A Review on the Dietary Management of Hypertension in Special Populations

Review Article

Abstract

Hypertension is a primary contributor to global cardiovascular morbidity and mortality. Sustained elevations in blood pressure induce structural arterial remodeling, endothelial dysfunction, and end-organ damage across diverse patient demographics. Tailoring non-pharmacological dietary interventions to vulnerable populations specifically elderly individuals, pregnant women, and patients presenting with metabolic or renal comorbidities is essential for optimizing clinical outcomes. Age-related physiological decline, characterized by reduced glomerular filtration, blunted renin-angiotensin-aldosterone signaling, and altered vascular compliance, heightens salt sensitivity in older adults, necessitating targeted sodium restriction and protein-caloric balancing. In pregnancy, hypertensive disorders such as preeclampsia originate from defective uterine spiral artery remodeling and subsequent systemic oxidative stress; targeted calcium supplementation and controlled micronutrient intake mitigate these pathogenic pathways while preserving fetal growth. For individuals with concurrent type 2 diabetes, chronic kidney disease, or overt cardiovascular disease, well balanced nutrition focussing on low glycemic load, modulated dietary protein, tight potassium calibration, and omega-3 polyunsaturated fatty acids serve to attenuate vascular inflammation and preserve parenchymal function. Adherence to structured dietary patterns, most notably modified versions of the Dietary Approaches to Stop Hypertension, consistently reduces systolic and diastolic blood pressure. Overcoming clinical challenges requires integrating behavioral stress mitigation, accommodating masticatory and physical limitations, and addressing socioeconomic barriers to fresh food access. Aligning physiological mechanisms with population-specific nutritional management establishes an evidence-based roadmap for effective blood pressure management and long-term risk reduction