1. High Blood Pressure and Congestive Heart Failure Topic 7

2. What Is Blood Pressure? • The pressure blood exerts on the arteries • It can rise and fall throughout the day • High blood pressure (hypertension) • Occurs when blood pressure remains elevated over a period of time • Hardening of the arteries (atherosclerosis) • When the heart works too hard it may lead to a stroke or heart attack

3. High Blood Pressure Facts • Systolic (top number) • Diastolic (bottom number) • Many individuals will attain their diastolic blood pressure goals once they reach their systolic blood pressure goal • Modifications in lifestyle can aid in improving systolic blood pressure

4. What Defines High Blood Pressure? • Normal • Systolic: < 120 mm Hg OR • Diastolic: <80 mm Hg • Pre-hypertension • Systolic: 120-139 mm Hg OR • Diastolic: 80-89 mm Hg

5. What Defines High Blood Pressure? (cont’d) • Stage 1 hypertension • Systolic: 140-159 mm Hg OR • Diastolic: 90-99 mm Hg • Stage 2 hypertension • Systolic : > or equal to 160 mm Hg • Diastolic: > or equal to 100 mm Hg

6. What Are Some of the Causes of High Blood Pressure? • Chronic kidney disease • Thyroid conditions • Genetics • Drugs (illegal) • Cocaine • Lifestyle • Certain medications • Birth control

7. Untreated Hypertension • Stroke • Heart failure • Renal failure • Memory trouble

8. High Blood Pressure: Interventions • Weight loss • Especially if overweight or obese • Physical activity • 30 minutes daily most days of the week • Healthy eating • DASH (Dietary Approaches to Stop Hypertension) diet • Limit sodium intake • 2-4 grams daily • Limit fat intake • Incorporate meat into a meal as “a part” of the meal and not as the “focus” of the meal • Restrict daily alcohol intake • Men=no more than 2 drinks and Women=no more than 1 drink

9. Nutrition: Sodium in Food Items • Aim to limit/avoid these items: • Table salt • Do not add table salt to food • Limit addition of table salt when cooking • Processed foods • Condiments, sauces and seasonings Tip #1: Purchase canned vegetables packed in water or rinse canned foods such as tuna and canned beans . Tip #2: Flavor foods with sodium free herbs and spices. Tip #3: When dinning out let your server know that you are looking for low salt or no salt items.

11. Nutrient Claims: Reading Labels • Sodium: • High=more than 300 mg/serving • Moderate=140-300 mg/serving • Low=<140 mg/serving • Very Low=<35 mg/serving • Sodium Free=<5mg/serving • Aim to limit high sodium foods • A high sodium food item may also equate to eating more than a serving size of a moderate or low sodium food item

12. What Is Heart Failure? • The heart is unable to efficiently pump blood throughout the body • Complications can occur • Lung congestion • Abdominal pain • Ankle swelling • Breathing difficulty • Statistics • Leading cause of cardiovascular disease related deaths • Over 630,000 deaths per year relating to heart disease

13. Heart Failure: Causes • Previous heart attack • Coronary heart disease • Chronic obstructive pulmonary disease (COPD) • Excessive alcohol consumption • Low thyroid function

14. Heart Failure: Risk Factors • Physical inactivity • Overweight/obesity • Cigarette smoking • Diabetes • Hypertension

15. Heart Failure: Complications • Edema (collection of fluid) in extremities • Fatigue • Pulmonary edema (collection of fluid in lungs) • Dyspnea (difficulty breathing) • Kidneys can function improperly • Liver can become damaged (scarring) • In some cases, cardiac cachexia (wasting through loss of weight and muscle mass)

16. Heart Failure: Treatment • Sodium restriction • Diuretics • May include pacemaker or transplant • Certain treatments can improve heart function Untreated heart failure can lead to death!

17. When Do I See a doctor? • Chest pain? • Fatigue and weakness? • Rapid or irregular heartbeat? • Shortness of breath when you exert yourself or when you lie down? • Reduced ability to exercise? • Persistent cough or wheezing with white/pink colored phlegm? • Swelling in your abdomen, legs, ankles and/or feet? • Difficulty concentrating or decreased alertness? • If the answer to any of these isYES, then see a doctor!

18. Can Heart Failure Be Prevented? Yes! • Control certain medical conditions: high blood pressure, high cholesterol and diabetes • Stay physically active • Maintain a healthy weight • Reduce and properly manage stress • Stop smoking • Eat healthy foods

19. Discussion and Questions? Food Model: Show and Tell

20. Reference Materials • American Heart Association • http://www.americanheart.org • Heart Failure Society of America • http://www.hfsa.org • National Heart, Lung and Blood Institute (NHLBI) Information Center • http://www.nhlbi.nih.gov/hbp/ • Mayo Clinic (DASH Diet Recipes): • http://www.mayoclinic.com/health/dash-diet-recipes/RE00089 • DASH Diet • http://www.nih.gov/news/pr/apr97/Dash.htm