Hypertension Dr Hildemar Dos Santos Assistant Professor Loma

Hypertension 高血壓 Dr. Hildemar Dos Santos 山度士醫生 Assistant Professor Loma Linda University School of Public Health Former Director of the Lifestyle Management Centre 健康生活促進中心 Hong Kong Adventist Hospital 香港港安醫院 Tsuen Wan Adventist Hospital 荃灣港安醫院 Stroke

Stroke Types 不同類型的中風 • Western 80% ischemic, 20% hemorrhagic 西方: 80% 局部缺血的， 20% 出血的 • China - 62. 4% ischemic, 29. 3% hemorragic, 8. 3% unknown - Lin-Feng Zhang et all, 2003 中國 - 62. 4%局部缺血的， 29. 3%出血的 • Hong Kong - 68. 3% ischemic, 27. 1% hemorrhagic, 4. 5% unknown - R. Kay et al, 1992 - Chinese University of Hong Kong 香港 - 68. 3%局部缺血的， 27. 1%出血的， 4. 5% 不明 - 1992 香港中文大學

Fruits and Vegetables and Strokes 水果、 水果 蔬菜與中風 • Danish Diet, Cancer and Health study Johnsen et all, 2003 丹麥食療、癌症與健康的研究 • Those who eat 673 g of fruits and vegetables have 30% less risk of ischemic stroke 吃超過673克水果及蔬菜的人患局 部缺血中風的危機會減少 30%

Whole Grain Consumption and Stroke Risk 進食全麥與中風的危機 • The Nurses’ Health Study - 12 years FU 護士健康研究 - 12年跟進 • 75, 521 women in the US 美國75, 521 名女士 • 38 -63 years 年齡 38 -63歲 • Whole grains: brown rice, oatmeal, whole wheat bread and products 全麥: 糙米、 糙米 燕麥、 燕麥 全麥麵包等 40% reduction of strokes among those regular whole grain users全麥食用者中風的機會減少 40% • JAMA, September 27, 2000 - Vol 284, No. 12

Hypertension in Hong Kong 香港的高血壓情況 • 17% of the population: +- 1, 000 佔人口的百分之17 • Obese people have higher risk of hypertension 肥胖人士患高血壓的危機較高

DASH Dietary Approaches to Stop Hypertension

Limit alcohol intake, if used at all 如飲用酒精, 盡量減少份量 BP drops 2 -4 points by limiting alcohol -減少酒精可降血壓 2 -4點

Hypertension and Anger 血壓高及憤怒 • Dr. Dick Tibbits醫生 • Results: Learn how to forgive can lower blood pressure on patients with high levels of anger. • 效果: 患高血壓的人如學怎樣寬恕可以降 低血壓

Blood pressure and anger 血壓與憤怒 Patient # 病人 # 1 2 3 4 5 Anger Score 憤怒指標 (Red 紅色) 34 28 26 26 19 Initial Blood Pressure 最初血壓 Final Blood Pressure 最後血壓 144/97 154/98 151/99 157/107 153/87 130/81 124/76 132/86 123/84 124/80 Tibbits, 2004

Soy and Hypertension 大豆與高血壓 • • Shanghai Women’s Health Study 上海婦女研究 45, 694 participants - 2 - 3 years follow up 45, 694人參與 - 二至三年跟進 Compared women who ate 25 g soy protein/day with those who took less than 2. 5 g soy protein/day 每日食用 25克大豆 蛋白質的女士與每日食用多過25克的女士比較地 American Journal of Clinical Nutrition 2005; 81: 10121017

Soy protein contents 大豆蛋白質的含量 • 1 cup cooked soybeans = 28. 6 g 1杯熟的王豆 = 28. 6 克 • 1/2 cup tofu raw = 10 g 半杯生豆腐 = 10 克 • 1/2 cup tofu firm = 19 g 半杯硬豆腐 = 10 克 • 1 cup soybean milk = 6. 6 g 1杯豆奶 = 6. 6克 • 1/2 cup green soybeans = 11 g 半杯綠大豆 = 11克

Garlic and Hypertension 蒜頭與高血壓 • Garlic can drop 8 -11 mm Hg for the systolic and 5 - 8 mm Hg for the diastolic 蒜頭可降低收縮壓 8 -11 mm Hg 及舒張壓 5 - 8 mm Hg • Garlic Daily Dose 每日食用蒜的份量: • 4, 000 mcg of Allicin 4, 000 mcg 蒜素 • 4 g of fresh garlic 4克新鮮蒜頭 • 1 - 4 garlic cloves 1 -4 瓣蒜頭 Encyclopedia of Natural Medicine page 527

Framinghan Heart Study Framinghan 心臟研究 (Franco et all, 2004) • Chocolate - 100 g day reduces systolic blood pressure by 5. 1 mm Hg, and diastolic by 1. 8 mm Hg • 朱古力 - 每日 100克可降低收縮壓 5. 1 mm Hg 及舒張壓 1. 8 mm Hg • 400 g of fruit and vegetables/day - similar results as chocolate 每日吃400克水果及蔬 菜會有同樣的效果

Co. Q 10 and Hypertension (Lowers Peripheral Resistance? ) 輔酵素Q 10與高血壓 (降低外周的阻力? ) • 39% of hypertension patients are deficient 高血壓患者當中 35百分比欠缺 • Some small studies have found a lower effect of Co. Q 10 on hypertension 有研究顯示C 0 Q 10有助降低高血壓 • Ten patients with high blood pressure 十個患高血壓的 病人 » 100 mg Co. Q 10/ day - 10 weeks 每日 100 mg - 10星期 » Systolic from 161 to 142 mm. Hg 收縮壓由 161 降至 142 » Diastolic from 98. 5 to 83 mm. Hg 舒張壓由 98. 5降至 83 Encyclopedia of Natural Medicine page 527

Vitamin C and Hypertension 維他命C 與高血壓 • • • Study 2 g loading dose 研究 - 開始兩克 500 mg/daily - 30 days 每日 500毫克 - 30日 Decrease systolic pressure by 13 mm Hg 降低收縮壓 13 mm Hg No effect on diastolic 舒張壓沒影響 Increased Nitric Oxide 增加氧化氮 Lancet, 1999; 354: 2048 -2049 醫學雜誌Lancet