Hypertension ControlHypertension Control

Dave Elger, M.A.Dave Elger, M.A.

ObjectivesObjectives

What is high blood pressure?What is high blood pressure? What causes high blood pressure?What causes high blood pressure? What does it do to the body?What does it do to the body? Recommendations for lifestyle Recommendations for lifestyle

changechange Tips for healthy eatingTips for healthy eating

What is Blood Pressure?What is Blood Pressure?

The force of blood against the wall The force of blood against the wall of the arteries.of the arteries.

Systolic- as the heart beatsSystolic- as the heart beats Diastolic - as the heart relaxesDiastolic - as the heart relaxes Normal Blood pressure Normal Blood pressure

(<120 mm Hg and <80 mm Hg) (<120 mm Hg and <80 mm Hg)

High Blood Pressure (HBP) High Blood Pressure (HBP) FactsFacts

A consistent blood pressure of 140/90 A consistent blood pressure of 140/90 mm Hg or higher is considered mm Hg or higher is considered HIGHHIGH..

An estimated An estimated 65 MILLION65 MILLION of adult of adult Americans over 18 yrs old have it (31%)Americans over 18 yrs old have it (31%)

62% of Americans over 55 yrs of age 62% of Americans over 55 yrs of age have ithave it

At age 55, 9 out of 10 of those with At age 55, 9 out of 10 of those with normal BP will eventually develop HBPnormal BP will eventually develop HBP

New Category for Blood New Category for Blood PressurePressure

Pre HypertensionPre Hypertension Between 120/80 and 139/89 mm/HgBetween 120/80 and 139/89 mm/Hg

(>140/90 is considered high)(>140/90 is considered high)

Risk of cv disease starts to rise at blood Risk of cv disease starts to rise at blood pressures over 115/75 mm/Hg and doubles pressures over 115/75 mm/Hg and doubles with each increment of 20/10 mg Hg!with each increment of 20/10 mg Hg!

Detection of “the silent killer”Detection of “the silent killer”(often there are no symptoms)(often there are no symptoms)

2 or more readings of 140/90mm 2 or more readings of 140/90mm Hg or higher taken on more than Hg or higher taken on more than one occasion.one occasion.

Tips for assessing an Tips for assessing an accurate blood pressure accurate blood pressure (you don’t (you don’t want to be misdiagnosed!) want to be misdiagnosed!)

Don’t eat, exercise, drink coffee or smoke Don’t eat, exercise, drink coffee or smoke cigarettes for 1 hr. before.cigarettes for 1 hr. before.

Empty your bladder.Empty your bladder. Sit relaxed for five minutes with back Sit relaxed for five minutes with back

supported and feet flat on the ground. supported and feet flat on the ground. Your arm should be supported and even with Your arm should be supported and even with

your heart when testedyour heart when tested Make sure the correct cuff size is used Make sure the correct cuff size is used (generally (generally

arm circumference > 13” requires a large cuff)arm circumference > 13” requires a large cuff)

Wear short sleeves so your arm is exposed.Wear short sleeves so your arm is exposed.

Risk Factors for HBPRisk Factors for HBP

Sedentary Lifestyle (couch potato)

Poor Diet Aging- vessels lose

elasticity (> 60 yrs age) Tobacco, alcohol,

caffeine Obesity/Overweight Sleep Apnea Male sex

Family History African-American Some sports/weight

loss supplements or medications (cold medications, antihistamines)

Oral Contraceptives Stress (type “A”

personality)

How Does HBP Effect the How Does HBP Effect the Body?Body?

Can cause a break in a weakened Can cause a break in a weakened blood vessel which then bleeds in blood vessel which then bleeds in the brain.the brain.

Stroke!

The HeartThe Heart

High Blood Pressure (HPB) is a High Blood Pressure (HPB) is a major risk factor for major risk factor for heart attackheart attack..

HBP is the number one risk factor HBP is the number one risk factor for for congestive heart failurecongestive heart failure..

5 million Americans

have CHF- 550,000

new cases annually-

American Heart Assoc.

The KidneysThe Kidneys

Kidneys act as filters to rid the Kidneys act as filters to rid the body of wastes.body of wastes.

High blood pressure can narrow High blood pressure can narrow and thicken the blood vessels.and thicken the blood vessels.

Waste builds up in the blood, can Waste builds up in the blood, can result in kidney damage.result in kidney damage.

1 in 9 Americans (20 million) have Chronic Kidney Disease (CKD)

another 20 million are at risk -National Kidney Foundation

The EyesThe Eyes

Can eventually cause blood vessels Can eventually cause blood vessels to break and bleed in the eye.to break and bleed in the eye.

Swelling of the optic nerve, retina Swelling of the optic nerve, retina damagedamage

Can result in blurred vision or even Can result in blurred vision or even blindness.blindness.

Hypertensive retinopathy

-What can you do to -What can you do to prevent or reduce high prevent or reduce high blood pressure?blood pressure?

1. Exercise1. Exercise Low to moderate intensity Low to moderate intensity

cardiovascular improves blood flow cardiovascular improves blood flow and keeps vessels elastic and and keeps vessels elastic and healthyhealthy

Heart becomes a stronger more Heart becomes a stronger more efficient pump efficient pump Accumulate 30 min

most days of the

week

If you already have HBP, you can expect an ave. drop of 10 mm Hg

2. Quit Tobacco2. Quit Tobacco

Smoking injures the walls of blood Smoking injures the walls of blood vessels accelerating hardening of vessels accelerating hardening of the arteries. the arteries.

Smokeless tobacco contains high Smokeless tobacco contains high levels of sodiumlevels of sodium

Both constrict or “squeeze” Both constrict or “squeeze” arteriesarteries

3. Decrease your intake 3. Decrease your intake of sodium and increase of sodium and increase potassiumpotassium

Humans evolved on a low sodium, Humans evolved on a low sodium, high potassium diet. high potassium diet.

Today’s modern diet is high in Today’s modern diet is high in sodium and low in potassium.sodium and low in potassium.

Watch out for Hidden Watch out for Hidden SodiumSodium

AMOUNT OF SODIUMAMOUNT OF SODIUM 3000 mg Frozen pizza (3 slices)3000 mg Frozen pizza (3 slices) 1213 mg Taco Bell Dbl Burrito 1213 mg Taco Bell Dbl Burrito

supreme supreme (beef)(beef) 1500 mg KFC Original recipe1500 mg KFC Original recipe 1213 mg BK Whopper w/cheese1213 mg BK Whopper w/cheese 1070 mg McDonald’s Big Mac1070 mg McDonald’s Big Mac 890 mg 1 can Campbell’s chicken 890 mg 1 can Campbell’s chicken noodle soupnoodle soup

Check your food labelsCheck your food labels

•5% daily value or less is low

•20% daily value or more is high

<2,300 mg/day is recommended

Eat More Potassium Rich Eat More Potassium Rich FoodsFoods

Banana Banana TomatoTomato Orange juiceOrange juice Spinach Spinach Cantaloupe Cantaloupe

Brussells Sprouts Brussells Sprouts

Almonds Almonds Grapefruits Grapefruits

BroccoliBroccoli Corn Corn CucumbersCucumbers Dates/raisinsDates/raisins Most salt water Most salt water

fishfish Dried beansDried beans

4. Get 1,000 mg Calcium 4. Get 1,000 mg Calcium

Mgs. of CalciumMgs. of Calcium ¾ cup Total Cereal 1,000 mg¾ cup Total Cereal 1,000 mg 1 cup skim milk 3001 cup skim milk 300 1 oz. Swiss cheese 2701 oz. Swiss cheese 270 1 cup low-fat plain yogurt 4001 cup low-fat plain yogurt 400 3 oz sardines canned 2203 oz sardines canned 220 8 oz orange juice 3508 oz orange juice 350 3 oz. shrimp, canned 1453 oz. shrimp, canned 145

Studies indicate low calcium may contribute to high bp

5. Try the DASH Diet 5. Try the DASH Diet (Dietary Approach to Stop (Dietary Approach to Stop Hypertension)Hypertension) Diet rich in fruits and vegetables Diet rich in fruits and vegetables

found effective in clinical study on found effective in clinical study on reducing high blood pressurereducing high blood pressure

DASH ResultsDASH Results

BP starting dropping within days FOR BP starting dropping within days FOR those put on a diet low in fat and those put on a diet low in fat and high in fruits and veggies (ave 11 high in fruits and veggies (ave 11 systolic and 5.5 diastolic points)! systolic and 5.5 diastolic points)!

"The beauty of DASH is that it doesn't take a genius to follow," says Norman Kaplan, a hypertension expert at the University of Texas Health Sciences Center in Dallas. "You just cut the fat, double your fruits and vegetables, and use low-fat dairy products."

DASH EATING PLANDASH EATING PLAN

7-8 daily servings grains & grain products7-8 daily servings grains & grain products 4-5 daily servings of vegetables4-5 daily servings of vegetables 4-5 daily servings of fruits4-5 daily servings of fruits 2-3 daily servings of low fat dairy2-3 daily servings of low fat dairy 2 or less daily servings of meat 2 or less daily servings of meat 4-5 servings per week of nuts, seeds, 4-5 servings per week of nuts, seeds,

beansbeans 2-3 daily servings of fats and oils2-3 daily servings of fats and oils 5 servings of sweets weekly5 servings of sweets weekly

6. Moderate Alcohol 6. Moderate Alcohol Intake (1-2 drinks)Intake (1-2 drinks)

Alcohol raises blood pressure and Alcohol raises blood pressure and can harm liver, brain, and heartcan harm liver, brain, and heart

What counts as a drink?What counts as a drink? 12 oz beer12 oz beer 5 oz of wine5 oz of wine 1.5 oz of 80 proof whiskey1.5 oz of 80 proof whiskey

7. Maintain Healthy 7. Maintain Healthy WeightWeight Blood pressure rises as weight Blood pressure rises as weight

rises.rises. Obesity is also a risk factor for Obesity is also a risk factor for

heart disease.heart disease. Even a 10 lb weight loss can Even a 10 lb weight loss can

reduce blood pressure.reduce blood pressure.

8. Supplements to AVOID!8. Supplements to AVOID!

Any supplement advertised to Any supplement advertised to speed up metabolism, burn fat, or speed up metabolism, burn fat, or lose weight should be avoided!lose weight should be avoided!

Some reports of creatine elevating Some reports of creatine elevating BPBP

9. Other Treatment9. Other Treatment

If Lifestyle Modification is not If Lifestyle Modification is not working, blood pressure working, blood pressure medication may be needed (i.e. medication may be needed (i.e. diuretics, beta blockers, ace diuretics, beta blockers, ace inhibitors) inhibitors)

Summary: Tips for Summary: Tips for lowering high blood lowering high blood pressure pressure

Regular cardiovascular exercise is a must!Regular cardiovascular exercise is a must! Quitting tobacco is also a must!Quitting tobacco is also a must! Reduce sodium and increase potassiumReduce sodium and increase potassium Increase your intake of calcium from low-fat Increase your intake of calcium from low-fat

sourcessources Follow the high fiber DASH Diet (lots of fruit and Follow the high fiber DASH Diet (lots of fruit and

veggies). veggies). Use alcohol in moderation only.Use alcohol in moderation only. If you are overweight, losing fat can help If you are overweight, losing fat can help

significantly!significantly! Avoid performance-enhancing supplements!Avoid performance-enhancing supplements! Take your medication if required!Take your medication if required!

About Dave Elger About Dave Elger

Dave holds a bachelor’s degree Dave holds a bachelor’s degree from the University of Wisconsin-from the University of Wisconsin-Stevens Point and a master’s Stevens Point and a master’s degree from Ball State University degree from Ball State University in exercise physiology. He can be in exercise physiology. He can be contacted at contacted at elgerdh@mail.comelgerdh@mail.com..