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Hypertension

Hypertension

Blood pressure levels are a function of cardiac output multiplied by peripheral resistance (the resistance in the blood vessels to the flow of blood)

Hypertension

The major factors which help maintain blood pressure (BP) include the sympathetic nervous system and the kidneys. Optimal healthy blood pressure is a systolic blood pressure of <120 mmHg and a diastolic blood pressure of <80 <120/80.

Hypertension
Category
Normal Pre-hypertension Hypertension Stage 1 Hypertension Stage 2

Systolic Blood Pressure < 120


120-139 140-159 >160

Diastolic Blood Pressure <80


80-89 90-99 >100

Hypertension

Approximately one in four American adults has hypertension. As many as 2.8 million children also have high blood pressure. The prevalence of hypertension increases with age.

Prevalence of Hypertension by Age

Age

% Hypertensive

18-29 30-39 40-49 50-59 60-69 70-79 80+

4 11 21 44 54 64 65

Hypertension

When the normal regulatory mechanisms fail, hypertension develops. Hypertension is so dangerous because it gives off no warning signs or symptoms.

Untreated

hypertension can result in:


--Kidney damage --Stroke --Blindness

Arteriosclerosis Heart Attack Enlarged

heart

Factors Influencing the Development of Hypertension

High-normal blood pressure Family history of hypertension African-American ancestry Overweight

Factors Influencing the Development of Hypertension

Excess Consumption of Sodium Chloride

Certain segments of the population are salt sensitive because their blood pressure is affected by salt consumption

Factors Influencing the Development of Hypertension

Alcohol consumption

Factors Influencing the Development of Hypertension

Exercise
Less active individuals are 3050% more likely to develop hypertension.

Factors Influencing the Development of Hypertension Other

Dietary Factors

Potassium: Calcium: Magnesium:

Treatment for Hypertension


Maintain a healthy weight, lose weight if overweight. Be more physically active. Drink alcoholic beverages in moderation. Reduce the intake of salt and sodium in the diet to approximately 2400 mg/day.

The DASH Diet

The Dietary Approaches to Stop Hypertension clinical trial (DASH) Diet rich in fruits, vegetables, and low fat dairy foods, can substantially lower blood pressure in individuals with hypertension and high normal blood pressure.

Dash Study

Control:

Ca, Mg, & K ~ 25% of US diet Macronutrients and fiber ~ US average Fruits and vegetables increased to 8.5 servings K and Mg to 75%
Add 2-3 servings low-fat dairy to fruit & vegetable diet. Ca, K and Mg increased to 75%

Fruits and Vegetables


Combination:

Dash Study Outcomes

Fruit and Vegetable Diet:

Decrease in systolic and diastolic blood pressure in entire study group and in the hypertensive subgroup. Significant decrease in both systolic and diastolic blood pressure in both groups. Greatest drop was in systolic BP in hypertensive group (11.4 mmHg)

Combination Diet:

Dash Diet Implications

Combination diet affects comparable to pharmacological trails in mild hypertension. Population wide reductions in blood pressure similar to DASH results would reduce CHD by ~ 15% and stroke by ~27% Great potential in susceptible groups: African Americans and elderly.

The DASH Diet

The DASH Diet includes:


7-8 servings of grains and grain products 4-5 servings of vegetables 4-5 servings of fruits 2-3 servings of low fat dairy products 2 or less servings of meat, poultry and fish 2-3 servings of fats and oils Nuts, seeds and dry beans 4-5 times /week Limited sweets low in fat.

Sodium in Foods

Conversion of milligrams to milliequivalents (mEq):

mg/atomic weight x valence = mEq.

Atomic weight sodium = 23, valence = 1 2400 mg/23 x 1 = 104.3 mEq sodium

Reducing Sodium in the Diet

Use fresh poultry, fish and lean meat, rather than canned or processed. Buy fresh, plain frozen or canned with no salt added vegetables. Use herbs, spices and salt-free seasoning blends in cooking and at the table; decrease or eliminate use of table salt. Choose convenience foods that are lower in sodium.

Reducing Sodium in the Diet

When available, buy low- or reducedsodium or no-salt-added versions of foods like:


Canned soup, canned vegetables, vegetable juices cheeses, lower in fat condiments like soy sauce crackers and snack foods like nuts processed lean meats

Food Labels
Claim
Low Sodium Very Low Sodium

Amount
>140 mg/serving >35 mg/serving

Sodium Free
Reduced Sodium

>5 mg/serving
25% less than original