Hypertension. Blood pressure levels are a function of cardiac output multiplied by peripheral resistance

2. Hypertension

3. 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)

6. 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.

7. Hypertension
Category Systolic Blood Diastolic Blood
Pressure Pressure
Normal < 120 <80
Pre-hypertension 120-139 80-89
Hypertension – 140-159 90-99
Stage 1
Hypertension – >160 >100
Stage 2

8. 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.

9. Prevalence of Hypertension by
Age
 Age  % Hypertensive
 18-29  4
 30-39  11
 40-49  21
 50-59  44
 60-69  54
 70-79  64
 80+  65

10. Hypertension
 When the normal regulatory mechanisms
fail, hypertension develops.
 Hypertension is so dangerous because it
gives off no warning signs or symptoms.

11. Untreated hypertension can result in:
Arteriosclerosis --Kidney damage
Heart Attack --Stroke
Enlarged heart --Blindness

12. Factors Influencing the Development of
Hypertension
 High-normal blood pressure
 Family history of hypertension
 African-American ancestry
 Overweight

13. 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

14. Factors Influencing the Development of
Hypertension
 Alcohol consumption

15. Factors Influencing the Development of
Hypertension
 Exercise
 Less active individuals are
30-50% more likely to develop
hypertension.

16. Factors Influencing the Development of
Hypertension
 Other Dietary Factors
 Potassium:
 Calcium:
 Magnesium:

17. 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.

18. The DASH Diet
 The Dietary Approaches to Stop
Hypertension 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.

19. 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%

20. 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)

21. 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.

22. The DASH Diet
 The DASH 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.

23. Effects of increasing Calcium-Rich Dairy
Food in Black Hypertensives
 Increases urinary sodium excretion
 Decreases volume
 Decreases peripheral vascular resistance
 Decrease blood pressure
 Reduces left ventricular mass and risk of
left ventricular hypertrophy
 Effects sustained for one-year period of study

24. 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

25. 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.

26. 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

27. Food Labels
Claim Amount
Low Sodium >140 mg/serving
Very Low Sodium >35 mg/serving
Sodium Free >5 mg/serving
Reduced Sodium 25% less than original