbers Reaching Out to Help Educate Routine Screenings) located throughout the Mississippi Delta, where heart disease and stroke are the second and fourth leading causes of death in black men.

The Mississippi Department of Health spent a year recruiting and training barber shop workers on how to read a blood pressure screening, and discuss risk factors. During appointments, barbers talk to their clients about heart health, take their blood pressure, and refer them to a physician if they need further counseling. Recruitment was, and continues to be a challenge since some of the barbers were on board with the benefits of educating their clients, but worried about whether the program would hurt their business.

So far, thought, the barbers are being pretty persuasive. The project, which involves 14 barbershops that have so far served 686 men, just released its first set of data. Only 35% of the customers said that they had a doctor and 57% did not have health insurance. Among the men who received blood pressure readings, 48.5% had prehypertension, and 36.4% had high blood pressure. The findings, published in the journal Preventing Chronic Disease, shows that the program provides care to men who need it, as well as gives public health care workers a better idea of how prevalent heart disease is in the region, and how many patients are in need of medical care. The next step for the researchers is to create a community health worker network that could introduce these men to the health care system and help them navigate more regular screenings and better treatment of their condition.

Shifting health care from the clinic to the community isn’t a new idea; in some areas, health screenings and education are conducted in churches. But the faithful are a select group, and the study’s lead author says it’s important to bring services to hard-to-reach populations, such as young black men, to where they are. “We realized in our standard community health screenings–which were happening in churches–that we were not reaching adult black men,” says lead study author Vincent Mendy, an epidemiologist at the Mississippi State Department of Health. “We think the best way to reach them is through barbershops.” The program is part of a partnership between the CDC and the Mississippi State Department of Health, and is funded through September 2015.

Mendy is hopeful that the program will reach more men and bring them into treatment, since a similar 2011 initiative in Texas, funded by the National Institutes of Health, found that barbers helped to lower blood pressure in a population of African American men by 20%. Based on this growing body of research, the CDC is considering relying on community health workers to help improve the health of minority groups that have a disproportionate risk of disease and death in the U.S. — but are often outside of the health care system. Barbershops aren’t clinics, but they do seem to be a good place to get health messages across.

TIME Diet/Nutrition

Yogurt Could Lower Your Blood Pressure: New Study

The latest study links certain probiotics with better blood pressure control

Bacteria aren’t the first allies we turn to for staying healthy – there are enough strains that can cause serious illness, after all – but there’s growing evidence that certain strains of the bugs can actually be good for your health, and may even relieve symptoms of inflammatory conditions, allergies and possibly even obesity.

In the latest report on these microbial allies, researchers add one more possible benefit of probiotics – the live concoctions of bacteria contained in foods like yogurt. In an analysis of nine studies that looked at probiotic use and blood pressure, the report in the journal Hypertension found that people using probiotics tend to have lower blood pressure compared to those who didn’t eat them. The effects seemed to be stronger among those with higher blood pressure to begin with, and among those consuming multiple probiotic strains and in higher doses.

What do bacteria have to do with blood pressure? The researchers say that the micro-organisms could be helping to address hypertension in a variety of ways, from lowering cholesterol levels, which can contribute to less fatty buildup in the vessels and therefore reduce the chances of developing hypertension, to controlling blood sugar and keeping the enzymes and proteins that control blood flow and fluid volumes in check.

The results aren’t exactly a prescription for treating hypertension — at least not yet. But they raise the interesting possibility of incorporating a probiotic regimen into blood pressure management. The study authors admit, however, that more questions still need to be answered, such as which micro-organisms might be associated with the strongest effect on blood pressure, as well as which combinations of bacterial strains work best. The formulation of the probiotic may also be important, they say – in the studies they reviewed, participants consumed probiotics primarily from yogurt, but also from cheese, sour milk and supplements (liquid or capsules). Hitting the right threshold of microbes also seems to be important, and figuring out that volume is also essential before any advice about using probiotics to lower blood pressure is given.

TIME Heart Disease

6 Ways to Lower Your Blood Pressure Naturally

Exercise and eating well can help keep your blood pressure down PASIEKA—Getty Images/Brand X

Before opting for drugs, here are some safe ways to lower your blood pressure

This week, two groups of researchers presented a major discovery in the New England Journal of Medicine: They identified mutations in a single gene that can help prevent heart attacks by keeping triglycerides—a type of fat in the blood—low. This discovery will likely help pave the way for the development of new drugs that mimic the effect of that mutation.

In the mean time, if you want to keep your own blood pressure in check, talk to your doctor, and try these natural approaches:

Lose weight
It’s established that blood pressure can rise with weight, so maintaining a healthy weight range is one of the best ways to protect yourself. Losing weight has also been shown to lower blood pressure and lessen the strain on the heart. According to the Mayo Clinic:

  • Men are at risk if their waist measurement is greater than 40 inches (102 centimeters, or cm).
  • Women are at risk if their waist measurement is greater than 35 inches (89 cm).

Eat healthy
Consuming a diet that’s rich in fruits and vegetables is a good idea to keep blood pressure in check. Studies looking at the Mediterranean diet—which is high in plant-based foods, grains, and healthy fats like nuts and olive oil—show it may have heart protective benefits. Why? It’s thought that compounds in these foods can lower inflammation, which allows for stronger and clearer blood vessels. And experts agree that whatever you do, avoid processed foods as much as possible.

Breaking a sweat can keep you protected from hypertension. Getting at least 30 to 60 minutes of exercise many days a week can lower blood pressure, according to the Mayo Clinic. Even exercise like walking can be good for your heart.

Cut back on caffeine
Even if you do not have high blood pressure, caffeine has been shown to spike heart rate and blood pressure. It’s unclear why, but it’s possible that the adrenaline gets blood pressure to rise, or caffeine interferes with how wide our arteries are. Some people are more sensitive to the effects of caffeine than others, so know your limit. Most public health agencies say that four cups of coffee per day should be your limit.

Chill out
Too much stress is known to get your blood boiling, at least temporarily. It’s not confirmed that stress causes high blood pressure, but the American Heart Association notes that the hormones involved with the body’s “flight or fight” response can make the heart beat faster and constrict blood vessels–that can cause blood pressure to rise for a short period. Taking care of your stress and mental health is important for your overall wellbeing, so don’t ignore signs you are feeling overwhelmed.

Avoid smoking and cut back on drinking
Nicotine raises blood pressure even after you’ve put the cigarette out, so people who smoke throughout the day are keeping their blood pressure elevated. Drinking too much alcohol can also temporarily raise blood pressure, and consuming a lot of alcohol similarly keeps these levels up. Not to mention, heavy drinking can lead to weight gain, which is another risk factor for blood pressure. Cutting back can lower your risk.


How Low Should We Go? (When It Comes To Blood Pressure)

A new study suggests getting blood pressure as low as possible may not be critical for people with hypertension

About one in three Americans has high blood pressure, and typically it’s thought that getting that blood pressure number down as low as possible is the goal. However, a new study published in the journal JAMA Internal Medicine didn’t find that to be true.

The researchers looked at data from 4,480 participants in a 21-year long study that followed them to see if they developed any sort of heart illness. The researchers specifically looked at the participants’ systolic blood pressure (SBP)—the top number in a standard blood pressure reading.

In the study, elevated SBP was classified as 140 or greater, standard was 120-139, and low was less than 120. The researchers found that among people with high blood pressure, lowering their blood pressure to below 120 provided no additional benefit for reducing heart attack, heart failure and stroke risk. Getting blood pressure levels below 140 helped, but lower than 120 didn’t.

“As a clinician there is a notion suggesting that lower blood pressure is better but our current research to date is controversial and not conclusive,” says lead study author Dr. Carlos J. Rodriguez, an associate professor of public health sciences at Wake Forest Baptist Medical Center. “We found that hypertensives with a blood pressure between 120-138mmhg have the greatest benefit and those with a blood pressure less than 120mmhg did not have additional benefit.”

The study goes against conventional blood pressure wisdom. The American Heart Associations’ numbers are a little different, and show that the objective is to get below 120.

Here are the blood pressure categories defined by American Heart Association:

Screen Shot 2014-06-16 at 2.33.31 PM
Source: American Heart Association

“Our study does emphasize that the greatest clinical benefit comes from getting patients below 140mmhg. This was not a treatment study so I do not think it changes treatment but it does bring into question the notion of whether lower blood pressure is better,” says Rodriguez.

There’s a lot of research on the benefits of lowering blood pressure, and there would need to be many more studies, including clinical trials to confirm whether these new findings are true. For now, it’s just preliminary.

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