Hypertension

Front 1

Definition of hypertension

Back 1

A systolic blood pressure of >140 or a diastolic blood pressure of >90

Front 2

What problems are caused by hypertension

Back 2

High blood pressure is associated with an increased risk of stroke, myocardial infarction, heart failure, renal failure, and cognitive impairment.

Front 3

At what level does hypertension affect the individual

Back 3

Systolic blood pressure above 115 mm Hg is the most important determinant of the risk of death worldwide,2 being responsible for 7.6 million cardiovascular deaths annually.

Front 4

Does hypertension increase with age

Back 4

the prevalence of hypertension increases dramatically with age; in the United States it rises from about 10% in persons 30 years of age to 50% in those 60 years of age.6 However, some persons, including strict vegetarians,10,11,12 populations whose diet consists mostly of vegetable products,11,13 and those whose sodium intake is low,13,14,15 have virtually no increase in hypertension with age.

Front 5

What is essential hypertension

Back 5

Essential hypertension is the name for hypertension that cannot be attributed to a specific renal or adrenal disease, such as chronic renal failure or an adrenal tumor

Front 6

How does increased sodium intake cause hypertension

Back 6

Sodium intake initiates an autoregulatory sequence that leads to increased intravascular fluid volume and cardiac output, peripheral resistance, and blood pressure.

Front 7

How does aging affect hypertension

Back 7

Especially in the elderly, large conduit arteries such as the aorta and carotid arteries become stiff and less compliant, increasing systolic blood pressure.19 Proliferation of smooth-muscle cells and endothelial dysfunction occur in resistance vessels, including small arteries and arterioles, causing vasoconstriction and increasing peripheral vascular resistance.

Front 8

Name two ways of lowering the blood pressure

Back 8

Two effective interventions for lowering blood pressure in patients with hypertension are reducing sodium intake and reducing weight.

Front 9

How does reduced sodium affect blood pressure

Back 9

Reductions in dietary salt lessen the amount of sodium the kidney has to excrete to restore normal blood volume. Compliance in the aorta and carotid artery in older patients with hypertension is improved when sodium intake is reduced.34 Reduction in sodium intake also improves arterial vasodilatation.21,2

Front 10

How does weight loss improve blood pressure

Back 10

Weight loss moderates activation of the renin–angiotensin–aldosterone axis35,36 and the sympathetic nervous system37,38 and diminishes sodium retention.

Front 11

How does weight loss affect hypertension

Back 11

Decreases in abdominal visceral fat also improve the functioning of both conduit and resistance vessels.40

Front 12

Describe a diet that lowers blood pressure

Back 12

the kinds of dietary patterns that have been proved to lower blood pressure emphasize fruits, vegetables, and low-fat dairy products; include whole grains, poultry, fish, and nuts; make use of unsaturated vegetable oils; and contain smaller amounts of red meat, sweets, and sugar-containing beverages.

Front 13

What is the effect of drug therapy on hypertension

Back 13

Drug therapy plays an essential role in treating hypertension. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure emphasizes that in patients for whom lifestyle modification (including dietary therapy, physical activity, and moderation of alcohol consumption) does not reduce blood pressure below 140/90 mm Hg (or 130/80 mm Hg for patients with diabetes or chronic renal disease), drug therapy should be implemented and modified over time given a patient's response.2 However, medication should not supplant dietary management; rather, the two forms of treatment should be considered complementary. The DASH diet is effective in combination with angiotensin-receptor blockers.60 Sodium reduction is highly effective in older patients with hypertension who are taking antihypertensive medicines61 and in those with resistant hypertension taking several antihypertensive agents.62

Front 14

Describe an effective diet for lowering blood pressure

Back 14

In simple terms, we encourage patients to eat poultry, fish, nuts, and legumes instead of red meat; low-fat and nonfat dairy products instead of full-fat dairy products; vegetables and fruit instead of snacks and desserts high in sugars; breads and pastas made from whole grain instead of white flour; fruit itself rather than fruit juice; and polyunsaturated and monounsaturated cooking oils such as olive, canola, soybean, peanut, corn, sunflower, or safflower rather than butter, coconut oil, or palm-kernel oil.