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
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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.
Hypertension
Category
Normal
Systolic Blood
Pressure
< 120
Diastolic Blood
Pressure
<80
Pre-hypertension
120-139
80-89
Hypertension –
Stage 1
140-159
90-99
Hypertension –
Stage 2
>160
>100
Hypertension
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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
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18-29
30-39
40-49
50-59
60-69
70-79
80+
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% Hypertensive
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4
11
21
44
54
64
65
Hypertension

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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
Heart Attack
Enlarged
heart
--Kidney damage
--Stroke
--Blindness
Factors Influencing the Development of
Hypertension



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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 3050% 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 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.
Dash Study

Control:

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Fruits and Vegetables

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Ca, Mg, & K ~ 25% of US diet
Macronutrients and fiber ~ US average
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 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.
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Sodium in Foods

Conversion of milligrams to
milliequivalents (mEq):


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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
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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 reducedsodium or ‘no-salt-added’ versions of foods
like:

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Canned soup, canned vegetables, vegetable
juices
cheeses, lower in fat
condiments like soy sauce
crackers and snack foods like nuts
processed lean meats
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