Diet and Health Guidelines to Lower Risk of High Blood Pressure

1. Diet and Health Guidelines to Lower Risk of High Blood Pressure Presented by Janice Hermann, PhD, RD/LD OCES Adult and Older Adult Nutrition Specialist

2. What Is Blood Pressure • Blood pressure is the pressure on the blood vessel walls • A blood pressure reading consists of two numbers, for example 120/80 • The first number is called systolic • Pressure when the heart contracts • The second number is called diastolic • Pressure when the heart is resting between contractions

3. How is Blood Pressure Classified

4. Diagnosing High Blood Pressure • To diagnose high blood pressure you need two high blood pressure readings, taken several weeks apart, with either the systolic or diastolic or both consistently above 140/90 • Blood pressure changes throughout the day • Just going to the doctor may make some people’s blood pressure rise

5. Diagnosing High Blood Pressure • High blood pressure can progress silently and without symptoms • Estimated 1/3 of people with high blood pressure and are unaware • However, with detection and proper treatment high blood pressure can be controlled • People need to have their blood pressure checked regularly, at least every two years

6. Children Should Have Blood Pressure Checked Too • Children should have blood pressure checked regularly too • High blood pressure in children may signal an underlying disease or early onset of high blood pressure

7. Effect of High Blood Pressure • High blood pressure is a serious health problem • High blood pressure causes the heart to work harder, and over time may damage blood vessels • Damage to blood vessels in the heart may increase the risk of heart disease • Damage to blood vessels in the brain may increase the risk of stroke • Damage to blood vessels in the kidney may increase the risk of kidney damage

8. Causes of High Blood Pressure • Blood pressure arises from: • Contractions of the heart muscle that pump blood away from the heart (cardiac output) and • Resistance that blood encounters as it moves through the arteries (peripheral resistance) • When either cardiac output or peripheral resistance increases, blood pressure rises

9. Causes of High Blood Pressure • Cardiac output is raised when: • Heart rate increases • Blood volume increases • Sodium retention • Fluid retention

10. Causes of High Blood Pressure • Peripheral resistance is mostly affected by physical and chemical signals that alter the blood vessel diameter • Signals from the nervous system influence the heart’s pumping activity and blood vessel diameter • Signals from hormones promote fluid retention and blood vessel constriction • The kidneys also control section of hormones involved in sodium and water retention and blood vessel constriction

11. Causes of High Blood Pressure • High blood pressure is a very complex condition • Primary or essential hypertension develops without an identifiable cause (95%) • Most cases of high blood pressure have no identifiable cause • Secondary hypertension is caused by a specific disorder (5%) • Usually due to abnormalities in organs or hormones involved in regulating blood pressure

12. Causes of High Blood Pressure • Causes of secondary hypertension • Chronic kidney disease interferes with the removal of sodium and water from the blood, thus increasing blood volume and blood pressure • Atherosclerosis in the renal blood vessels may cause increased production of hormones that stimulate water retention and blood vessel constriction

13. Causes of High Blood Pressure • Causes of secondary hypertension • Artery stiffness and thickening due to age, diabetes, atherosclerosis and other reasons can increase resistance to blood flow, increasing blood pressure • Hormonal disorders, including some thyroid diseases and adrenal disorders, can also cause high blood pressure

14. Risk Factors • There are factors that may affect high blood pressure • Family history of high blood pressure • Being overweight • Increasing age • Physical inactivity • Smoking • Diabetes • High sodium intake (sodium sensitive people) • High alcohol intake • High fat diet • Low potassium, calcium and magnesium intake

15. Family History • High blood pressure tends to run in families • People in the same family may have similar lifestyle and dietary habits that increase their risk of developing high blood pressure • High blood pressure is more prevalent and severe among African Americans

16. Overweight • Being overweight is a risk for high blood pressure • Carrying excess weight in the abdomen is a greater risk for high blood pressure than carrying excess weight in the hips and thighs • Bringing weight down may be all some people need to do to control their blood pressure 

17. Obesity • Rate of high blood pressure increases with overweight

18. Weight Management • Weight management recommendations are: • To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended • To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity

19. Age • Blood pressure tends to increase with age • Men typically begin having an increase in blood pressure by age 45 to 50 • Women typically begin having an increase in blood pressure after menopause • However, just because you get older doesn’t mean you will develop high blood pressure

20. Physical Activity • Physical activity can help you: • Lose weight • Lower total cholesterol • Lower LDL-cholesterol • Lower triglycerides • Increase HDL-cholesterol • All of which can lower the risk of: • High blood pressure • Heart disease • Stroke • Diabetes • Obesity

21. Physical Activity • Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight • Physical activity recommendations are: • 150 minutes of moderate-intensity per week or • 75 minutes of vigorous-intensity per week

22. Smoking • Smoking increases your risk of high blood pressure • Smoking raises blood pressure level and heart rate • Smoking lowers HDL-cholesterol • Smoking increases the tendency of blood to clot

23. Diabetes • High blood pressure is more common in people who have uncontrolled diabetes • Insulin resistance, commonly associated with obesity, signals the pancreas to produce more insulin • High insulin signals the kidneys to retain sodium and thus may increase the risk of developing high blood pressure

24. Sodium • Your kidneys regulate the sodium level in your body • Most people aren't affected by excess dietary sodium because their bodies just get rid of excess sodium in the urine

25. Sodium Sensitive People • However, some people are sodium-sensitive • For sodium-sensitive individuals, too much sodium in the diet can increase blood pressure

26. Sodium Sensitive People • For sodium-sensitive people, lowering sodium intake may help lower blood pressure • 55% white • 73% African Americans • Unfortunately, there’s no easy way to know who may be a sodium-sensitive individual

27. Sodium Sensitive People • People most likely to be sodium-sensitive: • Family history of high blood pressure • Chronic kidney disease • Diabetes • African American • Over 50 years of age • Overweight

28. How Much Sodium • Dietary Guidelines recommend • People reduce daily sodium intake to less than 2,300 mg (approximately 1 teaspoon of salt) and • Further reduce sodium intake to less than 1,500 mg sodium among those: • 51 years of age or older • of any age who are African American or have hypertension, diabetes or chronic kidney disease

29. How Much Sodium • The DRI for sodium is: • 1,500 mg/day for people 19-50 years of age • 1,300 mg/day for people 51-70 years of age • 1,200 mg/day for people >70 years of age • The Upper Level for sodium intake for adults is 2,300 mg/day • On average, most adults consume significantly more, 4,000 to 6,000 milligrams of sodium daily

30. Where Is Sodium • As much as 75% of the sodium in your diet comes from salt added to foods during processing • About 15% comes from salt added during cooking and at the table • Only 10% comes from the natural content in foods

31. Replacing Sodium Losses • Although you lose sodium and some other minerals in perspiration, the amount lost is usually small • Regular meals and snacks eaten after physical activity will normally replace electrolytes (sodium and potassium) lost in perspiration • In extreme heat beverages containing electrolytes such as Gatorade or Powerade help replace fluids and electrolytes lost in perspiration

32. Alcohol • Heavy alcohol consumption, 3 or more drinks daily, is strongly associated with increased risk of high blood pressure • Effect of moderate alcohol intake on blood pressure unknown • Recommended alcohol intake is: • Not more than one alcoholic drink a day for women • Not more than two alcoholic drinks a day for men

33. Alcohol • Role of alcohol with high blood pressure is unclear • May contribute extra calories which may increase body weight

34. Fat, Trans Fat, Saturated Fat & Cholesterol • High fat, trans fat, saturated fat and cholesterol intakes are linked to high cholesterol, LDL-cholesterol, and triglycerides which contributes to atherosclerosis and high blood pressure • Atherosclerosis narrows the blood vessels and decreases blood flow to the kidneys

35. Fat, Trans Fat, Saturated Fat & Cholesterol • The kidneys try to increase blood flow to the kidneys by expanding blood volume and constricting smaller blood vessels • However, blood pressure increases not only in the kidneys, but all over the body, which further damages blood vessels and increases atherosclerosis

36. Fat, Trans Fat, Saturated Fat & Cholesterol • Lowering total fat, saturated fat, cholesterol and trans fat helps lower blood cholesterol and triglycerides, which may lower atherosclerosis • Reducing fat helps with weight loss, which may lower blood pressure

37. Fat, Trans Fat, SaturatedFat & Cholesterol • Recommendations are: • Keep total fat intake between 20 to 35 % of calories, with most fats coming from polyunsaturated and monounsaturated fats • Consume less than 10 percent of calories from saturated fatty acids • Consume less than 300 mg/day of cholesterol • Keep trans fatty acid consumption as low as possible

38. Other Dietary Factors • Too little of some other nutrients including potassium, calcium and magnesium, may have an important link to high blood pressure • Adequate intakes of these minerals may have a protective effect against high blood pressure

39. Other Dietary Factors • Potassium has roles with: • Maintaining fluid balance • Muscle contraction • Calcium has roles with: • Activating messengers that help maintain normal blood pressure • Magnesium has roles with: • Heart function • Lessening blood vessel constriction

40. Other Dietary Factors • Fruits and vegetables are good sources of potassium • Milk and dairy products are a good source of all three nutrients • The best guideline is to follow the USDA Daily Food Plan

41. Other Dietary Factors • For some individuals potassium may be beneficial, but for individuals with kidney problems potassium may be restricted. • Check with your doctor before using a potassium chloride salt substitute.

42. Emotional Stress • For some people, stress may be a factor for high blood pressure • Learning how to relieve stress improves the overall quality of one's life

43. Lower Risk of High Blood Pressure • Follow Dietary Guidelines • Maintain a healthy weight • Be physically active each day • Consume ample fruits, vegetables or dairy products to provide calcium, potassium, and magnesium • Keep total fat, saturated fat, trans fat, and cholesterol intakes within recommended levels • Keep sodium intake below 2,300 mg or 1,500 mg • Use alcohol in moderation • Abstain from smoking • Keep diabetes in control