hypertension dietary management nutrients required DASH diet

2. HYPERTENSION
 WHO defines Hypertension as the condition in which systolic
pressure exceeds 120mm Hg and diastolic pressure exceeds 95 mm
Hg
 High blood pressure causes 1 in every 8 deaths worldwide, making
it the third leading cause of death worldwide.
 Blood pressure is necessary to move blood through arteries and
provide oxygen to the tissues of the body
 When the diastolic pressure in 100 or more therapy should be
initiated through drugs as well as diet
 High blood pressure, or hypertension, has no symptoms, and is
often called the “silent killer” because it can go undetected for
years until a fatal heart attack or stroke occurs.
 This can lead to other health complications such as stroke, kidney
failure, impaired vision, heart attack, or heart failure.

3. DIETARY MANAGEMENT
 Low calorie, low fat, low sodium diet with normal protein intake is prescribed
PRINCIPLES OF DIET
 Earlier Kempner's rice fruit diet was suggested
 This diet is very restrictive diet and deficient in many nutrients
1) ENERGY
 An obese patient is reduced to normal body weight with low calorie diet
 About 20 Kcal /Kg - sedentary worker
 25 Kcal/kg -moderately active worker
 Alcohol consumption should be reduced
2) PROTEIN
 A diet of 60g protein is necessary to maintain proper nutrition
 In severe hypertension protein restriction to 20g is required as a
temporary measure since protein foods are rich in sodium

4. 3) FATS
 As they are prone to atherosclerosis it is advisable to avoid high intake of
animal or hydrogenated fat.
 About 20g vegetable oil is permitted
 Omega 3 fatty acids has a role in regulation of blood pressure
 DHA is more potent than EPA
4) CARBOHYDRATE
 Easily avoilable carbohydrate is of great help in managemnet of high Blood
pressure
5) SODIUM
 Increased sodium intake leads to increased intravascular volume and thus
increases cardiac output by elevating blood pressure
 Restricted sodium and decrease in sodium/potassium ratio in diet
 Moderate sodium restriction 2-3glday reduces diastolic pressure 6-10mm HG
 Soduim restriction accompanied by weoght reduction effectively control
mild/moderate arterial blood pressure

5. 6) POTASSIUM
 Potassium works with sodium to regulate the body’s water balance.
 Low level of potassium cause the body to retain sodium and water and this can
elevate blood pressure
 Research shows that a high potassium-to-sodium ratio is associated with a greater
likelihood that normal blood pressure will be maintained.
 The recommended intake of potassium is 3500mg/day
 Instead, potassium rich foods such as leafy green vegetables, root vegetables like
potatoes and carrots, and fruit, should be eaten everyday to meet potassium
requirement
7) CALCIUM
 Intake of calcium has blood pressure lowering effects
 It is involved in the control of strength with which blood is pumped by the heart and
the flow of blood in the veins and capillaries both of which conribute the blood
pressure

7. DASH- DIETARY APPROACH TO STOP HYPERTENSION
 The DASH diet is rich in fruits, vegetables, whole grains, and low-
fat dairy foods; includes meat, fish, poultry, nuts and beans; and is
limited in sugar-sweetened foods and beverages, red meat, and
added fats.
 It is a dietary pattern promoted by the U.S.-based National Heart,
Lung, and Blood Institute to prevent and control hypertension.
 DASH is a flexible and balanced eating plan.
 It has been proven to lower blood pressure and cholesterol
 In addition to being a low salt (or low sodium) plan, the DASH
diet provides additional benefits to reduce blood pressure.
 It is a high fiber, low to moderate fat diet, rich in potassium,
calcium, and magnesium.

8. DIET SUGGESTED BY DASH
The DASH diet emphasizes portion size, eating a variety of foods and getting the right amount of nutrients.
Grains (6 to 8 servings a day)
 Grains include bread, cereal, rice and pasta.
 Focus on whole grains because they have more fiber and
nutrients than do refined grains.
 For instance, use brown rice instead of white rice, whole-wheat
pasta instead of regular pasta and whole-grain bread instead of
white bread.
 Grains are naturally low in fat, so avoid spreading on butter or
adding cream and cheese sauces.
Vegetables (4 to 5 servings a day)
 Tomatoes, carrots, broccoli, sweet potatoes, greens and other vegetables are full
of fiber, vitamins, and such minerals as potassium and magnesium
 Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup
cut-up raw or cooked vegetable

9. Fruits (4 to 5 servings a day)
 Many fruits need little preparation to become a healthy part of a meal or
snack.
 Like vegetables, they're packed with fiber, potassium and magnesium and
are typically low in fat — exceptions include avocados and coconuts.
 Examples of one serving include 1 medium fruit or 1/2 cup fresh fruit.
Dairy (2 to 3 servings a day)
 Milk, yogurt, cheese and other dairy products are major sources of calcium,
vitamin D and protein.
 Choose dairy products that are low-fat or fat- free .
Examples of one serving include 1 cup skim or 1 cup yogurt or 1 1/2 oz. cheese
Lean meat, poultry and fish (6 or fewer servings a day)
 •Meat can be a rich source of protein, B vitamins, iron and zinc.
 But because even lean varieties contain fat and cholesterol, don't make them a mainstay
of your diet Examples of one serving include 1 oz. cooked skinless poultry, seafood or
lean meat, 1 egg,/tuna.
 Trim away skin and fat from meat and then broil, grill, roast or poach instead of
frying. Eat heart-healthy fish, such as salmon, herring and tuna.
 These types of fish are high in omega-3 fatty acids, which can help lower your total
cholesterol.

10. Alcohol and Caffeine
 Drinking too much alcohol can increase blood pressure.
 The DASH diet recommends that men limit alcohol to two or fewer drinks a day
and women one or less.
FIBER
Getting the recommended daily amount—22 to 34 grams for adults—helps you feel
full and promotes good digestion. DASH provides more than enough.
Nuts, seeds and legumes: 4 to 5 servings a week
 Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this
family are good sources of magnesium, potassium and protein and full of fiber
and phytochemicals,
 They contain healthy types of fat — monounsaturated fat and omega-3 fatty
acids