5 things you can do today to be heart healthy

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5 things you can do today to be heart healthy

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5 things you can do today to be heart healthy

  1. 1. Blood Pressure Control William Abide, M.D.
  2. 2.     Normal: < 120/<80 Pre-Hypertension: 120-139/80-89 Stage I Hypertension: 140-159/90-99 Stage II Hypertension: >160/>100
  3. 3.  Genetics       If parents have it, 2x more likely Increase sodium intake Obesity Physical inactivity Race High cholesterol
  4. 4.  Secondary Causes: Kidney disease  Drug induced (NSAIDS)  Renovascular Disease  Endocrine disorders (hypo/hyperthyroidism)  Sleep Apnea 
  5. 5.  High Blood Pressure increases risk of: Kidney disease  Stroke  Heart failure   Mortality benefit with decreased BP starting at 115 mm Hg
  6. 6.      < 140/<90 ? With diabetes ? With CAD ? With CKD ACCORD Trial-5 years of follow up BP in treatment group 119 mmHg vs 134 mm Hg  No difference in outcomes (MI, non-fatal stroke, death)  More adverse events (3.3% vs 1.3%)   Hypotension, syncope, bradycardia, angioedema, renal failure
  7. 7.  Persistently above 140/90   medications > 160/100  medications
  8. 8.  Weight Loss 0.5-2 mmHg for every 1 Kg weight loss  Very effective with low sodium diet 
  9. 9.  Aerobic Exercise Can lower BP as much as 5-15 mmHg  Usually SBP decrease of 4-6 mmHg and diastolic decrease of 3 mmHg   Resistance Training   BP decrease of 4/4 Recommendations:  30 min of activity most days of the week
  10. 10.  Moderate salt restriction
  11. 11.   Diet of fruits, vegetables, low fat dairy products DASH Trial:  One of 3 diets:  Control diet: LOW in fruits, vegetables, and legumes and HIGH in snacks, sweets, meats and saturated fat  Trial diet: HIGH in fruits, vegetables, and legumes and LOW in snacks and sweets  Combination diet: HIGH in fruits, vegetables, legumes, and low fat dairy products and LOW in snacks, sweets, meats, and saturated fat
  12. 12.  Trial diet:   Combination diet:   Decrease in BP by 5.5/3 mmHg If dx of HTN, even more benefit   Decrease in BP by 2.8/1.1 mmHg 11.4/5.5 mmHg BP decrease was max at end of week 2 and continued until end of trial (week 8)
  13. 13.    Regardless of sodium, DASH diet lowered BP Low sodium in either diet lowered BP Biggest benefit between high sodium control diet and low sodium dash diet 11.5 mmHg
  14. 14.  Alcohol use Women with 2 or more drinks daily and men with 3 or more drinks daily have higher chance of HTN  Dose related effect   Is some alcohol good for me?? LOW to MODERATE amount may be  1 drink/day for women  1-2 drinks/day in men 

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