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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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hypertension3
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)
hypertension6
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.
hypertension8
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

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
hypertension10
Hypertension
  • When the normal regulatory mechanisms fail, hypertension develops.
  • Hypertension is so dangerous because it gives off no warning signs or symptoms.
slide11

Untreated hypertension can result in:

    • Arteriosclerosis --Kidney damage
    • Heart Attack --Stroke
    • Enlarged heart --Blindness
factors influencing the development of hypertension
Factors Influencing the Development of Hypertension
  • High-normal blood pressure
  • Family history of hypertension
  • African-American ancestry
  • Overweight
factors influencing the development of hypertension13
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 hypertension15
Factors Influencing the Development of Hypertension
  • Exercise
  • Less active individuals are 30-50% more likely to develop hypertension.
factors influencing the development of hypertension16
Factors Influencing the Development of Hypertension
  • Other Dietary Factors
  • Potassium:
  • Calcium:
  • Magnesium:
treatment for hypertension
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 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
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%
dash study outcomes
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)
dash diet implications
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 diet22
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.
sodium in foods
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
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 diet25
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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