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Hypertension

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.

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Hypertension

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  1. Hypertension

  2. 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)

  3. 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.

  4. Hypertension

  5. 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.

  6. Age 18-29 30-39 40-49 50-59 60-69 70-79 80+ % Hypertensive 4 11 21 44 54 64 65 Prevalence of Hypertension by Age

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

  8. Untreated hypertension can result in: • Arteriosclerosis --Kidney damage • Heart Attack --Stroke • Enlarged heart --Blindness

  9. Factors Influencing the Development of Hypertension • High-normal blood pressure • Family history of hypertension • African-American ancestry • Overweight

  10. 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

  11. Factors Influencing the Development of Hypertension • Alcohol consumption

  12. Factors Influencing the Development of Hypertension • Exercise • Less active individuals are 30-50% more likely to develop hypertension.

  13. Factors Influencing the Development of Hypertension • Other Dietary Factors • Potassium: • Calcium: • Magnesium:

  14. 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.

  15. 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.

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

  17. Dash Study Outcomes • Fruit and Vegetable Diet: • Decrease in systolic and diastolic blood pressure in entire study group and in the hypertensive subgroup. • Combination Diet: • Significant decrease in both systolic and diastolic blood pressure in both groups. • Greatest drop was in systolic BP in hypertensive group (11.4 mmHg)

  18. 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.

  19. The DASH Diet • The DASH Diet includes: • 7-8 servings of grains and grainproducts • 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.

  20. 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

  21. 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.

  22. Reducing Sodium in the Diet • When available, buy low- or reduced-sodium 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

  23. Food Labels

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