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

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.

HypertensionCategory Systolic Blood

PressureDiastolic Blood Pressure

Normal < 120 <80

Pre-hypertension 120-139 80-89

Hypertension – Stage 1

140-159 90-99

Hypertension – Stage 2

>160 >100

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

Hypertension When the normal regulatory mechanisms

fail, hypertension develops. Hypertension is so dangerous because it

gives off no warning signs or symptoms.

Untreated hypertension can result in:Arteriosclerosis --Kidney damageHeart Attack --StrokeEnlarged heart --Blindness

Factors Influencing the Development of Hypertension

High-normal blood pressure Family history of hypertension African-American ancestry Overweight

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 Hypertension

Alcohol consumption

Factors Influencing the Development of Hypertension

Exercise Less active individuals are 30-

50% more likely to develop hypertension.

Factors Influencing the Development of Hypertension

Other Dietary Factors Potassium: Calcium: Magnesium:

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 DDietary AApproaches to SStop

HHypertension 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 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 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

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 Diet

The DASH DietDASH Diet includes: 7-8 servings of grains and grain products 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 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 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 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

Food LabelsClaim Amount

Low Sodium >140 mg/serving

Very Low Sodium >35 mg/serving

Sodium Free >5 mg/serving

Reduced Sodium 25% less than original