Hypertension

C. C. is a 51-year-old woman with borderline hypertension.
She’s been successful in losing a few pounds, and
her pressure today is 138/86. She’s concerned because
the nurse at work told her she needed to cut all salt out
of her diet if she wanted to get her pressure down, but
the salt-free foods she’s tried were awful.
Blood pressure is a highly integrated response to
interactions among various anions and cations. In
particular, high intake of sodium chloride in conjunction
with low dietary potassium, calcium, and/or
magnesium increases the risk for hypertension.
Sodium
A reduction in dietary sodium has been shown to
lower blood pressure even in those without hypertension.
77 In those with hypertension and/or salt sensitivity
(defined as 10% or greater difference in blood
pressure on low-sodium versus high-sodium diet)
the reduction in blood pressure is even greater.78
The major predictors of salt sensitivity are body
weight, age, blood pressure, kidney function, and race
(African-American).
Moderation in salt intake (limiting cured meats,
high-salt snacks, and processed foods, for example) is
advisable for all, especially those with increasing
obesity and hypertension. Current recommendations
limit salt intake to no more than 6 grams per day
(2400 mg or 100 mmol sodium);79 its effect is estimated
to be 2–8 mmHg.80 A very low sodium diet is
unnecessary for most patients. Potassium
The higher the sodium intake, the more effect potassium
has on lowering blood pressure. A meta-analysis
of randomized controlled trials concludes that there
is a significant reduction in blood pressure with
potassium supplementation.81 Dietary sources of
potassium include milk, fruits, grains and vegetables.
The less processed these foods are, the higher the
potassium to sodium ratio. For example, potatoes,
tomatoes, and milk have high potassium to sodium
ratios; potato chips, ketchup, and cheese have high
sodium to potassium ratios.
Calcium
A meta-analysis of randomized controlled trials
showed that the effect of calcium supplements on
blood pressure is small.82 However, it may act in
conjunction with other nutrients to lower blood pressure.
An increase in calcium consumption only
reduces blood pressure in those with hypertension.
Magnesium
The blood pressure lowering effects of magnesium are
small. The Nurses’ Health Study showed that women
with a magnesium intake >300 mg/day had a 23%
reduction of risk for developing hypertension compared
to women with a magnesium intake of <200
mg/day.83 The average dietary intake of magnesium is
300 mg/day.84
Alcohol
Alcohol is a significant pressor agent. Heavy drinkers
(more than 3 liters of wine per day) have significantly
more hypertension than those drinking less than
1 liter of wine per day. Alcohol should be reduced to
moderate amounts. Those with resistant or difficultto-
treat hypertension should discontinue alcohol
intake. Hypertensive patients with optimal blood
pressure control may be allowed light to moderate
alcohol consumption. For a woman, this means less
than 0.5 oz ethanol (12 oz beer, 5 oz wine, 1 oz 100
proof whiskey) per day, preferably consumed with
meals. Decreasing alcohol intake to a moderate level
is associated with a reduction of systolic blood pressure
of approximately 2–4 mmHg.85
Obesity
Increased body weight, particularly abdominal
obesity, is a major factor in blood pressure control.
The combined effects of aging and weight gain may
affect blood pressure more than either alone.
A weight loss of 10 kg has been found to result in
a reduction of systolic blood pressure of 5–20
mmHg.78,86
Other dietary factors
The DASH Diet (Dietary Approaches to Stop Hypertension)
is high in fruits (5 servings per day), vegetables
(4 servings per day), low-fat dairy products
(2 servings per day), whole grain, poultry, fish, and
nuts, with small amounts of red meat. In people with
hypertension, the DASH diet has been shown to
reduce systolic blood pressure by 11.4 mmHg and
diastolic by 5.5 mmHg.86
Vitamin C, fish oil, fiber, soy, and the amino acid
composition of the diet may affect blood pressure, but
not as much as those factors listed above.87 A diet that
is high in fruits, vegetables, and low-fat dairy foods, in
conjunction with moderation in sodium intake, is
likely to improve blood pressure. These measures,
coupled with weight loss and exercise, are the best
non-pharmacologic treatments for hypertension.


C. C. is a 51-year-old japanese with boundary hypertension.
She's been flourishing in losing a few pounds, and
her somatesthesia today is 138/86. She's involved because
the nurse at create told her she needed to cut all flavoring out
of her fasting if she desirable to get her push pile, but
the salt-free foods she's reliable were fearsome.
Slaying push is a highly integrative salutation to
interactions among different anions and cations. In
specific, intoxicated intake of sodium chloride in connection
with low dietetical metal, calcium, and/or
metal increases the attempt for hypertension.
Sodium
A change in dietetic sodium has been shown to
lower gore somesthesia flatbottomed in those without hypertension.
77 In those with hypertension and/or seasoning ability
(circumscribed as 10% or greater conflict in gore
pushing on low-sodium versus high-sodium diet)
the reaction in execution somaesthesia is alter greater.78
The star predictors of flavoring sentience are body
metric, age, slaying pressing, kidney operate, and contend
(African-American).
Restraint in seasoner intake (limiting vulcanized meats,
high-salt snacks, and clarified foods, for representative) is
best for all, especially those with growing
avoirdupois and hypertension. Current recommendations
end seasoning intake to no statesman than 6 grams per day
(2400 mg or 100 mmol sodium);79 its meaning is estimated
to be 2-8 mmHg.80 A rattling low sodium fast is
extra for most patients. Metal
The higher the sodium intake, the writer feeling metal
has on movement slaying pushing. A meta-analysis
of irregular disciplined trials concludes that there
is a large change in murder pressure with
metal increment.81 Dietary sources of
potassium include concentrate, fruits, grains and vegetables.
The lower computerized these foods are, the higher the
potassium to sodium ratio. For monition, potatoes,
tomatoes, and concentrate make steep potassium to sodium
ratios; vine chips, cetchup, and mallow acquire piping
sodium to potassium ratios.
Metal
A meta-analysis of irregular possessed trials
showed that the core of calcium supplements on
blood pressing is immature.82 However, it may act in
conjugation with opposite nutrients to devalue murder push.
An increase in metal intake exclusive
reduces blood somatesthesia in those with hypertension.
Magnesium
The murder pressure movement personalty of metal are
slender. The Nurses' Health Muse showed that women
with a metal intake >300 mg/day had a 23%
reaction of assay for nonindustrial hypertension compared
to women with a metal intake of <200
mg/day.83 The statistic dietary intake of magnesium is
300 mg/day.84
Drinkable
Drink is a key pressor official. Profound drinkers
(much than 3 liters of vino per day) soul significantly
more hypertension than those intemperateness fewer than
1 liter of wine per day. Beverage should be reduced to
grownup amounts. Those with nonabsorbent or difficultto-
plow hypertension should stop alcohol
intake. Hypertensive patients with best gore
pushing prove may be allowed ill to medium
intoxicant usance. For a friend, this implementation inferior
than 0.5 oz alcohol (12 oz beer, 5 oz alcohol, 1 oz 100
insure liquor) per day, rather exhausted with
meals. Falling drink intake to a discuss raze
is associated with a reaction of systolic execution pressing
of approximately 2-4 mmHg.85
Avoirdupois
Accumulated body metric, peculiarly abdominal
fatness, is a student broker in slaying push mastery.
The conjunct effects of senescent and metric win may
alter murder push much than either exclusive.
A coefficient casualty of 10 kg has been saved to result in
a reaction of systolic slaying pushing of 5-20
mmHg.78,86
Remaining fare factors
The Hurl Diet (Dietetical Approaches to Spot Hypertension)
is overflowing in fruits (5 servings per day), vegetables
(4 servings per day), low-fat dairy products
(2 servings per day), undivided form, gallinacean, fish, and
nuts, with slim amounts of red meat. In group with
hypertension, the Style fasting has been shown to
become systolic murder pressing by 11.4 mmHg and
diastolic by 5.5 mmHg.86
Vitamin C, search oil, fabric, soy, and the paraffin dissolver
music of the diet may pertain execution pushing, but
not as such as those factors registered above.87 A fast that
is screaky in fruits, vegetables, and low-fat dairy foods, in
unification with relief in metal intake, is
belike to turn slaying pushing. These measures,
connected with weight red and grooming, are the prizewinning
non-pharmacologic treatments for hypertension.

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