FOUNDATIONS OF NUTRITION 1020-055 Hypertension Research Paper By Jessica Richardson 2011 S A L T L A K E C O M M U N I T Y C O L L E G E
In researching my family health history I have found there is a common health condition arising in my family members after reaching their 40 s and 50 s. That condition is commonly known as high blood pressure, but is medically called hypertension. I have chosen to research this disorder, its causes, treatments, preventative measures, and the effects of nutrition and exercise on the disease. High blood pressure is a common condition in which the force of the blood against the artery walls is high enough that it may eventually cause health problems. Blood pressure is determined by the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries. The more blood the heart pumps and the narrower the arteries, then the higher the blood pressure. A person can have high blood pressure, hypertension, for years without any symptoms. Among North Americans, an estimated one in five adults has hypertension. In adults over 65 years old that number rises to one in every two and only about half of adults seek treatment (Wardlaw 329-331). Around 76.4 million adults in the United States have been diagnosed with high blood pressure, it has been often called the silent killer, since there are virtually no symptoms. Uncontrolled high blood pressure increases a person s risk of serious health problems. Although high blood pressure typically develops over many years, and it affects nearly everyone eventually, so one can and should be proactive in practicing healthy heart habits. Fortunately, high blood pressure can be easily detected (American Heart Association). Blood pressure is typically measured by a device called a sphygmomanometer; comprised of an inflatable cuff to restrict blood flow, a gauge, valve, and a bulb pump, and it is used in conjunction with a stethoscope, an acoustic medical device used to
listen to internal sounds, such as the heartbeat. The cuff is placed around the upper arm, and then the cuff is inflated until the artery is completely occluded, or closed off. While listening with a stethoscope to the brachial artery, at the elbow, the nurse or doctor would then slowly release the pressure in the cuff. As the pressure falls the examiner is listening for the sound of blood flowing into the artery. The pressure at which the sound began is recorded as the systolic blood pressure. The cuff pressure is continually released until the sound can no longer be heard, and that pressure is recorded as the diastolic pressure (Web MD). The blood pressure is expressed by two numbers, systolic and diastolic, that were recorded by the examiner. The higher number represents the systolic pressure, the blood pressure in the arteries when the heart muscle is contracting and pumping blood into the arteries. Optimal systolic blood pressure is 120 millimeters of mercury (mm Hg) or less. The lower number represents the diastolic pressure, the artery pressure when the heart is relaxed. Optimal diastolic blood pressure is 80 mm Hg or less. Normal blood pressure is 120/80 and below, pre hypertension is 139/89 and below. Stage 1 hypertension is defined as sustained systolic pressure exceeding 140 mm Hg and/or diastolic pressure exceeding 90 mm Hg. Stage 2 hypertension is 160/100 and higher. You can see how important and how simple it is to know your numbers and what range you are in (American Heart Association). Elevation in blood pressure is a strong predictor of disease. Hypertension unchecked and ignored can progress into other diseases such as cardiovascular disease, heart attacks, kidney disease, strokes, poor circulation to extremities, vision loss, and sudden death (Mayo Clinic). Since there aren t many symptoms of high blood
pressure, a person may experience only dull headaches and dizzy spells, it is recommended that blood pressure should be checked at least every two years starting at age twenty. For most adults there is no identifiable cause to their high blood pressure, it just tends to develop gradually over the years. Only in some adults is hypertension caused by an underlying condition such as, congenital defects, adrenal tumors, or medications/illegal drugs (Web MD). There are many risk factors associated with high blood pressure to be aware of. Age is a factor, risk increases with age. High blood pressure is more common in men, but women are likely to develop hypertension after menopause. Race is a factor too, African Americans tend to develop high blood pressure younger and more often than Caucasian Americans. High blood pressure is hereditary and seems to run in families. The more a person weighs, the pressure on the arteries increases, and blood pressure goes up. Overweight people have a very high risk of hypertension. People who are inactive tend to have a higher heart rate. Using tobacco immediately raises blood pressure temporarily, but also the chemicals in tobacco damage the lining of the artery walls. Too much sodium in a person s diet will cause water retention and raise blood pressure, as well as too little potassium in a diet to balance the sodium in the blood. Too little vitamin D in a diet may affect an enzyme produced in the kidneys that affects blood pressure. Drinking too much alcohol over time can damage the heart. Heavy drinking in a single sitting can temporarily raise blood pressure by causing the body to release hormones that increase blood flow and heart rate. Stress causes a dramatic increase in blood pressure, it stimulates hormones that speed up heart rate and increase blood flow. Chronic stress is damaging to the heart in two ways; one by the
stress hormone response raising blood pressure, and the other is most people try to relax using unhealthy habits like overeating, drinking alcohol heavily, and smoking tobacco, which contribute to hypertension too. Other risk factors include chronic diseases like high cholesterol, diabetes, kidney disease, sleep apnea, and for some women during pregnancy they may experience high blood pressure (Mayo Clinic). Why do you need to treat hypertension? Uncontrolled high blood pressure leads to complications. The longer it is not treated the greater damage it does. Hypertension can cause heart attacks, strokes, aneurysm, heart failure, kidney problems, vision problems, metabolic syndrome, and trouble with your memory (Mayo Clinic). In order to treat hypertension a person should make an appointment to see a doctor and in the meantime make healthy lifestyle changes like quit smoking and get physically active. One should also try to eat a variety of healthy foods and keep a positive outlook as he or she finds ways to better manage stress. The doctor will ask about one s lifestyle choices and family health history, as well as take simple tests to determine the best method for treatment. By changing one s lifestyle, a person can go a long way toward controlling his or her own high blood pressure, but sometimes that is not enough. The doctor may prescribe medications depending on what stage of hypertension a particular person is in and other medical conditions he or she may have. Typical medications for the treatment of high blood pressure include diuretics that act to help the kidneys eliminate sodium and reduce blood volume, beta blockers that open blood vessels causing the heart to beat slower, enzyme inhibitors to block formation of natural chemicals that narrow blood vessels, receptor blockers to block the actions of natural chemicals that narrow blood vessels, and calcium channel blockers to
relax the muscles of blood vessels. In stage 2 cases, a person may also be prescribed alpha blockers to reduce nerve impulses to blood vessels, central acting agents that prevent the brain from signaling nervous system to increase your heart rate, and vasodilators to work directly on the muscle walls of the arteries preventing them from tightening and narrowing. The doctor may prescribe a combination of medications and he or she may change them around to find the most effective solution to your specific needs. Once the hypertension is under control, the doctor may also prescribe a daily aspirin to reduce further risks for cardiovascular disorders (Everyday Health, Inc.). If blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, one of which should be a diuretic, the person may have resistant hypertension. Resistant hypertension is blood pressure that's resistant to treatment. People who have controlled high blood pressure, but are taking four different types of medications at the same time to achieve that control, are also considered to have resistant hypertension. Having resistant hypertension doesn't mean blood pressure will never get lower. If the person and their doctor can identify what is behind the persistently high blood pressure, there's a good chance that he or she can meet the goal of lowering blood pressure to a safe level with the help of a treatment that's more effective. This may mean big lifestyle changes and getting help for emotional and mental support. The person will also be counseled to not change their personal treatment plan without the doctor's guidance and knowledge (Mayo Clinic). Lifestyle changes can control and prevent high blood pressure, even while already taking medication. The most important lifestyle changes one can make are changes in diet. Eat a variety of healthy foods. Try the Dietary Approaches to Stop
Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, and lowfat dairy foods. The DASH diet is rich in calcium, phosphorus, magnesium, and low in salt. Get plenty of potassium and take a daily vitamin. Supplements such as alphalinolenic acid, blond psyllium, calcium, cocoa, cod-liver oil, coenzyme Q10, omega-3 fatty acids and garlic have been shown to have effectiveness in lowering your blood pressure naturally (Mayo Clinic). Make meals at home that consist of less saturated fats, trans fats and sodium than fast food restaurants. Decrease the salt in your diet to 1500 mg a day if over 50 years old and 2300 mg for those less than 50 years old. Limit alcohol intake; up to one drink a day for women and two a day for men. Quit smoking tobacco or do not start using tobacco; it speeds up the process of the hardening of the arteries (Everyday Health, Inc.). The other most effective treatments and preventative measures to control high blood pressure are to maintain a healthy weight and to get and stay physically active. Overweight individuals are six times more likely to develop high blood pressure. Obesity is the number one lifestyle factor related to the development and early onset of hypertension. Inactivity is considered the number two lifestyle factor related to hyper tension. If an obese person can engage in regular physical activity, at least 5 days a week for an hour a day, and lose weight, blood pressure often returns to normal (Wardlaw 329-331). Losing weight, even ten to fifteen pounds, and keeping it off has been shown to reduce blood pressure. Increasing physical activity will help achieve this amazing benefit of weight loss. Exercising more often and making a habit of it, in turn helps to relieve stress and promote better sleep patterns, which will help to keep blood pressure lower too.
Making time for physical activity also means the person needs to be making time just for him or herself, in this busy overscheduled world, time alone is precious and valuable. Anything a person can do to reduce tension and manage your stress will reflect positively on one s heart rate and blood pressure. This may mean learning to say no to extra tasks, recognizing automatic negative thoughts and letting them go as untruths, maintaining healthy social relationships, and aiming to be more patient and optimistic to reduce blood pressure. By learning and practicing relaxation and deep breathing techniques, a person takes time to calm their body and mind without worrying about what deadlines he or she needs to meet and places they have to be. It is just as simple as making time to read a good book or confide in a good friend over a healthy lunch in the park, to learn to cope with stress in a constructive and beneficial way. I have learned that your health is in your hands. A person can be proactive against the inevitable break down of the human body. It s better to stay informed, know about one s heredity, live a healthy balanced lifestyle, and have a good relationship with a healthcare professional to keep hypertension from being a problem in life.
Works Cited Reference Page 1. Mayo Clinic Health Information. 22 March 2011. Mayo Clinic. Web. 2 December 2011. <http://www.mayoclinic.com/health/high-blood-pressure/ds00100> 2. American Heart Association Learn and Live. 30 June 2011. American Heart Association. Web. 2 December 2011. <http://www.heart.org/heartorg/conditions/highbloodpressure/high-blood- Pressure-or-Hypertension_UCM_002020_SubHomePage.jsp> 3. WebMD Better information. Better health. 5 April 2011. Healthwise, Incorporated. Web. 2 December 2011. <http://www.webmd.com/hypertension-high-blood-pressure> 4. Everyday Health feel good, feel better. 24 November 2009. Everyday Health, Inc. Web. 2 December 2011. <http://www.everydayhealth.com/hypertension/understanding.aspx> 5. Wardlaw, Gordon. Contemporary Nutrition A Functional Approach. 2. Boston: McGraw Hill Learning Solutions, 2012. 329-331. Print.