Transcript Blood Pressure Workshop

Blood Pressure Basics
Julie Hetteman, PhD
Wellness Specialist
Martha Lowry, MS
Wellness Coordinator
Cindy Modlin-Adams, RN, MSN, ANP, BC
Coordinator, Nursing Center for Family Health
What is blood pressure?
Measures force of blood in the arteries
High blood pressure (HBP) = hypertension (HTN)
How is BP measured?
Blood pressure cuff
mm mercury
2 numbers shown as a fraction
Systolic/Diastolic
Ex. 120/80
Systolic
The top number in blood pressure readings
Measures the pressure in arteries when heart is
beating
Diastolic
The bottom number in blood pressure readings
Measures pressure when heart is at rest
Values
Systolic
Category
Normal
Pre-hypertensive
(top number)
Less than 120
120-139
Diastolic
(bottom number)
Less than 80
80-89
High Blood Pressure
Stage 1
Stage 2
140-159
160 and higher
90-99
100 and higher
Who is at risk for HBP?
Individuals With Family History
Parents, brother, sister
Increasing age
Gender
Women - after menopause
Early middle age more common in men
Race
More common among blacks (Occurs earlier)
These factors are beyond our control.
Risk Factors
Factors Within our Control
 Excess weight
 Increases volume of blood
 Increases pressure/resistance that heart has to pump against--enlarged heart muscle
 Inactivity
 Heart is not used to “work” = heart beats harder/faster = more force
on arteries = uses more oxygen per beat = higher heart rate at rest
 Tobacco use
 Can lead to damage of artery wall, increases heart rate, encourages
narrowing of arteries
 Stress
 Causes unpredictable blood pressure and pulse increases along with
potential inflammation in the vessel walls.
Risk Factors
More Factors Within Our Control
Sodium intake
Leads to more fluid/water in the vessels
= increased blood pressure
Low potassium intake
Potassium helps balance sodium in cells
and control heart rhythm
Excessive alcohol
Long term: damages liver and pressure
within our circulation and heart.
How do I know if I have it?
Very few people experience symptoms. This is a
silent disease.
Damage is done before symptoms develop.
Some symptoms may be:
Headaches
Dizzy spells
More nosebleeds than normal
This is why we screen for HBP!
Primary vs. Secondary Hypertension
Most cases are called “primary”
No identifiable cause
Family history likely
~5-10% are secondary
Caused by underlying conditions:
Kidney abnormalities
Tumor of adrenal gland
Congenital heart failure defects
What effect does it have on the body?
Uncontrolled high blood pressure can damage vital organs
Heart: heart attack and heart failure
Brain: stroke and “mini strokes”/transient ischemic attacks
Kidneys: slow loss of function
Eyes: small vessel damage—blindness
Arteries: narrowing in legs and bulging in aorta: aneurysm
Prevention of High Blood Pressure
Maintain a healthy weight
Be physically active most days of the week
Eat healthfully
Quit smoking
Limit alcohol
Reduce stress
Treatments for HBP
Diet
Lifestyle change
Medication
Treating HBP with DASH diet
Developed by the National Heart, Lung & Blood
Institute
Eating plan that is…
Low in saturated fat
Low in cholesterol
Low in total fat
Emphasizes
 Fruits
 Vegetables
 Low fat and fat free milk
 Potassium, calcium and magnesium
Type of food
Number of
servings for
1600 - 3100
Calorie diets
Servings
on a
2000
Calorie
diet
6 - 12
7-8
Fruits
4-6
4-5
Vegetables
4-6
4-5
Low fat or non fat dairy foods
2-4
2-3
1.5 - 2.5
2 or less
3 - 6 per week
4 - 5 per
week
2-4
limited
Grains and grain products (include at
least 3 whole grain foods each day)
Lean meats, fish, poultry
Nuts, seeds, and legumes
Fats and sweets
Goals of the DASH diet
Total fat 27% of calories
Sodium 2,300 mg
Saturated fat 6% of calories
Potassium 4,700 mg
Protein 18% of calories
Calcium 1,250 mg
Carbohydrate 55% of calories
Magnesium 500 mg
Cholesterol 150 mg
Fiber 30 g
DASH menu example (2,300 mg sodium)
Breakfast
1/2 cup instant oatmeal
1 mini whole wheat bagel
1 Tbsp peanut butter
1 medium banana
1 cup low-fat milk
Lunch
chicken breast sandwich
3 oz chicken breast, skinless
2 slices whole wheat bread
1 slice (3/4 oz) natural cheddar
cheese, reduced fat
1 large leaf romaine lettuce
2 slices tomato
1 Tbsp mayonnaise, low-fat
1 cup cantaloupe chunks
1 cup apple juice
DASH menu example (2,300 mg sodium)
Dinner
Snacks
1 cup spaghetti
3/4 cup vegetarian spaghetti sauce
1/3 cup almonds, unsalted
1/4 cup dried apricots
3 Tbsp Parmesan cheese
spinach salad
1 cup fresh spinach leaves
1/4 cup fresh carrots, grated
1/4 cup fresh mushrooms, sliced
1 Tbsp vinaigrette dressing
1/2 cup corn, cooked from frozen
1/2 cup canned pears, juice pack
1 cup fruit yogurt, fat-free,
no sugar added
Potassium
Potassium
Works with sodium to regulate water
balance and heart to beat regularly
Potassium rich foods are suggested over
supplements for HBP
Orange juice, Prune juice
Cottage cheese, Milk
Avocado, Raisins
Careful if taking certain medicines
 Potassium supplements, water pills, ACE inhibitors
Calcium
Low calcium intake ↑ risk of hypertension
Suggested intake:
1,000 mg for adults
1,200 mg for adults over 50
Milk 1% (1 cup) 290 mg
Sardines (3 oz) 325 mg
Broccoli (1 cup raw) 43 mg
Spinach (1 cup boiled) 245 mg
Fortified orange juice (1 cup) avg. 351mg
Medications
Most Americans will be on more than two medicines to
get blood pressure to normal values.
Three main types are:
Diuretics
Beta-Blockers
Ace inhibitors
All work in different ways so more than one is
commonly used to treat HBP
Diuretics
Also known as “Water pills”
Reduce blood volume
Cause kidney’s to release more
sodium and water in urine
Shown to be the key in preventing
heart failure caused by HBP
Dyazide and Lasix
Beta-Blockers
Blocks effect of hormone norepinephrine on beta
receptor sites in body.
 Heart beats slower and with less force, but
more efficiently per beat therefore:
 Reduces work load on heart
Work better when combined with diuretics
 Especially in African Americans
Examples
 Toprol XL, Tenormin & Inderal
Angiotensin-converting enzyme
(ACE) Inhibitors
Relax blood vessels
Blocks formation of natural chemical
that narrows blood vessels
Also blocks production of aldosterone
Retention of sodium and water
Examples
Altace & Vasotec
Other Common Medications
Calcium channel
blockers
Angiotensin II Receptor
Blockers
Combination Drugs
Questions to ask your doctor
Do I already have any damage to my
organs from HBP? How do you find out?
What’s the name of my drug? What are the
side effects? Can I stop it?
How do I know the medicine is working?
How often should I check my blood pressure?
Who do I call if I have questions?
Lifestyle Changes
Weight loss
Increase physical activity
Reduce stress
Limit alcohol
 Even healthy people can have blood pressure increases with alcohol use
Quit smoking
 Injures artery wall
 Speeds up hardening of arteries
Reduce sodium
 Read the label
 Banish the shaker!
 Prepare food with less salt
Weight Reduction & Physical Activity
↑ Physical activity can result in weight loss
Take small steps at first
 Take stairs
 Park farther away
 Walk the dog one extra time
 Just keep moving
Stress Reduction
Can reduce blood pressure
Not replacement for medication
Examples
 Yoga
 Meditation
 Whatever relaxes YOU!
Treating HBP
Many methods
 Lifestyle changes
 Diet changes – DASH
 Medication
Combination approach very popular and necessary
 Best results for many
Blood Pressure
High blood pressure is preventable.
High blood pressure is silent.
High blood pressure is also treatable.