Can I eat sushi if I have high blood pressure?

January 11, 2026 •

4 min read

According to the CDC, nearly half of American adults have high blood pressure. When managing this condition, many people wonder about their favorite foods, including sushi. Can I eat sushi if I have high blood pressure? The short answer is yes, but with careful considerations and mindful choices to reduce the high sodium content typically found in traditional preparations.

Quick Summary

Sushi can be included in a diet for managing high blood pressure, but mindful adjustments are crucial. The main concern is high sodium from soy sauce, salted rice, and certain sauces. However, sushi also offers beneficial omega-3 fatty acids from fish like salmon and tuna. Strategies for enjoying it safely include opting for low-sodium soy sauce or alternatives, choosing sashimi or simple rolls, and moderating portion sizes.

Key Points

Check Sodium: Be mindful of high sodium in soy sauce, salted rice, and certain sauces when eating sushi.
Choose Omega-3s: Opt for fatty fish like salmon and tuna to benefit from blood pressure-lowering omega-3 fatty acids.
Make Substitutions: Use low-sodium soy sauce or alternatives like coconut aminos to drastically cut salt.
Pick Simpler Options: Favor sashimi or basic vegetable rolls over elaborate, sauce-heavy specialty rolls.
Control Portions: Practice portion control, as small pieces can lead to overconsumption of sodium and calories.
Mindful Condiments: Limit high-sodium sauces like eel sauce and spicy mayo, and moderate your use of wasabi and pickled ginger.
Consult a Professional: Always talk to your doctor or a dietitian about dietary changes if you have high blood pressure.

Understanding the Nutritional Landscape of Sushi

Sushi is often perceived as a healthy meal, but for those with high blood pressure, its nutritional profile presents a double-edged sword. On one side, you have the heart-healthy benefits of omega-3 fatty acids from fatty fish. On the other, you face the significant risk of high sodium from key ingredients like soy sauce and prepared sushi rice. Navigating this balance is key to incorporating sushi safely into a hypertension-friendly diet.

The Health Benefits of Sushi (The Good Side)

Many types of sushi incorporate fatty fish like salmon, tuna, and mackerel, which are excellent sources of omega-3 fatty acids. These essential fats are known to help lower blood pressure, reduce inflammation, and support overall cardiovascular health. A diet rich in omega-3s can also help reduce blood triglyceride levels and the risk of irregular heartbeats. Furthermore, plain, fresh fish like sashimi offers a lean source of high-quality protein without added sugars or fats. Many sushi rolls also include fresh vegetables like cucumber and avocado, which add vitamins, minerals, and fiber to the meal.

The Hypertension Risks in Sushi (The Not-So-Good Side)

The primary concern with sushi for individuals with high blood pressure is its often-high sodium content. This is largely due to three main culprits:

Soy Sauce: A single tablespoon of traditional soy sauce can contain a large portion of the recommended daily sodium intake.
Sushi Rice: The rice itself is typically cooked with salt, sugar, and vinegar, adding to the overall sodium count.
Other Ingredients: Many popular rolls and sauces, such as those made with imitation crab (surimi), eel sauce (unagi), or certain pickled vegetables, are loaded with additional sodium. Excessive sodium intake can increase blood pressure, fluid retention, and strain on the heart, making it crucial to be aware of hidden salt. The typical white sushi rice also contains refined carbohydrates and less fiber than brown rice, which can affect blood sugar levels, although rice vinegar may mitigate this effect to some extent.

Practical Strategies for Enjoying Low-Sodium Sushi

If you have high blood pressure, you don't need to eliminate sushi entirely. Instead, focus on moderation and smart substitutions. By making small changes, you can enjoy the flavors you love while protecting your heart health.

Here are some actionable tips:

Request low-sodium soy sauce: Most sushi restaurants offer a lower-sodium option. Still, use it sparingly. A small dropper bottle can help you control your intake.
Opt for sashimi: This is the healthiest choice, consisting of thinly sliced raw fish without any rice. It provides all the omega-3 benefits with almost no added sodium.
Choose simple rolls: Stick to basic maki rolls with fresh ingredients like avocado, salmon, or cucumber. Avoid complex, 'specialty' rolls that are often topped with high-sodium sauces like eel sauce or spicy mayo.
Ask for brown rice: Some restaurants offer brown rice as a healthier, higher-fiber alternative to white rice. While still prepared with some salt, it's a step in the right direction.
Skip high-sodium appetizers: Side dishes like miso soup are notoriously high in sodium. Consider healthier alternatives like a side salad with a vinegar-based dressing.
Create your own: Making sushi at home gives you complete control over the ingredients, allowing you to use unsalted rice and low-sodium seasonings.
Don't overdo it: Portion control is important. Sushi pieces can add up quickly, especially when you consider all the small dips and sauces.

Navigating the Menu: A Comparison Table

Here is a comparison of different sushi options to help guide your choices when dining out or preparing sushi at home.


Sushi Option	Pros (for blood pressure)	Cons (for blood pressure)	Recommended for Hypertension?
Sashimi	High in omega-3s, very low sodium, lean protein	No cons relevant to hypertension management	Yes (Best choice)
Simple Maki (Salmon/Tuna)	Good source of omega-3s, some fiber from vegetables	Contains salted rice, relies on soy sauce for flavor	Yes (With low-sodium soy sauce)
Vegetable Rolls	Contains fiber, vitamins; naturally low-sodium ingredients	Still contains salted rice, sauces can be high in sodium	Yes (With low-sodium soy sauce)
California Rolls	Some healthy fats from avocado	Imitation crab is high in sodium, uses salted rice	Moderate (Limit or make at home with fresh crab)
Eel (Unagi) Rolls	Good protein source	Very high in sodium due to eel sauce	No
Crunchy/Tempura Rolls	May contain some vegetables	Battered and fried, high in sodium and unhealthy fats	No

Conclusion: Mindful Indulgence is Possible

For those with high blood pressure, enjoying sushi is not off-limits but requires a strategic approach. The core takeaway is to control sodium intake, which means being selective with your choices and condiments. By favoring simple options like sashimi and fresh vegetable rolls, using low-sodium soy sauce, and moderating portion sizes, you can reap the cardiovascular benefits of omega-3s while minimizing the risks associated with excessive salt. Always remember to consult with your doctor or a registered dietitian before making significant changes to your diet, especially when managing a condition like high blood pressure. With the right knowledge, you can still find a place for sushi in a heart-healthy lifestyle.

World Health Organization: Diet, nutrition and the prevention of hypertension

Frequently Asked Questions

The main issue with sushi is its potential for very high sodium content, which can increase blood pressure. This comes from traditional soy sauce, salt used in the sushi rice, and high-sodium sauces or processed ingredients like imitation crab.

No, soy sauce is a major contributor, but not the only one. Salt is also added to the rice during preparation, and many specialty rolls and appetizers contain additional high-sodium ingredients like certain sauces or processed seafood.

Sashimi (thinly sliced raw fish) is the best option because it contains minimal to no added salt or rice. Simple maki rolls with fresh fish and vegetables are also good choices when you use low-sodium soy sauce sparingly.

Tempura rolls are not recommended for individuals with high blood pressure. They are battered and deep-fried, adding unhealthy fats, and the breading often contains high levels of salt.

Yes, brown rice is generally a better choice than white sushi rice. It offers more fiber and nutrients, though it's still prepared with some salt, so other modifications are still necessary.

To keep sodium low, use low-sodium soy sauce sparingly or choose low-sodium alternatives like coconut aminos. Vinegar-based dips or simply a small amount of wasabi can also add flavor without excessive salt.

Fatty fish like salmon and tuna are rich in omega-3 fatty acids, which have been shown to help lower blood pressure, reduce triglycerides, and decrease inflammation.