Diet, genetics play roles in preventing high blood pressure

This story first appeared in Healthy You - January 2026, The Gazette’s quarterly health publication.

Every time you visit a physician, you’re sure to get a blood pressure check. Local providers say knowing your numbers and taking steps to help prevent high blood pressure are things individuals can strive for.

Mary Boksa, certified physician assistant, works in family medicine at the Eastern Iowa Health Center and explained that a patient is not diagnosed with high blood pressure until they have two consecutive readings on two separate occasions.

“Of course, blood pressure fluctuates throughout the day,” she said. “If you're sitting, standing, if you're being active, if you're at rest, all of those things go into it, and that's why we need two separate readings on two separate occasions to know if it’s high. If you just went out and were exercising for 30 minutes and check your blood pressure, it's going to be high because your brain needs that oxygen.”

“When you tell someone that they have high blood pressure, they don't really feel it,” added Boksa.“It's one of those things where they may feel fine and feel normal, but it's one of the diagnoses that can have long-term complications if it's not treated or managed.”

According to Dr. Keith Kopec, cardiologist with UnityPoint Health in Cedar Rapids, there are different guidelines for categorizing high blood pressure, but they are typically above 130/80 or 140/90.

“Most high blood pressure is what we call primary hypertension, meaning we don't really understand how people get it,” Kopec said. “There's a huge genetic component to it. And blood pressure tends to go up as you get older.” He notes it is very common in people over the age of 70, and race can play a role as it is more common for Black patients.

Both Boksa and Kopec agree that focusing on keeping your blood pressure in check is important to prevent heart attack, stroke or kidney disease.

“High blood pressure is considered the most prevalent, modifiable risk factor for heart disease, in fact,” said Kopec.

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Diet is perhaps the biggest factor.

“There’s increased risk of hypertension with obesity, so interestingly, a majority of people who lose significant weight can come down on blood pressure medicines,” said Kopec. “But again, a lot of it is a genetic component, so many people are not eliminating all meds, but are simplifying and going from three to two medications or from two to one.”

Kopec and Boksa share information about the DASH diet, or Dietary Approaches to Stop Hypertension, with patients.

“It’s a diet that primarily emphasizes fruits and vegetables, which are high in potassium, which helps balance blood pressure. It also focuses on low fat dairy products, avoiding so-called bad calories and decreasing meat consumption,” Kopec said. “Lowering sodium intake is also important. There's some evidence that the combination of the DASH diet, plus a low sodium diet, can have the same benefit as one blood pressure pill.”

Reducing alcohol consumption is another improvement individuals can make to help lower blood pressure.

“Plus, we know that long-term stress can increase blood pressure, so we recommend patients try something like mindfulness, yoga, breathing exercises and remembering that getting quality sleep is a big part of that too,” he added. “And regular aerobic exercise of moderate intensity for 30 minutes a day or 150 minutes a week can lower your numbers five to ten points.”

Treatment plans for high blood pressure, providers add, can vary depending on a lot of factors.

“It can depend on previous readings,” Boksa said. “If it's been borderline high and we're typically watching it, then we can start by doing some lifestyle modifications to see if we can manage it without medications.”

Boska added that if individuals are checking their blood pressure at home and they are concerned about it, they should check in with a medical professional.

“I tell patients to bring in the monitor that you're using at home because sometimes your machine is not calibrated. If they bring it in, we can compare readings in the clinic,” she said. “And position when checking blood pressure is also important. Sitting with your legs crossed or dangling can raise your reading. So, we can make sure people are sitting properly and holding their arm at heart height.”

Most cases of high blood pressure should be managed or manageable by a primary care physician, Kopec said.

“I want to empower patients to take care of themselves and know that lifestyle issues are important. I would much rather see someone lose 15 pounds, back off on salt intake, exercise more and do everything he or she can do to control blood pressure before I have to step in. But I also acknowledge there is a role clearly where I do have to step in,” he said. “There are certain things we can't control. We cannot control the genetics of things. We cannot control our age, and as we get older, we're more vulnerable to these things. But I want you to be in charge of you when it comes to your health care.”