Transcript Diet and Health Guidelines to Lower Risk of High Blood Pressure

Diet and Health Guidelines to Lower
Risk of High Blood Pressure
Presented by
Janice Hermann, PhD, RD/LD
OCES Adult and Older Adult Nutrition Specialist
What Is Blood Pressure
 Blood pressure is the pressure on the blood
vessel walls
 A blood pressure reading consists of two numbers,
for example 120/80
 The first number is called systolic
 Pressure when the heart contracts
 The second number is called diastolic
 Pressure when the heart is resting between
contractions
How is Blood Pressure Classified
Recommended
Blood Pressure
Borderline-high
Blood Pressure
High Blood
Pressure
Systolic mm Hg Diastolic mm Hg
< 120
< 80
120-139
80-89
≥ 140
≥ 90
Diagnosing High Blood Pressure
 To diagnose high blood pressure you need
two high blood pressure readings, taken
several weeks apart, with either the systolic
or diastolic or both consistently above 140/90
 Blood pressure changes throughout the day
 Just going to the doctor may make some people’s
blood pressure rise
Diagnosing High Blood Pressure
 High blood pressure can progress silently and
without symptoms
 Estimated 1/3 of people with high blood pressure
and are unaware
 However, with detection and proper
treatment high blood pressure can be
controlled
 People need to have their blood pressure checked
regularly, at least every two years
Children Should Have Blood Pressure
Checked Too
 Children should have blood pressure checked
regularly too
 High blood pressure in children may signal an
underlying disease or early onset of high
blood pressure
Effect of High Blood Pressure
 High blood pressure is a serious health
problem
 High blood pressure causes the heart to work
harder, and over time may damage blood
vessels
 Damage to blood vessels in the heart may increase
the risk of heart disease
 Damage to blood vessels in the brain may increase
the risk of stroke
 Damage to blood vessels in the kidney may
increase the risk of kidney damage
Causes of High Blood Pressure
 Blood pressure arises from:
 Contractions of the heart muscle that pump blood
away from the heart (cardiac output) and
 Resistance that blood encounters as it moves
through the arteries (peripheral resistance)
 When either cardiac output or peripheral
resistance increases, blood pressure rises
Causes of High Blood Pressure
 Cardiac output is raised when:
 Heart rate increases
 Blood volume increases
 Sodium retention
 Fluid retention
Causes of High Blood Pressure
 Peripheral resistance is mostly affected by
physical and chemical signals that alter the
blood vessel diameter
 Signals from the nervous system influence the
heart’s pumping activity and blood vessel
diameter
 Signals from hormones promote fluid retention
and blood vessel constriction
 The kidneys also control section of hormones
involved in sodium and water retention and blood
vessel constriction
Causes of High Blood Pressure
 High blood pressure is a very complex
condition
 Primary or essential hypertension develops
without an identifiable cause (95%)
 Most cases of high blood pressure have no
identifiable cause
 Secondary hypertension is caused by a specific
disorder (5%)
 Usually due to abnormalities in organs or
hormones involved in regulating blood pressure
Causes of High Blood Pressure
 Causes of secondary hypertension
 Chronic kidney disease interferes with the removal
of sodium and water from the blood, thus
increasing blood volume and blood pressure
 Atherosclerosis in the renal blood vessels may
cause increased production of hormones that
stimulate water retention and blood vessel
constriction
Causes of High Blood Pressure
 Causes of secondary hypertension
 Artery stiffness and thickening due to age,
diabetes, atherosclerosis and other reasons can
increase resistance to blood flow, increasing blood
pressure
 Hormonal disorders, including some thyroid
diseases and adrenal disorders, can also cause
high blood pressure
Risk Factors
 There are factors that may affect high blood
pressure
 Family history of high blood pressure
 Being overweight
 Increasing age
 Physical inactivity
 Smoking
 Diabetes
 High sodium intake (sodium sensitive people)
 High alcohol intake
 High fat diet
 Low potassium, calcium and magnesium intake
Family History
 High blood pressure tends to run in families
 People in the same family may have similar
lifestyle and dietary habits that increase their
risk of developing high blood pressure
 High blood pressure is more prevalent and
severe among African Americans
Overweight
 Being overweight is a risk for high blood
pressure
 Carrying excess weight in the abdomen is a greater
risk for high blood pressure than carrying excess
weight in the hips and thighs
 Bringing weight down may be all some people
need to do to control their blood pressure
Obesity
 Rate of high blood pressure increases with
overweight
Rate of High
Men
Blood Pressure
Obese
38%
Healthy weight 18%
Women
32%
16%
Weight Management
 Weight management recommendations are:
 To maintain body weight in a healthy range,
balance calories from foods and beverages with
calories expended
 To prevent gradual weight gain over time, make
small decreases in food and beverage calories and
increase physical activity
Age
 Blood pressure tends to increase with age
 Men typically begin having an increase in blood
pressure by age 45 to 50
 Women typically begin having an increase in blood
pressure after menopause
 However, just because you get older doesn’t
mean you will develop high blood pressure
Physical Activity
 Physical activity can help you:
 Lose weight
 Lower total cholesterol
 Lower LDL-cholesterol
 Lower triglycerides
 Increase HDL-cholesterol
 All of which can lower the risk of:
 High blood pressure
 Heart disease
 Stroke
 Diabetes
 Obesity
Physical Activity
 Engage in regular physical activity and reduce
sedentary activities to promote health,
psychological well-being, and a healthy body
weight
 Physical activity recommendations are:
 150 minutes of moderate-intensity per week or
 75 minutes of vigorous-intensity per week
Smoking
 Smoking increases your risk of high blood
pressure
 Smoking raises blood pressure level and heart rate
 Smoking lowers HDL-cholesterol
 Smoking increases the tendency of blood to clot
Diabetes
 High blood pressure is more common in
people who have uncontrolled diabetes
 Insulin resistance, commonly associated with
obesity, signals the pancreas to produce more
insulin
 High insulin signals the kidneys to retain sodium
and thus may increase the risk of developing high
blood pressure
Sodium
 Your kidneys regulate the sodium level in your
body
 Most people aren't affected by excess dietary
sodium because their bodies just get rid of
excess sodium in the urine
Sodium Sensitive People
 However, some people are sodium-sensitive
 For sodium-sensitive individuals, too much
sodium in the diet can increase blood
pressure
Sodium Sensitive People
 For sodium-sensitive people, lowering sodium
intake may help lower blood pressure
 55% white
 73% African Americans
 Unfortunately, there’s no easy way to know
who may be a sodium-sensitive individual
Sodium Sensitive People
 People most likely to be sodium-sensitive:
 Family history of high blood pressure
 Chronic kidney disease
 Diabetes
 African American
 Over 50 years of age
 Overweight
How Much Sodium
 Dietary Guidelines recommend
 People reduce daily sodium intake to less than
2,300 mg (approximately 1 teaspoon of salt) and
 Further reduce sodium intake to less than 1,500 mg
sodium among those:
 51 years of age or older
 of any age who are African American or have
hypertension, diabetes or chronic kidney disease
How Much Sodium
 The DRI for sodium is:
 1,500 mg/day for people 19-50 years of age
 1,300 mg/day for people 51-70 years of age
 1,200 mg/day for people >70 years of age
 The Upper Level for sodium intake for adults
is 2,300 mg/day
 On average, most adults consume
significantly more, 4,000 to 6,000 milligrams
of sodium daily
Where Is Sodium
 As much as 75% of the sodium in your diet
comes from salt added to foods during
processing
 About 15% comes from salt added during
cooking and at the table
 Only 10% comes from the natural content in
foods
Replacing Sodium Losses
 Although you lose sodium and some other
minerals in perspiration, the amount lost is
usually small
 Regular meals and snacks eaten after physical
activity will normally replace electrolytes
(sodium and potassium) lost in perspiration
 In extreme heat beverages containing
electrolytes such as Gatorade or Powerade
help replace fluids and electrolytes lost in
perspiration
Alcohol
 Heavy alcohol consumption, 3 or more
drinks daily, is strongly associated with
increased risk of high blood pressure
 Effect of moderate alcohol intake on blood
pressure unknown
 Recommended alcohol intake is:
 Not more than one alcoholic drink a day for
women
 Not more than two alcoholic drinks a day for
men
Alcohol
 Role of alcohol with high blood pressure is
unclear
 May contribute extra calories which may
increase body weight
Fat, Trans Fat, Saturated Fat &
Cholesterol
 High fat, trans fat, saturated fat and
cholesterol intakes are linked to high
cholesterol, LDL-cholesterol, and triglycerides
which contributes to atherosclerosis and high
blood pressure
 Atherosclerosis narrows the blood vessels and
decreases blood flow to the kidneys
Fat, Trans Fat, Saturated Fat &
Cholesterol
 The kidneys try to increase blood flow to the
kidneys by expanding blood volume and
constricting smaller blood vessels
 However, blood pressure increases not only in
the kidneys, but all over the body, which
further damages blood vessels and increases
atherosclerosis
Fat, Trans Fat, Saturated Fat &
Cholesterol
 Lowering total fat, saturated fat, cholesterol
and trans fat helps lower blood cholesterol
and triglycerides, which may lower
atherosclerosis
 Reducing fat helps with weight loss, which
may lower blood pressure
Fat, Trans Fat, Saturated
Fat & Cholesterol
 Recommendations are:
 Keep total fat intake between 20 to 35 % of
calories, with most fats coming from
polyunsaturated and monounsaturated fats
 Consume less than 10 percent of calories from
saturated fatty acids
 Consume less than 300 mg/day of cholesterol
 Keep trans fatty acid consumption as low as
possible
Other Dietary Factors
 Too little of some other nutrients including
potassium, calcium and magnesium, may
have an important link to high blood pressure
 Adequate intakes of these minerals may have
a protective effect against high blood
pressure
Other Dietary Factors
 Potassium has roles with:
 Maintaining fluid balance
 Muscle contraction
 Calcium has roles with:
 Activating messengers that help maintain normal
blood pressure
 Magnesium has roles with:
 Heart function
 Lessening blood vessel constriction
Other Dietary Factors
 Fruits and vegetables are good sources of
potassium
 Milk and dairy products are a good source of
all three nutrients
 The best guideline is to follow the USDA Daily
Food Plan
Other Dietary Factors
 For some individuals potassium may be
beneficial, but for individuals with kidney
problems potassium may be restricted.
 Check with your doctor before using a
potassium chloride salt substitute.
Emotional Stress
 For some people, stress may be a factor for
high blood pressure
 Learning how to relieve stress improves the
overall quality of one's life
Lower Risk of High Blood Pressure
 Follow Dietary Guidelines
 Maintain a healthy weight
 Be physically active each day
 Consume ample fruits, vegetables or dairy
products to provide calcium, potassium, and
magnesium
 Keep total fat, saturated fat, trans fat, and
cholesterol intakes within recommended levels
 Keep sodium intake below 2,300 mg or 1,500 mg
 Use alcohol in moderation
 Abstain from smoking
 Keep diabetes in control