Diet and Health Guidelines to Lower Risk of High Blood Pressure
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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