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Hypertension PowerPoint PPT Presentation


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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.

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Hypertension

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Hypertension


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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)


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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.


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Hypertension


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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.


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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


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Hypertension

  • When the normal regulatory mechanisms fail, hypertension develops.

  • Hypertension is so dangerous because it gives off no warning signs or symptoms.


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  • Untreated hypertension can result in:

    • Arteriosclerosis--Kidney damage

    • Heart Attack--Stroke

    • Enlarged heart--Blindness


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Factors Influencing the Development of Hypertension

  • High-normal blood pressure

  • Family history of hypertension

  • African-American ancestry

  • Overweight


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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


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Factors Influencing the Development of Hypertension

  • Alcohol consumption


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Factors Influencing the Development of Hypertension

  • Exercise

  • Less active individuals are 30-50% more likely to develop hypertension.


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Factors Influencing the Development of Hypertension

  • Other Dietary Factors

  • Potassium:

  • Calcium:

  • Magnesium:


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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.


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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.


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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%


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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)


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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.


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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.


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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


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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.


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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


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Food Labels


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