Image Credit: Sally Plank

High Blood Pressure: Normal but Not Natural

The most comprehensive and systematic analysis of causes of death ever undertaken allows us to answer questions like, how many lives could we save if people cut back on soda? The answer is 299,521.  Soft drinks aren’t just bad because they’re empty calories. More than just not being a health-promoting item, soda appears to be an actively death-promoting item. Of course, it’s not as deadly as processed meats, such as bacon, bologna, ham, or hot dogs, which account for about 800,000 deaths every year—killing twice as many women as domestic violence and five times more people than all illegal drugs combined.

On the other hand, eating more whole grains could save 1.7 million lives. And more vegetables could save 1.8 million lives every year. If only we ate more nuts and seeds, we’d save 2 and a half million lives. But fruit is apparently what the world needs most (they didn’t look at beans) with 4.9 million lives hanging in the balance every year. The cure is not drugs or vaccines; the cure is fruit. The #1 dietary risk factor for death in the world may be not eating enough fruit.

One reason why plant-based diets can save so many millions is because the #1 killer risk factor in the world is high blood pressure, laying to waste nine million people year after year. In the United States, high blood pressure affects nearly 78 million—that’s one in three of us. As we age our pressures get higher and higher, such that by age 60, it strikes more than half of that population. If it affects most of us when we get older, maybe it’s less a disease and more just a natural, inevitable consequence of getting older?


We’ve known for nearly a century that high blood pressure need never occur. Researchers measured the blood pressure of a thousand people in rural Kenya. Up until age 40, the blood pressures of rural Africans were about the same as Europeans and Americans, down around 120’s over 80’s, but as Westerners age, our pressures creep up such that by age 60 the average person is hypertensive, exceeding 140 over 90. But the pressures of those in rural Africa improved with age; not only did they not develop hypertension, their blood pressures actually got better.

The 140/90 cut-off is arbitrary. Just like studies that show the lower our cholesterol the better—there’s really no safe level above about 150—blood pressure studies also support a “lower the better” approach. Even people who start out with blood pressure under 120/80 appear to benefit from blood pressure reduction. The ideal blood pressure, the no-benefit-from-reducing-it-further blood pressure, appears to be 110/70. Is it possible to get blood pressures under 110 over 70? It’s not just possible, it can be normal for those eating healthy enough diets (see How Not to Die from High Blood Pressure).

Over two years at a rural Kenyan hospital, 1,800 patients were admitted. How many cases of high blood pressure were found? Zero. Wow. They must have had low rates of heart disease. Actually, they had no rates of heart disease. Not low risk—no risk. Not a single case of arteriosclerosis was found.

Having a “normal” blood pressure may set you up for dying from “normal” causes such as heart attacks and strokes. For more on this concept, see When Low Risk Means High Risk. It’s like having a normal cholesterol level (see Optimal Cholesterol Level).

It seems high blood pressure is a choice. Like cavities:  Cavities and Coronaries: Our Choice.

Even end-stage malignant hypertension can be reversed with diet (thereby demonstrating it was the diet and not other lifestyle factors that protected traditional plant-based populations). See Kempner Rice Diet: Whipping Us Into Shape.

Flax seeds, hibiscus tea, whole grains, and nitrate-rich vegetables may offer additional protection:

Why not just take the drugs? See The Actual Benefit of Diet vs. Drugs and Why Prevention is Worth a Ton of Cure. And be sure to check out my summary video, How Not to Die from High Blood Pressure, as well as The Evidence that Salt Raises Blood Pressure.

In health,

Michael Greger, M.D.



Michael Greger M.D., FACLM


74 responses to “High Blood Pressure: Normal but Not Natural

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  1. I’ve read four or five different articles about kenyons getting heart disease… high incidences of heart disease? Where does this article come off saying that they don’t have cvd….zero really?!?

    1. This article refers to a rural hospital, which I would take to imply a traditional diet. And the non-existence of heart disease among rural African peoples eating traditional diets has been noted for many decades. Perhaps what you read is indicative of what happens when urban Kenyans adopt a “modern” diet. If you have a link to the articles you refer to please post them here so someone can address them more specifically.

      1. I think what is going on in Africa generally is that the big money buys the land in order to grow typical cash crops…people end up in the cities eating the same chemically farmed food that makes westerners sick….instead of encouraging locally sustained farming. Traditional diets are based on traditional farming.

    2. Thanks for you comment Chris.

      Dr Greger is strictly referring to rural Kenyans:


      Here is a link to the study cited by Dr Greger. It is from 1929 but still valuable to see how their traditional diet (amongst other important factors) was a major reason for them not having hypertension.

      Hope this answer helps.

      1. Dr Greger really should have said that the study was almost one hundred years old. It shows, at the very least, that he is prepared to be economical with the truth to advance his extreme position on diet.

    3. The article mentions that the study examined rural Kenyans and if you follow the link you will see that it goes to a study published in the Lancet in 1929. Much has changed in Kenya since then, especially in the area of nutrition and diet. As a result there are probably many Kenyans, especially those living in urban areas that can afford to eat a more Western diet, who today have heart disease.

      But that is why these older studies are so valuable. They give us a window into a time when most people outside of the Western world at a diet consisting of 90+% whole plant foods yet Western doctors and medicine were present and could rigorously measure their vital statistics, assess their diet, and record what diseases were present and at what percentages of the population.

      With increasing wealth and westernization of these parts of the world, that window where we could look at entire populations eating their traditional diet is closing very rapidly, if not already closed.

    1. I’ve tried the same as you indicated. Been a pesco-vegetarian for over 40 yrs. The only thing which worked demonstratively is raw fruit / vegetable diet. BP dropped precipitously from high BP to 115/75 within a few days everytime undertaken. Very telling.

      1. Get off completely off animal and animal products for at least 3 months you will see good results. I tried it about 8 months ago. My blood pressure now is 100/60. You may also try eat right for your blood type diet, it is amazing as well.

        1. quite happy to know that it works for you. but it does not for me.. what’s the right food?
          as i said, i eat very healthy – oatmeal in the morning and quinoa, vegetables, tempeh and a lot of beans for lunch and dinner. no animal protein. still BP is always at 140/90.
          recently it went above 150 when a doc prescribed BP meds, i stopped in two months but it has not come back below 140/90

          1. Two things come to mind, one is that the body seems to have a preferred weight for Normal blood pressure. Even people who aren’t really overweight can benefit from losing any extra.
            Second, heart and artery function are also affected by exercise. I personally have to do fairly intense workouts 5-6 times a week to keep my BP where it needs to be.

        2. If I recall correctly, in a recent Facebook live q & A, Dr. Greger indicated the blood type has no scientific validity. I have heard other doctors advocating WFPB nutrition say the same thing.

          1. I am the living proof of the diet. I had chronic back pain that persisted for 3 years. Since I started the blood type diet, the pain had gone for good. Before the diet I was eating a lot of avoid food for blood type B such as pumpkin seeds, wholewheat, avocado, corn, lentils, tomato and many other foods that are thought to be the best for vegetarians. I no longer gain weight, my blood pressure is at 100/60. Don’t over depend on science and published article, nutrition science should be more personalized and there is no one single diet that fit all. I am research scientist currently doing PhD in epidemiology, very families with statistics in nutrition studies.

        3. I Eat real food, high fat, high animal, high veg. I am active and lean. 50, no meds, BP 100/60, sometimes 96/56 is about the lowest. Eating real whole food, not processed, animal or plant is the answer.

    2. Eat greens and at least 4 stalks of celery a day. Get Dr. Michael T Murrays book on hypertension at Amazon ($1,00 used) He highlights lifestyle and dietary changes that are reasonable to achieve and also states the results of extensive studies re healthy and natural alternatives to drug.

    3. Often it’s connected to weight, even a few extra pounds drives bp up. Of course a plant based diet is very best way to lose weight effortlessly and permanently.

      1. On plant based and healthy diet. No bad eating habits. No sugar, gluten free etc. I take flax and tea regularly. And really lean and thin – so weight is not an issue as well

        1. I had great success by starting each day with whole beets and restricting sodium. Went from 140/90 to 116/70. And of course eat vegan whole plant diet including Dr. Greger daily dozen.

  2. Anyone have ideas regarding Tim Ferriss’ 4 hour body take on fruit which is to avoid it completely? I am all for scientific research backed conclusions and have been an avid follower of Dr. Gregor but apparently there’s science research on the other side? Ferriss is not a doctor but I believe he does rely on science backed research. His take is that fructose is worse than table sugar and is convered by the liver into fat. In this article it sounds like eating more fruit can save four million lives. What is it that fruit provides that vegetables cannot? Additional nutritional factors? Thank you!

    1. Thanks for your comment Steve.

      I watched the video closely and here are some of the claims presented:

      1) Drinking fruit juice is not good for the human body
      2) Apples are designed to have more fructose than a few decades ago
      3) Fruit was only consumed by those population living in Equatorial countries
      4) Fructose is rapidly converted to fat by the liver and therefore it’s really bad for human health.
      5) Fruit is available all year round and this is not a good thing

      I will briefly comment on these affirmations.

      1) According to the following paper:

      “Contribution of 100% fruit juices to the epidemic of obesity was analyzed in a study reported in [13]. When fruits are juiced, the nutritional portion, the fiber, is discarded. Researchers claim that calories and sugar ob- tained from liquid extracted from fresh fruit do not provide feelings of fullness, which in turn may cause people to consume excessive amounts. The study reported in the same article suggests that while some studies show an improved diet quality with the consumption of 100% fruit juice, other studies demonstrate correlations between increased juice consumption and increased risk of obesity and diabetes”.

      Dr Greger has also pointed out to similar observations in the following videos::

      Apple Juice May Be Worse than Sugar Water

      Juicing Removes More than Just Fiber

      However, watch this video to see the exception: The Fruit Whose Juice Is Healthier. In the video you have referred, they mention cranberry juice, to which Dr Greger has also pointed out some information:

      Can Cranberry Juice Treat Bladder Infections?

      2) “Three recent studies of historical food composition data found apparent median declines of 5% to 40% or more in some minerals in groups of vegetables and perhaps fruits” (see here). However, I have found no evidence for increasing fructose content as stated on the video but not refuting its claim.

      3) Although I am not a fruit historian, the University of Vermont states that in northern Europe, berries were consumed centuries ago.

      4) I highly recommend you to watch the following video: If Fructose is Bad, What About Fruit?.

      According to this review:

      “As discussed, it is generally believed that the consumption of fructose leads to an immediate increase in lipid synthesis in the liver and a subsequent increase in circulating TAG. This assumed relationship between fructose, lipid synthesis and hypertriacylglycerolaemia has been extrapolated to obesity( 28 , 32 ). However, careful studies in human subjects, using stable isotopes, do not confirm this relationship.”

      5) I may agree, as we should, whenever possible, respect the seasonality of the fruit.

      Hope this answer helps.

      1. Fruits is all human need to survive. Fruits do not require a lot of insulin, fruits are living food and full of electricity. I am consuming high amounts of fruits, no weight gain, I am actually loosing weight some times. I have tested glucose response for several fruits myself and I can assure you that it takes less than 45 min for the blood glucose to normalize to fasting levels after eating fruits. But try other foods such as beans, lentils, nuts, carbohydrate and fats and see how longer the blood glucose stays elevated.

  3. A study of Kenyans is not representative of all people. I have a family history of high blood pressure (Ashkenazy Jewish heritage). I am a vegan, eat very healthfully (I pay attention – lots of variety, lots of fruits, vegetables, legumes, nuts, etc.) and eat no commercially processed food or soda (I cook all my own food from basic ingredients), and exercise regularly. My blood pressure is about 145/85. My bmi is 21.5. I am 73 years old and can be a poster ‘child’ for a healthy older person. Perhaps most people with my life style can have very low blood pressure, but it is wrong to suggest everyone can, and puts blames where is should not be.

      1. I spend a lot of time outdoors (using sun screen, of course) and take Vit D supplements (one of the few such that I take). My blood labs report good Vit D levels.

    1. Thank you for your comments Arthur Michelson, I can relate to what you sre saying. I hold to the same healthy vegan no-oil home-made foods, regular exercise, and bmi under 20. Years ago eating some fish, meat and dairy, my blood pressure was always 110/65 or less. Now the range is much higher, and has gone over 140/70 at times. I am almost tempted to do a week or 2 of the kempner diet of rice and fruit to see if my blood pressure responds.

    2. Arthur.
      I eat the same as you but my BMI is a bit higher. My BP is all over the place during the course of the day. The only time it is low is when I take it first thing in the morning when I wake up and I take the average of 3x.
      Normal… I mean 112/73 type normal.. I’m 67.
      If I’m running around or get pissed off It spikes.

      1. Your ‘normal ‘ is a figure I never get down to. I measure my bp at various times of the day – it is only a bit lower in the morning, though I don’t take it immediately upon waking. Both parents and older brother had bypass surgeries and high bp barely controlled by meds. That my bp is under as much control as it is is a testament to my lifestyle but is also, I believe, an indication of the limits of control I have over me genetic dispositions.

    3. I agree and it’s the same in my case. someone with my diet will probably have 120/70 BP but my genetics are not good. If I am not following good diet, i would be already taking BP meds by now.

  4. It that many people don’t know that many of what they see are vegetables are really fruit, you might offer an informative blog or video and raise a fruitful awareness.

    The homepage might be more helpful if it took the reader directly to the blog when there is a blog for the day. If not that, and very obvious link not the one hidden in the fine print. Getting a new website right takes time.

  5. Dr. Greger, are you implying in the first paragraph that somewhere on the order of 200,000 women die of domestic violence each year? I can’t find anything to back this up. The closest I can find is a UN Dept. of Crime publication citing 43,600 female domestic abuse deaths worldwide in 2012. That’s an absolutely appalling figure no doubt, but 1/4 of the figure you quote.

    1. Actually, if I’m reading it right, assuming 1/2 of the the 800,000 are women, you seem to be off by a factor of ten. I am absolutely a fanatic of your site by the way, so please don’t take this as unduly harsh criticism!

        1. Luis, I follow a plant based diet largely because of the amazing work of Dr. Greger. I am forever in his gratitude. I get the point of this blog post. My point, is that I would hate for any of his important health message to be clouded by referring to debatable statistics on a controversial subject, derived from a study funded by a foundation with an agenda. And if Dr. Greger found it important enough to mention, it’s obviously not irrelevant.

        1. Thanks Susan. Obviously there is conflicting information between the UN study and the study Dr. Greger refers to. As this study is funded by the Bill and Melinda Gates foundation, which has a dubious agenda linked to global population control efforts, I will chose to stand with my objection.



  7. I have the same questions about fruit. I don’t do well with sugary fruit, so I don’t eat it. Are cucumbers and avocado considered fruit in the sense that they are life-saving?

      1. I know they are. That’s why I’m asking. I’m wondering if fruits like cucumber and avocado provide the same protective effect on blood pressure that sugary fruits do.

        1. Sorry for misunderstanding your question.

          Although I could not have full access to the study (see here), it has indeed found that cucumber and garlic administration over a period of 12 may help reduce blood pressure in elderly people with hypertension.

          In regards to avocado, there are previous NF videos on this fruit (see here and here) but not related to the subject.

          One review has suggested it has potential:


          One the other hand, one early publication has reported the first documented case of avocado induced hypertensive crisis (see here).

          Hope this answer helps.

          1. Thank you for your efforts.

            I don’t doubt that avocado can reduce blood pressure, as can many different fruits and vegetables. Michael said that fruits are more protective than vegetables. I’m wondering which category these “technical fruits” fall into when it comes to protecting from high blood pressure. Cucumbers, grains, nuts, avocado – they are all technically fruits. When Michael says that fruits are more protective than vegetables, what is he including – just the sugary fruits, or all of these “technical fruits”?

            1. It wasn’t technically Dr. Greger saying that fruits are the most protective in that blog post, he was citing a study. Check the research he was talking about and you’ll be able to see how they defined ‘fruit’ in their analysis

            2. Hi, Nina Moliver. Even though the title of the blog post mentions blood pressure, the reference to fruit consumption is related to all-cause mortality. I don’t think it refers to “technical fruits,” although I did not see that the term “fruit” was defined in the study. I can tell you that, generally, increasing potassium intake (from whole plant foods, of course) and decreasing sodium intake will usually lower blood pressure, but you can overdo it, so be careful. If you are interested in blood pressure control specifically, there is a plethora of information on this site. You can find links to many videos on diet and blood pressure here:
              I hope that helps!


  8. If we are following, as we are, a WFPB no oil diet with plenty of fruit and vegetable consumption and our BP is still hovering around 140/90, will taking BP-lowering drugs help with survival?

    1. The SPRINT study looked at people with at least one risk factor, such as smoking, high cholesterol, or kidney disease–not specifically at WP vegans–and found that survival rates increased when systolic pressures were brought down to (or near) 120. Other studies have found that those with diabetes do better when BP is NOT brought down below 130. Among those > 60 years of age, there seems to be no benefit to reducing systolic BP below 150, and guidelines were relaxed for this group a few years ago.

      So there seems to be a wide range of opinions. The Canadians and British like to treat people when their home BP is above 135/85 (don’t know if they have a different standard for seniors).

      I think the important thing is that these are averages, and one shouldn’t freak out if one has an isolated high reading (most of us do!).

      1. Jason, thank you, this is great. I would love to see your sources for some of your claims here, if you can dig them up. Especially this one: “Among those > 60 years of age, there seems to be no benefit to reducing systolic BP below 150, and guidelines were relaxed for this group a few years ago.” Anything you can pass on will be most appreciated.

  9. Surely there is more to Rural Kenyans’ low bp rates than just their diet. How about the fact that they walk everywhere and live physically demanding lives while perhaps having fewer stresses that westerners?

    Secondly, I have read articles that higher bp as we age is normal, and I don’t mean normal like we are going to die normal, but actually normal.

    My father had very low bp, less than 110/60 and he passed out when he stood up, so how is it that lower than average bp is good?

  10. Due to chronic kidney disease (type 1 Diabetes), I have to take 4 meds to get y BP down to 140/80. I eat a low fat WFPB diet, low SOS. 40 in exercise/da. At a loss to know what else I can do. Really hate the meds, tired, but my nephrologist (who support my diet) says that the kidney disease causes adrenal like compounds that affect the BP. Would love to know what else to do.

    1. hi Mike, I’ll bet your doctors are mightily impressed with how you are taking care of your health with wfpb eating and daily exercise! Can’t get a better foundation than that. I too get frustrated with spiking blood pressure readings but my doctors remind me of all that is going right. So, re the blood pressure, I use a kind of portfolio method in tackling that. See the 2nd to last paragraph in Dr Greger’s article starting with “Flax seeds… “, well, I take a look at the videos listed in that paragraph and check off the ideas I am already applying. Doing the flax seed and whole grain oat porridge in the mornings, the wfpb diet,
      and I cook beets regularly to eat with my nitrate rich spinach/kale salads/vegies twice a day. Havent tried hibiscus tea though, so that might be something I can add to my routine.
      I just keep collecting ideas as Dr Greger keeps making videos. I may try one or two “raw” days per week next and see how it goes. If I run across any ‘new’ suggestions Mike, I’be sure to pass it along !

      1. Thank you for the reply. I do use flax seed powder with my oatmeal. My Nephrologist says my diet is “perfect”. Nice to know, but unfortunately kidney keep getting worse and BP doesn’t change. I guess it would have been worse sooner without a WFPB diet. She also agrees that animal protein is especially hard on the kidneys.

  11. I started eating health food in 1962. That evolved into a diet almost like the diet you recommend now. I still lost all but six teeth. At that time it was not obvious what healthy diet was. Given the Paleolithic ideas it is not obvious now. I have been disease free but I have still had teeth and vision problems. With just front teeth I have not had more decay for years. The gum disease is gone. My cataracts have dissolved but I still have other problems. This is very difficult. To say this is a choice is too much of a value judgment. It is extremely difficult. I love your website but you are very dogmatic. I find high levels of vit. C very beneficial.

  12. Dr. Greger often talks about “saving lives.” My own doctor, now retired, used the same term. Thanks to my him and all the scientific learning he showed me (including this web site), I’ve been eating vegan etc. for over 3 years, I feel a better, my numbers are better, and it seems fair to assume I’ll live this better life longer.

    But saving lives? I have never understood what it means in this context. The best we can hope and strive for is to live better and longer but we are all going to die at some point. I don’t know what the right term is, but “saving lives” does not seem appropriate in this context. We are improving and likely prolonging lives but “saving” them.?

    This is not just a semantic point. Language helps shape people’s thinking. When we say to someone “this way of eating could save your life,” many people I know reflexively, understandably and somewhat correctly respond with something like “we’re all going to die.” That’s hardly something I can dispute and if a had a better term than “saving lives” I wouldn’t have to even try disputing it.

    1. Just tell other folks that the diet prevents and disrupts the progression of disease. This issue is nothing more than semantics.

      Saying “we’re all going to die”, about the wfpb diet, indicates disbelieve in the possibility of sustaining a long and healthy life through diet. I think faith in the diet plays a role in it’s success.

  13. Interesting! I suspect there is more to this question that meets the eye. I don’t benefit from sugary fruits, and I cannot understand why they would be better for health than vegetables.

  14. If the data on fruit vs. vegetables are based on population questionnaires, then here is my guess. I think when people say they eat vegetables, they are thinking of lettuce, tomatoes, and French fried potatoes, or maybe baked potatoes. Very few people eat a lot of vegetables beyond that – cooked kale, beets, winter squash, avocado, asparagus, red cabbage… Five servings every day? Then, when people say eat fruit, they probably mean sugary fruits, not “technical fruits,” like cucumbers and avocados, or whole grains, which are fruits, too.

    So I think I am going to take this aspect of the data with a grain of salt (not really, of course!), and stay away from the sugary fruits that I believe are not beneficial for me. I think the vegetables I eat (see above) should do me fine. If anyone disagrees, please tell me why.

    1. If you can’t handle sugary fruits that points to yeast overgrowth. I have issues if oranges for example are on sale and I pig out on them. There are ways to deal with yeast issues….just not sure exactly what they are…..

      Likely keeping fruit down some and using probiotic foods…..

    2. hi Nina, I think you are making some grand assumptions there on what people define as fruit and vegetables and in guessing what they eat. Searching the sources lists of studies can give added info when the full text is available – then the trial protocols are described. For more info on fruit , a topic search at NutritionFacts yields this link

      The most beneficial fruits and vegies are highly coloured ones ie all colours of the rainbow, particularly deep reds, blues, greens. Also, try to eat more fruit and vegies where the flesh is coloured also. like tomatoes, mangoes etc. Non tropical fruits such as apples and pears can be eaten with the skin for added benefits.

      Berries are so packed with nutrients that Dr Greger lists them separately on his Daily Dozen list. Enjoy a half cup daily to get thise powerful antioxidants and phytonutrients!

      1. Susan, I looked at the study, and I did not see definitions of fruits or vegetables. Most questionnaires of this kind do not spell out that kind of detail for the participants. I have taken these questionnaires myself. They just asked about “fruits,” without elaborate definitions.

        Sugary fruits do not work for me. That includes berries, unfortunately. I can eat small amounts occasionally in warm weather on a day off, but that is all. On a work day, they deplete me of energy too much, and they can keep me awake at night. That is why I am asking these questions.

        1. Thanks for clarifying Nina, I find that often I can’t get the details I want out of reading study abstracts but once in a while get lucky in finding a free full text version. (not in this case though)

          I did write you a reply with links about blood pressure and best vegies this morning, but it seems to have been swallowed up by the system.. maybe it will appear later. This link mentions why some veg are so great at lowering blood pressure. We cant go wrong in including these in our diet.

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