Transcript High Cholesterol & Hypertension

HIGH CHOLESTEROL &
HYPERTENSION
CMT Training
The Center for Life Enrichment
High Cholesterol
Section 1
What is it?
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Cholesterol is necessary for proper digestion,
hormone balance, and healthy cell membranes
When the blood cholesterol is too high, it forms
deposits or plaque inside the walls of arteries
When the deposits are large enough to decrease
blood flow, heart disease, stroke, or peripheral
vascular disease develops
Why does it occur?
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Cholesterol is made by the liver
In some people, the liver makes too much cholesterol
Cholesterol is also contained in food rich in animal
fats
Cholesterol circulates in the blood stream bound to
proteins of various densities called “lipoproteins”
LDL vs. HDL
LDL
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“Low Density Lipoproteins”
(LDL) in excess increase the
risk of plaque formation
Commonly called “Bad
Cholesterol”
LDL Cholesterol: Less than
100 mg/dl
HDL
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“High Density Lipoproteins”
(HDL) are cardio-protective
Commonly called “Good
Cholesterol”
HDL Cholesterol: 40 mg/dl
or higher for men; 50
mg/dl or higher for women
What the person might complain
about/What to look for?
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There are no specific symptoms of high cholesterol;
that is why it is recommended that everyone have a
blood cholesterol test
The “desirable” amount of total cholesterol in the
blood is less than 200 mg/dl. This level, if normal,
should be rechecked every five years
If the cholesterol level is greater than 200 mg/dl,
the doctor may recommend dietary interventions
and/or cholesterol lowering medications
Other Risk Factors for Heart Disease:
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High Blood Pressure
Smoking
Family History of Heart Disease
Diabetes
Elevated LDL or Decreased HDL Cholesterol
Elevated Triglycerides (A type of fat found in your
blood)
Obesity
Sedentary Lifestyle
What medications are used?
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There are numerous medications on the market to lower
cholesterol
What to look for while the person is taking medication
to lower cholesterol:
Muscle cramping
 Rash/Hives
 Constipation/Diarrhea
 Flushing
 Stomach Upset/Pain
 Headache
 Labs will be routinely followed to monitor liver and kidney
function
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Your Responsibility
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The individual/caregiver must know:
 Some
of these medications may interact with other
medications the person may take- Make sure the
Healthcare Professional (HCP) is aware of all
medications being taken
 The person should exercise regularly
 Follow a diet low in cholesterol, saturated fats
(including “hydrogenated” fats) and transfatty acids
Specific Foods to Avoid
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Fried Foods:
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If not avoided, consider using olive or sunflower oil when frying
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A recent study published in the science journal BMJ found that in Spain, where olive and sunflower oils
are used for frying, eating fried food is not associated with increased rates of heart disease as it is in
Western countries, where saturated fats, like lard and butter, are used
Hydrogenated Oil:
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Found in packaged foods, such as cookies, pastries, mayonnaise, crackers, microwave popcorn, frozen
dinners, etc.
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Hydrogenated oil is used to increase a product’s shelf life
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Check food labels and ingredients carefully- if you see the word “hydrogenated,” avoid it!
Meat:
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Avoid meat with visible fat
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Try to reduce the amount of meat in your diet
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When preparing/eating meat, trim off any visible fat on steaks and chops, always remove the skin off
turkey and chicken, and choose the leanest ground meat possible
Full-Fat Dairy Products:
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Instead, choose dairy products that are fat-free, made with 2% milk, or part skim
Foods that Lower Cholesterol
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Monounsaturated and polyunsaturated fats:
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Soy Foods:
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Good sources of soy protein include tofu, soy milk, and edamame
High-Fiber Foods:
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Can help decrease LDL cholesterol
Eat fish high in omega-3 fatty acids, such as salmon, tuna, trout, herring, or king
mackerel, at least twice a week
Other good sources of unsaturated fats include avocados, almonds, walnuts, and
olive oil
High-fiber foods that lower cholesterol include whole grains, such as 100
percent whole-wheat bread, oats, and barley; beans; dark, leafy green
vegetables; and fruits with a tough skin
Spices:
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Not only do spices help flavor foods, but some in particular are also a good
part of a cholesterol-lowering diet, such as turmeric, red cayenne pepper, thyme
oil, and ginger
Resources
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MTTP Student Manual
http://www.everydayhealth.com/healthreport/healthy-living-with-high-cholesterol/bestand-worst-foods-for-high-cholesterol.aspx
Hypertension
Section 2
What is it?
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Hypertension or “high blood pressure” usually has no symptoms and, because of
this, is called the “silent killer”
Normal blood pressure is generally below 120/80
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Desirable blood pressure is:
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When the reading is between 120/80 and 139/89
Hypertension:
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Systolic - from 90 to 119
Diastolic - from 60 to 79
Pre-hypertension:
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120 represents the systolic measurement
80 represents the diastolic measurement
When the reading is at least 140/90
The persistent elevated pressure in the vascular system can damage the heart,
brain, kidney, and eyes. Therefore, untreated high blood pressure can lead to heart
disease, stroke, kidney disease, and blindness!
Taking a blood pressure measurement
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The procedure is straightforward and provides
the HCP with vital data regarding the condition
of the individual’s blood vessels and heart
Two blood pressure readings are measured:
 The Systolic Pressure: the maximum
pressure in an artery. It occurs when the
heart contracts; when it is beating, and
blood is being pumped through
 The Diastolic Pressure: the minimum
pressure in an artery. It occurs just before
the heart contracts; in between heartbeats.
It occurs when the heart is resting
Both readings are important. If either the
systolic or diastolic pressure is too high, the
individual has hypertension
Blood pressure readings may be taken while
the individual is sitting or standing
Several different readings (on different days)
are usually taken before the diagnosis of high
blood pressure, or hypertension, is made
Why does it occur?
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In 90% of individuals, there is no known cause for high blood pressure or
hypertension
However, many factors may contribute to hypertension including:
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Obesity
High Salt Intake
Alcohol Use
Sedentary Lifestyle
Use of Certain Medications (which may cause a rise in blood pressure)
A Family History of High Blood Pressure
Excessive Stress
In 10% of people with high blood pressure, there is a known cause for high
blood pressure. Known causes include: kidney disease, diabetes mellitus,
adrenal tumors, or diseases of the blood vessels
What the individual might complain about/What to look for?
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High blood pressure is generally without symptoms
Having blood pressure checked routinely is the best method for
detecting the problem
In some people with high blood pressure, signs and symptoms may
be present. If the following signs or symptoms are noted, report
them to the RN CM/DN or HCP:
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Change in vision
Chest pain
Confusion
Dizziness (blackout)
Nausea and vomiting
Nosebleeds
Shortness of breath
What medications are used?
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There are many different types of medications that
can be used to treat high blood pressure
Some medications are a combination of two or
more medications
It often takes more than one medication to manage
hypertension
How to determine if the medication is working?
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The individual’s blood pressure should be checked regularly in order to tell if the
blood pressure is within the target range identified by the HCP
The following side effects are common to many medications used to treat high blood
pressure. They often disappear after a few weeks of treatment. If they continue to
be a problem, contact your RN CM/DN and the HCP. It may be necessary for the
HCP to reduce the dose or change the medication:
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Dizziness
Persistent coughing
Mood changes
Change in bowel habits
Loss of energy
Sexual impotence
Fatigue
Muscle Weakness
Your Responsibility
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It is important for the individual/caregiver to understand the
following:
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Individuals who are on a diuretic need to have their blood tested to be
certain that their potassium, sodium, and other important electrolytes
remain normal. Individuals should not buy/take potassium supplements
on their own
Many individuals who receive a diuretic are also on digoxin. If this is
true, more careful monitoring of side effects is necessary
It is very important for individuals to drink plenty of fluids and limit salt
intake, unless told otherwise by the HCP
The individual should move from a sitting to standing position or from a
lying to standing position slowly to avoid becoming dizzy
Be sure to tell the HCP if the individual has gout or diabetes. Diuretics
may interfere with the treatment of both of these diseases
Your Responsibilities Continued…
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Report any side effects to the RN CM/DN or HCP. The
HCP may decide to change the medication or reduce
the dose
If the individual’s blood pressure is being monitored,
have the equipment checked each year to be certain it
is working correctly
The individual should not stop taking any medication
suddenly as this could be life-threatening! If the
individual wants to discontinue a blood pressure
medication, it must be discussed with the HCP
Be certain that you know exactly how to operate the
blood pressure measuring equipment
Blood Pressure Monitors
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Digital Blood Pressure
Monitors are available at
TCLE and our off-sight
locations to measure
blood pressure
On occasion, CMTs may
need to use a Blood
Pressure Monitor to
measure a participant’s
blood pressure; please
contact the agency nurse
with any questions or
concerns (301-373-8100)
Resources
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http://www.medicalnewstoday.com/articles/24152
7.php
MTTP Student Manual