Research paper: nutrition-related diseasehypertension

Part 1: my family health history

In my family health history, my grandfather has died from lung cancer. My aunt has
died from cervical cancer. Although my grandfather and aunt both died with cancer, I
believe the primary causes of their cancer were their dietary habituation and unhealthy
lifestyles. They both were heavy and long-standing smokers as well as had long-term
simplex nutrition. My grandmother and mother have been undergoing the chronic
disease: hypertension which is the most prominent family health-related condition and
disease I am considering in this research paper.
Within the Chinese traditional dietary culture, salt and oil are essential seasonings
during food processing and preparation. My family would add excessive salt and plant
oil into the daily food preparation. As we consumed the excessive salt intake, it may
have potential risk of hypertension. On the other hand, as I recalled, my mother had
low frequent physical activities and high stresses which were additional contributing
risk factors to hypertension.

Part 2: the definition of hypertension

First, we need to know what blood pressure is. Blood pressure is the measure of force
that moves blood through the circulatory system. Maintaining normal blood pressure
is vital to force our blood to flow through the cardiovascular system. White blood
cells, an essential part of our immune system, would not get distributed around our
bodies without appropriate blood pressure. But blood pressure can be unhealthily
high, or it can also be too low.
Blood flows through our body because of a difference in pressure - it has potential.
Our blood pressure is highest at the start of its journey from our heart - when it enters
the aorta - and it is lowest at the end of its journey along gradually smaller branches
of arteries and / or capillaries. That pressure difference is what causes blood to flow
through our bodies.
Blood pressure is expressed by two numbers. The higher number represents systolic
blood pressure, the pressure in the arteries when the heart muscle is contracting and
pumping blood into the arteries. Optimal systolic blood pressure is 120 mm Hg or
less. The second value is diastolic blood pressure, the artery pressure when the heart is
relaxed. Optimal diastolic blood pressure is 80 mm Hg or less.
Hypertension (high blood pressure) is defined as sustained systolic pressure exceeding
139 mm Hg or diastolic blood pressure exceeding 89 mm Hg. The following range of
blood pressure is defined by the American Heart Association.
1. Normal blood pressure is below 120 systolic and / or below 80 diastolic
2. Pre-hypertension is 120-139 systolic or 80-89 diastolic
3. Stage 1 high blood pressure (hypertension) is 140-159 systolic or 90-99 diastolic
4. Stage 2 high blood pressure (hypertension) is 160 or higher systolic or 100 or
higher diastolic
5. Hypertensive crisis (a medical emergency) is when blood pressure is
above 180 systolic or above 110 diastolic.
Part3: the symptoms of hypertension
Most of the time, hypertension has no obvious symptoms to indicate that somethings
wrong. It is described as a silent disorder.
As the resource is described in the American Heart Association:
The best evidence indicates that high blood pressure does not cause headaches or
nosebleeds, except in the case of hypertensive crisis, a medical emergency when
blood pressure is 180/110 mm Hg or higher.
Other inconclusively related symptoms
A variety of symptoms may be indirectly related to, but are not always caused by,
high blood pressure, such as:
Blood spots in the eyes
Blood spots in the eyes (subconjunctival hemorrhage) are more common in
people with diabetes or high blood pressure, but neither condition causes the
blood spots. Floaters in the eyes are also not related to high blood pressure.
However, an eye doctor may be able to detect damage to the optic
nerve caused by untreated high blood pressure.

Facial flushing
Facial flushing occurs when blood vessels in the face dilate. It can occur
unpredictably or in response to certain triggers such as sun exposure, cold
weather, spicy foods, wind, hot drinks and skin-care products. Facial flushing
can also occur with emotional stress, exposure to heat or hot water, alcohol
consumption and/ or exercise all of which can raise blood pressure
temporarily. While facial flushing may occur while your blood pressure is
higher than usual, high blood pressure is not the cause of facial flushing.

Dizziness
While dizziness can be a side effect of some blood pressure medications, it is
not caused by high blood pressure. However, dizziness should not be ignored,
especially if the onset is sudden. Sudden dizziness, loss of balance or
coordination and trouble walking are all warning signs of a stroke. High blood
pressure is a leading risk factor for stroke.

Part 4: the contributors to hypertension

Circadian rhythm is a biological rhythm that takes place over a period of about 24
hours. Circadian rhythm plays a role in the fluctuation of our heart rate, blood
pressure, blood sugar, and body temperature. Therefore our blood pressure does
constantly vary. It lowers during sleep and relaxation, raises when we are awakened,
excited, startled, anxious, and also during physical activities.
Approximately 95% of cases of hypertension have no clear-cut cause. Such cases are
classified as primary hypertension. Other causes such as kidney dysfunction, sleep-
disordered breathing (sleep apnea) often lead to the other 5% of cases, classified as
secondary hypertension. Since 95% of cases of hypertension have no clear causes, we
can only identify the risk factors which may contribute to its development. There are
many potential risk factors which contribute to a state of high blood pressure to a
certain degree.
The risk factors of primary hypertension
1. Age: blood pressure steadily increases with age. As we age, the arteries become
stiffer and narrower and lose their flexibility and elasticity due to the plaque build up.
With the blood vessels remaining rigid and narrow, blood pressure remains high. A
person who has atherosclerosis is more susceptible to high blood pressure.

2. Family history: a family health history of hypertension is a threatening genetic

factor, especially if both parents have high blood pressure.

3. Race: African-Americans and Asian-Americans are more likely than whites or

Hispanics to develop hypertension

4. Body size: overweight people have six times greater risk of having hypertension
than lean people. Expanded blood vessels develop to support excess tissue in
overweight and obese individuals, and these extra blood vessels increase work by the
heart and also increase blood pressure.

5. Sex: - males and females have different risk profiles. Men are more prone to
hypertension at a younger age and women have a higher rate of hypertension at older
ages.

6. Lifestyle: salt-rich and fatty foods diets, excessive alcohol and tobacco use, and
prolonged or habitual physical inactivity all contribute to an increase of blood
pressure.

7. Stress: long-term stress or acute short term stress also contribute to high blood
pressure.

The secondary risk factors of high blood pressure

Secondary hypertension has specific causes - that is, it is secondary to another
problem. One example, now thought to be one of the most common causes of
treatment-resistant hypertension, is primary aldosteronism, a hormone disorder
causing an imbalance between potassium and sodium levels, thus leading to high
blood pressure.
Common reversible causes of secondary hypertention are excessive intake of alcohol
and use of oral contraceptives, which can cause a slight rise in blood pressure.
Hormone therapy for menopause is also a culprit.
Secondary hypertension can also result from:
Diabetes (both due to kidney problems and nerve damage)
Kidney disease
Pheochromocytoma (a cancer)
 Cushing syndrome (which can be caused by use of corticosteroid drugs)
Congenital adrenal hyperplasia (disorder of the adrenal glands, which secrete
the hormone cortisol)
Hyperthyroidism (overactive thyroid gland).
Hyperparathyroidism (which affects calcium and phosphorous levels)
Pregnancy
Sleep apnea
Obesity.

Part5: The treatment of high blood pressure

Medications to treat high blood pressure
Thiazide diuretics. Diuretics, sometimes called water pills, are medications
that act on your kidneys to help your body eliminate sodium and water,
reducing blood volume.
Thiazide diuretics are often the first, but not the only, choice in high blood pressure
medications. Thiazide diuretics include hydrochlorothiazide (Microzide),
chlorthalidone and others.
Diuretics or calcium channel blockers may work better for black and older people
than do angiotensin-converting enzyme (ACE) inhibitors alone. A common side effect
of diuretics is increased urination.
Beta blockers. These medications reduce the workload on your heart and
open your blood vessels, causing your heart to beat slower and with less force.
Beta blockers include acebutolol (Sectral), atenolol (Tenormin) and others.
When prescribed alone, beta blockers don't work as well, especially in black and older
people, but may be effective when combined with other blood pressure medications.
Angiotensin-converting enzyme (ACE) inhibitors. These medications
such as lisinopril (Zestril), benazepril (Lotensin), captopril (Capoten) and
others help relax blood vessels by blocking the formation of a natural
chemical that narrows blood vessels. People with chronic kidney disease may
benefit from having an ACE inhibitor as one of their medications.
Angiotensin II receptor blockers (ARBs). These medications help relax
blood vessels by blocking the action, not the formation, of a natural chemical
that narrows blood vessels. ARBs include candesartan (Atacand), losartan
(Cozaar) and others. People with chronic kidney disease may benefit from
having an ARB as one of their medications.
Calcium channel blockers. These medications including amlodipine
(Norvasc), diltiazem (Cardizem, Tiazac, others) and others help relax the
muscles of your blood vessels. Some slow your heart rate. Calcium channel
blockers may work better for black and older people than do ACE inhibitors
alone.
Grapefruit juice interacts with some calcium channel blockers, increasing blood levels
of the medication and putting you at higher risk of side effects.
Renin inhibitors. Aliskiren (Tekturna) slows down the production of renin, an
enzyme produced by your kidneys that starts a chain of chemical steps that increases
blood pressure. Tekturna works by reducing the ability of renin to begin this process.
Due to a risk of serious complications, including stroke, you shouldn't take aliskiren
with ACE inhibitors or ARBs.
Additional medications sometimes used to treat high blood pressure
If you're having trouble reaching your blood pressure goal with combinations of the
above medications, your doctor may prescribe:
Alpha blockers. These medications reduce nerve impulses to blood vessels,
reducing the effects of natural chemicals that narrow blood vessels. Alpha
blockers include doxazosin (Cardura), prazosin (Minipress) and others.
Alpha-beta blockers. In addition to reducing nerve impulses to blood vessels,
alpha-beta blockers slow the heartbeat to reduce the amount of blood that must
be pumped through the vessels. Alpha-beta blockers include carvedilol
(Coreg) and labetalol (Trandate).
Central-acting agents. These medications prevent your brain from signaling
your nervous system to increase your heart rate and narrow your blood
vessels. Examples include clonidine (Catapres, Kapvay), guanfacine (Intuniv,
Tenex) and methyldopa.
Vasodilators. These medications, including hydralazine and minoxidil, work
directly on the muscles in the walls of your arteries, preventing the muscles
from tightening and your arteries from narrowing.
Aldosterone antagonists. Examples are spironolactone (Aldactone) and
eplerenone (Inspra). These drugs block the effect of a natural chemical that
can lead to salt and fluid retention, which can contribute to high blood
pressure.
Lifestyle change and nutrition approach to alleviate high blood pressure
To maintain proper and normal blood pressure requires lifestyle change.
1. Limiting and weaning off smoking or alcohol use is a good way to start.

2. Control of calorie intake: since being overweight plays a role in high blood
pressure, thus, the control of calorie intake is required in order to lose weight or retain
healthy body mass.
Consuming various groups of vegetables, fruits, and whole grains as an essential part
of regular dietary style is a healthier approach to maintain or lose weight.

3. Increasing physical activities: according to the recommendations of the physical

activity guidelines of Americans, adults should avoid inactivity. Adults should engage
in at least 150 minutes a week of moderate-intensity, or 75 minutes a week of
vigorous-intensity aerobic physical activity.

4. Control of salt intake: excessive addition of salt results from much of the common
processes of food manufacturing and food preparation at restaurants. Moderation of
salt intake is important to remain a healthy blood pressure. Changing the behavior of
dining out and preparing fresh, home-cooked foods as much as possible is a key to
control unnecessary excessive salt intake. As the RDA recommendation of salt intake
is 1500 mg per day at age 19-50, we should set this index into our daily food
consumption.

References:
http://www.medicalnewstoday.com/articles/150109.php?page=2

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandSympt
omsRisks/What-are-the-Symptoms-of-High-Blood-
Pressure_UCM_301871_Article.jsp#.WOMsyNR97Dd

http://www.mayoclinic.org/diseases-conditions/high-blood-
pressure/basics/treatment/con-20019580