11d. CV Health - Hypertension Flashcards
What does blood pressure reflect?
The force of circulating blood against artery walls
How is blood pressure expressed?
Systolic
Diastolic
What is systolic BP?
The pressure blood exerts on arterial walls when the heart contracts
What is diastolic BP?
Blood pressure when the heart relaxes
What measurement is considered as hypertension?
140/90 mmHg or higher
Signs and symptoms of hypertension
Fatigue
Headache
Dizziness
Visual disturbance
What is essential hypertension?
No specific underlying medical cause
What are the drivers of essential hypertension?
Vascular resistance
Obesity
Stress
Anxiety
Smoking
High salt intake
What is secondary hypertension?
Due to diseases of kidneys, adrenals, thyroid, diabetes
What is malignant hypertension?
Pressure above 180/120
Risks damaging organs
Causes and risk factors for hypertension
Genetic
Obesity
Excess alcohol
Stress
Nutritional deficiencies
High table salt
Inactivity
Smoking
Drugs
Raised uric acid
Why is obesity a risk factor for hypertension?
Activates RAAS causing vasoconstriction and water restriction
Why is excess alcohol a risk factor for hypertension?
Reduces the baroreceptor reflex (ability to respond to BP changes)
Increases sympathetic outflow
Increases HR and BP
Stimulates the endothelium to release vasoconstrictors
Activates the RAAS
Why is stress a risk factor for hypertension?
Increases SNS activity causing vasoconstriction
High cortisol increases the potent vasoconstrictor ET-1
Activates the RAAS
What nutritional deficiencies are risk factors for hypertension?
Mg (vasodilator)
K (increases urinary excretion of Na; reduces blood volume)
Why is inactivity a risk factor for hypertension?
Associated with higher HR
Increased cardiac contractility
Greater force on arteries
Why is smoking a risk factor for hypertension?
Damages endothelium
Nicotine constricts blood vessels
Nicotine increases HR
Which drugs are risk factors for hypertension?
NSAIDs
Corticosteroids
Decongestants
(can increase BP)
Why is raised uric acid a risk factor for hypertension?
Stimulates the RAGE pathway
Increasing NF-kB
Disrupts eNOS activity - lowers NO
Exacerbates endothelial insulin resistance
Natural approach to hypertension
Increase K/Na ratio >3:1
Lower uric acid levels
DASH diet
ACE inhibitory peptides
Optimise sleep
Optimise weight
Stress management
Why is K important in supporting hypertension?
Increases natriuresis
Encourages vasodilation
Reduces sensitivity to angiotensin II
Lowers SNS activity
Lowers NADPH oxidase
How much should salt be restricted to in hypertension?
1.5g/day
What does the DASH diet consist of?
Fresh fruit/veg
Legumes
Nuts
Seeds
Wholegrains
Fish
Lean meat
Low fat dairy
Restricted Na
What do ACE inhibitory peptides do?
Encourage ACE to react with the peptides
Reduces vasoconstriction via angiotensin II
Food sources of ACE inhibitory peptides
Spirulina
Mushrooms
Spinach
Hemp seeds
Walnuts
Why should sleep be optimised to support hypertension?
Melatonin is associated with anti-hypertensive effects through GABA stimulation
Angiotensin II
Increases NO
Why is stress management important in supporting hypertension?
Diaphragmatic breathing - shown to decrease systolic and diastolic BP, HR and anxiety
Promotes sense of relaxation
Earthing - walking barefoot on grass or sand
Improves HR variability, lowers night-time cortisol and promotes a parasympathetic state
Nutrients to support hypertension
C, D
Mg
L-arginine
B6
CoQ10
Hawthorn
Why is vit D important in supporting hypertension?
Deficiency leads to overexpression renin, activating RAAS
Increases vasoconstriction and retention of Na and water
Reduced proinflammatory cytokines
Increases NO
Increases endothelial function
Reduces hsCRP
Why is Mg important in supporting hypertension?
Effects cardiac and vascular tone and reactivity
Why is L-arginine important in supporting hypertension?
Substrate for vascular NO synthesis
Inhibits ACE activity
Dosage of L-arginine in supporting hypertension
1000-2000mg/day x3
Why is B6 important in supporting hypertension?
Deficiency is associated with hypertension
Increases cysteine synthesis, glutathione
Blocks Ca channels
Reduces SNS tone
Herbs to support hypertension
Hawthorn
Yarrow
Lime flower
Dandelion leaf
Actions of hawthorn in supporting hypertension
Cardiotonic
Hypotensive
Actions of yarrow in supporting hypertension
Diuretic
Hypotensive
Actions of lime flower in supporting hypertension
Nervine relaxant
Diuretic
Anti-hyperlipidaemic
Actions of dandelion leaf in supporting hypertension
Diuretic
Rich in K
(3-4 fresh leaves/day)
