Hypertension and diet therapy By Mysara Salim Saleh
Hypertension and diet therapy By: Mysara Salim Saleh Supervised by: Dr. Baker Al-Zabut
(Hypertension (HBP § High blood pressure usually occurs without any symptoms and has therefore been labeled "the silent killer". • High Blood Pressure can lead to any one or more of several potentially fatal complications, such as heart attack or stroke.
How to take the BP § Patient should be seated with the back straight and the arm supported at heart level § The patient should rest for 5 minutes § The bladder of the pressure cuff should encircle at least 80% of the upper arm § Use the average of two or more readings on at least two occasions
Classification § The optimal BP is <120/80 mm. Hg § Increased BP readings reflect the cardiovascular, cerebrovascular and renal risk across the blood pressure continuum
A Muscular Pump
Hypertension The arterioles supply oxygen-containing blood and nutrients to all of the tissues of the body. § The vast majority of patients with hypertension have in common a particular abnormality of the arteries: an increased resistance (stiffness or lack of elasticity) in the tiny arteries that are most distant from the heart.
Essential HTN § Usually occurs in the fourth or fifth decade § Risk factors § Obesity § Excessive salt intake § Excessive alcohol intake § Lack of exercise § Family history of essential HTN § Caffeine and smoking increase the BP acutely but are not risk factors for the development of chronic essential HTN
Essential HTN – The long term effects § In patients with HTN the most common cause of death is due to complications of coronary artery disease. § Left ventricular hypertrophy is a powerful predictor of sudden death in patients with HTN.
• This left ventricle is very thickened • The left ventricle is (slightly over 2 cm in thickness), markedly thickened in but the rest of the heart is not this patient with greatly enlarged. This is typical for severe hypertension hypertensive heart disease. The that was untreated hypertension creates a greater for many years. pressure load on the heart to The myocardial fibers induce the hypertrophy. have undergone hypertrophy.
Left Coronary System
Treatment of Essential HTN ** Drug Therapy: § Diuretics § Thiazides § Potassium sparing diuretics - Aldosterone antagonists § ACE (angiotensin converting enzyme) Inhibitors - converts angiotensin I to angiotensin II ( a vasoconstrictor) § Beta Blockers § Calcium Channel Antagonists
Diet therapy for hypertension
Diet Therapy Lowers Blood Pressure Similar to Drug Therapy § The Dietary Approaches to Stop Hypertension (DASH) study concluded that the diet focused on decreased sodium, increased fruits, vegetables, and fat-free diary products is likely to show up to 12 percent reduction in risk of CHD. § A key to healthy eating is choosing foods lower in salt and sodium. § Before the widespread availability of medication to control high blood pressure, people with serious hypertension had only one treatment option, a drastically salt-reduced, low-calorie "rice diet. " Some people can significantly lower their blood pressure by avoiding salt. § Additional benefits were seen with sodium restriction. § A high potassium-low sodium diet reduces the rise in blood pressure during mental stress by reducing the blood vessel constricting effect of adrenaline. § Sodium restriction alone does not improve blood pressure control; it must be accompanied by a high potassium intake.
Food/Diet Therapy for Hypertension § A healthy eating plan can both reduce the risk of developing high blood pressure and lower an already elevated blood pressure. § Vegetarian Diet § Vegetarians, in general, have lower blood pressure levels and a lower incidence of hypertension and other cardiovascular diseases. Experts postulate that a typical vegetarian's diet contains more potassium, complex carbohydrates, polyunsaturated fat, fiber, calcium, magnesium, vitamin C and vitamin A, all of which may have a favorable influence on blood pressure.
Food/Diet Therapy for Hypertension § Fiber § A high-fiber diet has been shown to be effective in preventing and treating many forms of cardiovascular disease, including hypertension. The types of dietary fiber is important. Of the greatest benefit to hypertension are the water soluble gel-forming fibers such as oat bran, apple pectin, and psyllium seeds. § These fibers, in addition to be of benefit against hypertension, are also useful to reduce cholesterol levels, promote weight loss, etc. § Sugar § Sucrose, common table sugar, elevates blood pressure. Underlying mechanism is not clearly understood. It is possible that sugar increases the production of adrenaline, which in turn, increases blood vessel constriction and sodium retention.
Beneficial Vegetables and Spices for Hypertension § A number of common vegetables and spices have beneficial effects in controlling hypertension. § Celery (Apium graveolens). Oriental Medicine practitioners have long used celery for lowering high blood pressure. There are some experimental evidence that shows that celery is useful for this. In one animal study, laboratory animals injected with celery extract showed lowered blood pressure. Eating as few as four celery stalks was found to be beneficial in lowering blood pressure in human beings. § Garlic (Allium sativum). Garlic is a wonder drug for heart. It has beneficial effects in all cardiovascular system including blood pressure. In a study, when people with high blood pressure were given one clove of garlic a day for 12 weeks, their diastolic blood pressure and cholesterol levels were significantly reduced. Eating quantities as small as one clove of garlic a day was found to have beneficial effects on managing hypertension. Use garlic in your cooking, salad, soup, pickles, etc. It is very versatile. § Onion (Allium cepa). Onions are useful in hypertension. What is best is the onion essential oil. Two to three tablespoons of onion essential oil a day was found to lower the systolic levels by an average of 25 points and the diastolic levels by 15 points in hypertension subjects. § This should not be surprising because onion is a cousin of garlic.
Beneficial Vegetables and Spices for Hypertension § Tomato (Lycopersicon lycopersicum). Tomatoes are high in gamma-amino butyric acid (GABA), a compound that can help bring down blood pressure. § Broccoli (Brassica oleracea). It contains several active ingredients that reduce blood pressure. § Carrot (Daucus carota). Carrots also contain several compounds that lower blood pressure. § Saffron (Crocus sativus). Saffron contains a chemical called crocetin that lowers the blood pressure. You can use saffron in your cooking. (It is a very popular spice in Arabic cooking. ) You can also make a tea with it. Many Indians add a pinch of saffron in the brewed tea to give a heavenly flavor. Unfortunately, it is very expensive. § Hawthorn. dilates the arterial walls.
Vitamin/Nutrition Therapy § Coenzyme Q 10 (Co. Q 10) is an essential component of the metabolic processes involved in energy production. Individuals with cardiovascular disease ( including hypertension, angina and congestive heart failure) often are deficient in Co. Q 10 and require increased tissue levels of Co Q 10. Clinical studies have indicated that Co Q 10 is of considerable benefit in the treatment of hypertension and other cardiovascular disease. § Potassium helps to prevent and control blood pressure. Be sure to get enough potassium in the foods you eat. Some good sources are various fruits, vegetables, dairy foods, and fish. § Magnesium deficiency has been implicated in high blood pressure. Magnesium levels are shown to be consistently low in people suffering from hypertension. § Leafy greens, legumes, whole grains, purslane, poppy seeds and string beans are good dietary sources for magnesium. (Or you can take a daily supplement of 400 milligrams of magnesium. )
§ Calcium is an important nutrient for overall good health. Population studies indicate that hypertensive individuals consume less daily calcium. They may benefit from calcium supplementation. Take 1 gram of elemental calcium daily. § Good sources of calcium are diary foods such as milk, yogurt, and cheese. Be sure to choose skim or low fat varieties. Low fat and nonfat dairy products have more calcium than the high fat versions. § Essential Fatty Acids § Increasing dietary linoleic acid decreases the blood pressure. Hypertensive patients are deficient in E series prostaglandins. Linoleic acid was found to normalize prostaglandins.
Treatment of Essential HTN § Lifestyle modification Is always recommended but is frequently inadequate on its own § Salt restriction to 4 grams per day ** The antihypertensive effect of many medicines is enhanced by sodium restriction § Weight loss to within 15% of ideal body weight is the goal § Alcohol restriction § Regular exercise even without weight loss § Reduce all other cardiovascular risk factors
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