Академический Документы
Профессиональный Документы
Культура Документы
John Turner, MD
January 14, 2002
Overview
<What is hypertension?
<What causes it?
<Who gets it?
<How is it diagnosed?
<Why is it a problem?
<How is it treated?
<Can it be prevented?
< Depends on
<
<
Age
Activity
<Diastolic
<
128
74
How is it Measured?
<Patient sitting
<No smoking or caffeine 30 minutes
before measurement
<Rest at least 5 minutes
<Measure twice and average
<Recheck in the opposite arm if elevated
<Use a reliable blood pressure cuff
Blood
pressure
cuffs
Sphynomanometer
Hypertension - Definition
<Systolic blood
pressure of 140
mmHg or greater
or diastolic blood
pressure of 90
mmHg or greater
or taking high
blood pressure
medication
140
90
Symptoms of Hypertension
< Usually None
< Rarely can be
associated with
migraine headaches
< Often called the Silent
Killer because it does
serious damage inside
the body without any
symptoms
How is it diagnosed?
< Blood pressure readings at a physicians office
which show elevated pressures at two visits (2
months apart)
Hypertension - Causes
<Unknown Essential Hypertension
90 - 95% of all cases of high blood
pressure
<Medications / OTC drugs / supplements
<Medical problems (kidney, thyroid)
<Hardening of the arteries
Types of Hypertension
Stage 1
Systolic
140-159
Diastolic
90-99
Stage 2
160-179
100-109
Stage 3
>180
>110
Family history
Diet
Exercise
Medical problems
Medications (OTCs, herbals)
Smoking
Stress level
Blood count
Kidney function
Urinalysis
Cholesterol
< EKG
< Arrange to see you regularly
<Hypertension damages
blood vessels in every
part of the body
<Makes them thick and
stiff
<Speeds up the build-up
of cholesterol and fats
in the vessels
<This prevents blood
flow just like rust
building up in a pipe
Atherosclerosis
<Thickening and
hardening of
the blood
vessel
<Seen with age,
obesity, high
cholesterol, and
high blood
pressure
Stroke
<High blood
pressure damages
vessels in the
brain which can
lead to stroke
<Hypertension
reduces blood
flow to the heart
and makes the
heart work much
harder
<Heart Attack
<Heart Failure
<Elevated blood
pressures damage
arteries in the kidneys
<Over time this
weakens the kidneys
and causes a build-up
of wastes inside the
body
<If left uncontrolled
high blood pressure
will lead to kidney
failure and the need
for dialysis
<Hypertension
damages the
blood vessels in
the eye and can
lead to vision
problems and
blindness
Treatment
<Exercise
<Healthy diet
DASH Diet
<Sodium reduction
<Weight reduction
<Limit alcohol
<Quit smoking
<Medications
Exercise
< Goal is moderate
levels of activity
< Exercise most
days of the week
for 30 minutes
< Consult a doctor
if you have other
medical diseases
Moderate Exercise
<Walking briskly (3-4 miles per hour)
<Conditioning or general calisthenics
<Home care and general cleaning
<Home repair, such as painting
<Mowing the lawn (with power mower)
<Gardening
<Dancing
<Racket sports, such as table tennis
Healthy Diet
Dietary
Approach to
Stop
Hypertension
DASH Diet
<Shown to help reduce blood pressure
<
<
<
<
<
<
More fruits
More vegetables
Low fat dairy products
Less total fat
Less saturated fat
Less cholesterol
Sodium
< Sodium reduction can help
treat high blood pressure
< Eat no more than 2300 mg
(1 tsp) a day
< Diets with less than 1500 mg
showed even better control of
hypertension
Sodium
<What foods help reduce sodium
in the diet?
< Choose fresh, frozen or canned food items without
added salts.
< Select unsalted nuts or seeds, dried beans, peas
and lentils.
< Avoid adding salt and canned vegetables to
homemade dishes.
< Select unsalted, fat-free broths, bouillons or soups.
Sodium
<What foods help reduce sodium
in the diet? (cont)
< Select fat-free (skim) milk or low-fat milk, lowsodium, low-fat cheeses, as well as low-fat yogurt.
< When dining out, be specific about what you want
and how you want it prepared. Ask for your dish to
be prepared without salt.
< Learn to use spices and herbs to enhance the taste
of your food.
Weight Reduction
< Body Mass Index (BMI) > 27
is closely correlated with
hypertension
< Increased waist size has
been associated with
hypertension
<
<
wt (kg)
ht 2(m)
www.nhlbisupport.com/bmi/bmicalc.htm
Alcohol
<Alcohol can be used in
moderation
<Limit alcohol to 1 oz a day
<
<
<
<
<
12 oz beer
7 oz light wine
5 oz table wine
3.5 oz desert wine
1.5 oz liquor
Medication
<Medication use for high blood pressure
has clearly demonstrated reduction in:
<
<
<
<
<
Stroke
Heart attack
Heart failure
Kidney disease
Overall death rate
Medication
<When blood pressure
normalizes on
medication you
cannot stop taking
the pills
<Medications have
side effects and often
blood work must be
repeated
Types of Medication
< Diuretics (fluid pills)
< Beta Blockers
< ACE Inhibitors
< Angiotensin Receptor
Blockers (ARBs)
< Calcium Channel
Blockers (CCBs)
< Alpha Blockers
< Alpha-Beta Blockers
< Nervous System
Inhibitors
< Vasodilators
Common Questions
<Do vitamin, minerals, or certain foods
help treat hypertension?
<
<
<
Common Questions
<Foods High in Potassium
Apricot
Lean pork
Bananas
Lean veal
Pumpkin
Catfish
Spinach
Cod
Dry beans
Trout
Peaches
Flounder
Plantain
Yogurt
Stewed tomatoes
Sweet potatoes
Green beans
Winter squash
Orange juice
Prunes
Prune juice
Lima beans
Dry peas
Potatoes
Common Questions
<Foods High in Calcium
<
<
<
<
<
<
<
<
<
<
<
<
Milk
Cheese
Yogurt
Soy
Collard greens
Turnip greens
Kale
Okra
Orange juice (fortified)
Figs
Almonds
Waffles & Pancakes
Common Questions
<Does caffeine cause
hypertension?
<
<
<
Common Questions
<Do fats in my diet cause hypertension?
<
<
<
Common Questions
<Do oral contraceptive medications cause
hypertension?
<
Common Questions
<Does stress cause elevated blood
pressure?
<
<
Common Questions
<If medication is controlling my blood
pressure can I stop the diet and
exercise changes?
NO
Common Questions
<Are my headaches from high blood
pressure?
<
<
Very doubtful!
Only certain types of specialized headaches
(Migraines) can be associated at all with
hypertension
Common Questions
<Can hypertension be cured?
<
<
<
<
No
Many individuals can make lifestyle changes
that keep them from talking medications
Medications can also make blood pressure
normal
But high blood pressure rarely goes away or
is cured
Summary
< Hypertension is the Silent Killer because it
has no symptoms
< Treatment always involves changes in diet and
exercise
< Without treatment many organs are
permanently damaged
< Treatment works to help people live better and
live longer
Internet Resources
< National Institute of Health
www.nhlbi.nih.gov/hbp.index.html
Internet Resources
< DASH Diet
www.nhlbi.nih.gov/health/public/heart/
hbp/dash/index.htm
Blood Pressure
www.nhlbi.nih.gov/health
public/heart/hbp/hbp_low/
index.htm