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Hypertension in Spinal Cord Patients

Hypertension in Spinal Cord Patients. Rebecca Linstead. Hypertension is…. Systolic BP > 140 mmHg OR Diastolic BP > 90 mmHg. Regulation of Blood Pressure. Baroreceptor Reflex. One Significant Difference in SCI…. Autonomic Dysreflexia. Parasympathetic. S ympathetic. Etiology.

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Hypertension in Spinal Cord Patients

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  1. Hypertension in Spinal Cord Patients Rebecca Linstead

  2. Hypertension is… Systolic BP > 140 mmHg OR Diastolic BP > 90 mmHg

  3. Regulation of Blood Pressure Baroreceptor Reflex

  4. One Significant Difference in SCI…

  5. Autonomic Dysreflexia Parasympathetic Sympathetic

  6. Etiology

  7. What to watch for… • Sweating above the level of injury • Hypertension • Nausea • Cold, clammy skin below the level of injury • Goose bumps • Blotching of the skin

  8. Emerging Research:Testing an alternative mineral salt • Inclusions/Exclusions • Methods • Results VS

  9. Emerging Research …

  10. Emerging Research …

  11. Emerging Research:Protein Supplementation • Inclusions • Methods • Results VS

  12. Emerging Research …

  13. MNT for Hypertension • Potassium • Magnesium • Fruits/veggies • Lean meats • Healthy fats • Whole grains • Highly processed meats and cheeses • High sugar foods • Sedentary lifestyle

  14. Special Considerations Lose excess weight Adequate fluid intake Smoking cessation

  15. B.B. – 75 y/o WM • Diagnoses: atherosclerosis of extremities with gangrene, pressure ulcers, GERD, DB, Autonomic Dysreflexia, HTN, hyperlipidemia • Admitted June 2013 for worsening pressure ulcers • Allergies: Amikacin, hydrochlorothiazide • Current medications: • Laxative/Stool softener : Docusate • Antihypertensive: Metoprolol • DB regimen: SSI, 6 units @ bedtime, 16 units every morning • Vitamin D2: ergocalciferol • Bowel training 3x/week

  16. B.B. • Currently on a 2200 CHO diabetic diet • Supplements include 1 Prostate with each meal (discontinued Boost Glucose Control 10/24) • Main concern: maintain blood sugars <180 and heal pressure ulcers

  17. References http://apbrwww5.apsu.edu/thompsonj/Anatomy%20&%20Physiology/2020/2020%20Exam%20Reviews/Exam%201/CH19%20Blood%20Pressure.htm http://betterthandormfood.com/2012/02/do-you-really-need-8-cups-of-water-per-day/ http://www.spinalcordinjury-paralysis.org/heartandnerve/2012/07/31/foodie-fest http://www.studyblue.com/notes/note/n/spinal-cord-injuries/deck/5449625 http://eprimarycare.onf.org/AutonomicDysreflexia.html http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/P/PNS.html http://pvamag.com/pn/article/5039/autonomic_dysreflexia_an_emergency_situation http://hyper.ahajournals.org/content/55/3/636.full http://www.spinal-injury.net/autonomic-dysreflexia.htm http://www.ninds.nih.gov/disorders/sci/detail_sci.htm

  18. References Teunissen-Beekman KF, Dopheide J, Geleijnse JM, Bakker SJ, Brink EJ, de Leeuw PW, van BaakMA. Protein supplementation lowers blood pressure in overweight adults: effect of dietary proteins on blood pressure (PROPRES), a randomized trial. Am J ClinNutr. 2012 Apr;95(4):966-71 Sarkkinen ES, Kastarinen MJ, Niskanen TH, Karjalainen PH, Venäläinen TM, Udani JK, Niskanen LK. Feasibility and antihypertensive effect of replacing regular salt with mineral salt -rich in magnesium and potassium- in subjects with mildly elevated blood pressure. Nutr J. 2011 Sep 2;10:88. doi: 10.1186/1475-2891-10-88.

  19. Questions?

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