Hypertension Flashcards
Exam 1/ Ch 30 Cardiovascular
What is the most frequently encountered health issue in primary care?
Hypertension
Hypertension is also known as ….
high blood pressure
If left untreated hypertension can lead to what health conditions?
stroke, heart attack, kidney failure or death
What do the latest guidelines from the American College of Cardiology and the American Heart Association recommend to maintain the blood pressure below for everyone?
130/ 80 mm Hg
For patients whose bp exceeds the target of 130/80 mm Hg what do the guidelines advocate for?
treatment with medication and lifestyle changes
Any factor that increases peripheral vascular resistance, HR or SV raises what?
systemic arterial pressure
Any factor that decreases peripheral vascular resistance, HR, or SV lowers what?
systemic arterial pressure
What can result when systemic arterial pressure is lowered?
reduced tissue perfusion
What are the 4 major control systems in regulating bp?
-the arterial baroreceptor system
-regulation of body fluid volume
-the renin-angiotensin- aldosterone system
-vascular auto-regulation
Where are the arterial baroreceptors located?
the carotid sinus, aorta, and the left ventricle wall
What do the arterial baroreceptors monitor?
arterial pressure and counteract increases in it
The reason baroreceptor control fails in hypertension?
is not well understood
What changes impact systemic arterial pressure?
fluid volume changes
If the kidneys function properly an increase in systemic arterial pressure leads to what?
diuresis or excessive urination and a subsequent decrease in pressure
The kidneys produce what?
renin
What does renin transform angiotensinogen into?
angiotensin II
Angiotensin II is a potent what?
vasoconstrictor
Angiotensin II regulates the release of what?
aldosterone
Aldosterone acts on the kidneys to reabsorb what?
sodium
Sodium retention in the kidneys prevents what? increases what?
fluid loss; blood volume and blood pressure
Normally, when BP is high, renin levels should decrease… however in most individuals with essential hypertension what happens?
Renin levels remain normal
What maintains relatively constant tissue perfusion?
vascular auto-regulation
Although auto-regulation maintains relatively constant tissue perfusion what role does it play in essential hypertension?
causes it, and reasons are unknown how this system operates
What 4 categories is BP classified?
normal, elevated/ prehypertension, stage 1 or stage 2
all categories can be essential or primary or secondary
The most common type of hypertension and is not caused by an existing health condition?
essential hypertension
Essential hypertension can lead to damage of what?
vital organs
Essential hypertension can lead to what conditions?
heart attacks, strokes, peripheral vascular diseases or kidney failure
How does secondary hypertension occur?
when specific diseases or medications contribute to elevated bp
A severe form of high BP that progresses rapidly and is a medical emergency is what?
hypertensive crisis or malignant hypertensive
What are some symptoms of hypertensive crisis/ malignant hypertension?
morning headaches, blurred vision, dyspnea, or signs of uremia (late stage kidney disease)
Hypertensive crisis/ malignant hypertension is characterized by a systolic blood pressure above what? and a diastolic blood pressure exceeding what?
*systolic blood pressure >200 mm Hg
*diastolic blood pressure > 150 mm Hg
WIthout prompt intervention a hypertensive crisis can lead to what?
kidney failure, left ventricular heart failure, or stroke
What can develop when a patient has one or more of these risk factors: family hx of hypertension, African-American ethnicity, hyperlipidemia, smoking, age over 60, postmenopausal status, excessive sodium and caffeine intake, overweight or obesity, physical inactivity, excessive alcohol consumption, low intake of potassium, calcium, or magnesium; and chronic stress
essential hypertension
What is a leading cause of secondary hypertension?
kidney disease
When does renovascular hypertension occur?
when one or more of the main arteries supplying blood to the kidneys narrow.
Many patients can reduce their need for antihypertensive medications after undergoing what?
angioplasty with stent placement to dilate the narrowed arteries
Dysfunction of the adrenals can also lead to what due to excess production of aldosterone, cortisol, or catecholamines?
secondary hypertension
What medications can cause secondary hypertension?
estrogen and steroids
What is likely the most common cause of secondary hypertension in women?
estrogen-containing oral contraceptives
What is a global epidemic?
hypertension
Up until age 45, a higher percentage of whom have hypertension?
Men
Between what ages are the rates of hypertension equal in men and women?
45- 64
The percentage of women with hypertension surpasses men after what age?
after 64
In the US, the prevalence of hypertension in what race is among the highest in the world and continues to rise?
African- Americans
When do African- Americans tend to develop high BP?
early in life
What does the fact that African-Americans tend to develop high BP earlier in life significantly increase their risk of?
death from strokes, heart disease, and kidney disease
What can lead to significant reductions in cardiovascular morbidity and mortality?
controlling hypertension
Evidence-Based Dietary and exercise practices that can help lower BP include:
*Achieving weight reduction through lifestyle changes, combining reduced caloric intake with increased physical activity.
*Reducing dietary sodium intake, aiming for an optimal goal of less than 1500 mg daily.
*Following the Dietary Approaches to Stop Hypertension or DASH diet, which emphasizes fruits, vegetables, and low-fat dairy products and increases the intake of potassium, calcium, magnesium, and fiber.
*Increasing physical activity through aerobic exercise, resistance training, and static isometric exercises.
What are some modifiable risk factors that you can educate your patients on regarding hypertension?
smoking cessation and stress management
Most patients with hypertension do not exhibit symptoms, however, some may…. what are they?
headaches, facial flushing, dizziness, or fainting
When assessing your patient for orthostatic hypotension… in what position should your patient be in when you take the first reading?
supine or sitting
After waiting how long should you take the 2nd BP reading when assessing your patient for orthostatic hypotension? What position should they be in?
3 minutes; standing
What is indicated by decreased blood pressure when the patient changes position from lying to sitting to standing?
orthostatic hypotension
Although no lab tests can diagnose essential hypertension, several lab tests can assess for possible causes of secondary hypertension such as?
protein and RBCs in urine; elevated BUN & serum creatinine levels – kidney disease (the creatinine clearance test indicates the glomerular filtration ability of the kidneys)
The expected outcome of health teaching on hypertension is?
that the patient with hypertension understands and articulates their personalized plan of care for managing hypertensioin
The primary collaborative concerns for most patients with hypertension include?
*the need for health education related to the hypertension management plan
*the potential for reduced adherence to treatment due to the side effects of medication and the required lifestyle changes
What is the cornerstone of hypertension management?
lifestyle modifications
If lifestyle modifications are not effective, what may the primary care provider consider?
antihypertensive medications
What should the patient be educated in regards to management of hypertension?
*Restrict dietary sodium according to ACC/AHA guidelines.
*Reduce weight if overweight or obese.
*Adopt a heart-healthy diet, such as the DASH diet.
*Increase physical activity through a structured exercise program.
*Limit alcohol consumption to no more than one drink per day for women and two drinks per day for men.
*Quit smoking and avoid tobacco use.
*Practice relaxation techniques to manage stress.
Is there a surgical treatment for essential hypertension?
No
Is there a surgical treatment for secondary hypertension?
in certain cases- yes
What herb may help lower cholesterol and BP in patients with hypertension?
garlic
What does garlic do to patients taking anticoagulants?
increases the risk of bleeding and may interfere with the effectiveness of certain medications.
Some patients have found success incorporating what into their hypertension management plan? For whom can these methods also be helpful for?
biofeedback, mediation, and acupuncture; those experiencing chronic and severe stress
Drug therapy should be what to each patient?
tailored
What should be considered when tailoring drug therapy for each patient?
culture, age, coexisting conditions, severity of BP elevation, and cost of medications; and follow-up care
What kind of drug regimen is preferable, especially for older adults?
once-a-day
Why is once-a-day drug regimen preferable for older adults?
fewer daily doses reduce the risk of non-adherence
Many patients with hypertension require ____ or ________ medications to achieve adequate BP control.
2 or more
Another expected outcome is that the patient with hypertension is expected to adhere to what?
their plan of care, including necessary lifestyle changes
Patients with essential hypertension prescribed medication often need what?
continue treatment for life
Do patients with essential hypertension that are to continue their medication treatment for life, adhere to this care plan?
They may discontinue due to the absence of symptoms or bothersome side effects
Interprofessional collaboration with a pharmacist can help patients understand what outcome?
their therapy including potential side effects, and tailor the treatment regime to fit their lifestyle and daily schedule
Patients who do not adhere to antihypertensive treatment are at an increased risk for what?
target organ damage and hypertensive crisis that can cause organ damage in the kidneys or heart
A gradual reduction in systolic blood pressure is preferred (in a crisis), as rapid lowering can cause what?
cerebral ischemia, heart attack, and renal failure
Patients in hypertensive crisis who are admitted to an ICU unit will get what kind of antihypertensive medications until they are stable.. then they will receive what?
IV; oral
When caring for patients with hypertensive crisis, assess for symptoms such as?
headache, extremely high BP, dizziness, blurred vision, shortness of breath, nosebleeds, or severe anxiety
Nursing care for a patient going through hypertensive crisis-
*place the patient in semi-Fowler position
*administer oxygen
*administer an IV beta blocker, nicardipine, or other infusion drug as prescribed; one stable transition to oral antihypertensive medication
* monitor BP every 5 to 15 mins until diastolic pressure is below 90 but not less than 75; then monitor BP every 30 min to ensure it is not lowered too quickly
*watch for neurological or cardiovascular complications, such as seizures; numbness, weakness, or tingling in extremities; dysrhythmias; or chest pain
the expected outcomes for patients with hypertension would be:
*clearly articulate their understanding of the care plan, including medication and required lifestyle changes
*promptly report any adverse drug effects, such as coughing, dizziness, or sexual dysfunction, to their primary healthcare provider
*consistently adhere to the care plan, including attending regular follow-up appointments with their primary healthcare provider
Purposes of Diuretics
-reduce hypertension (blood pressure)
-decrease edema (in conditions such as heart failure and renal or liver disorders)
types of diuretics
*thiazide and thiazide-like
*loop
*osmotic
*potassium-sparing
diuretics increase what?
urine production/ diuresis
The body’s extracellular fluid is filtered through the kidneys how often?
approx. every 1.5 hrs
How do diuretics lower blood pressure?
by promoting sodium and water loss, reducing fluid volume (thus decreasing BP)
Diuretics often lead to a loss of what along with fluid loss?
electrolytes (potassium, magnesium, chloride, and bicarbonate)
Diuretics that increase potassium loss are known as what?
potassium- wasting diuretics
Diuretics that increase retention of potassium are called what?
potassium-sparing diuretics
Thiazide diuretics are used to manage what?
hypertension and peripheral edema
Thiazide diuretics are not suitable for what?
immediate diuresis, especially in patients with severe renal impairment
Best suited for patients with normal renal function.
Thiazides can impact what potentially leading to hyperglycemia?
glucose tolerance
Thiazides should be used with extreme caution in what type of patient? What should be monitored regularly?
patients with diabetes mellitus; lab tests results- such as electrolytes and glucose levels
What thiazide diuretic is often combined with various medications such as ACE inhibitors, beta-blockers, alpha-blockers, angiotensin II receptor blockers, and centrally acting sympatholytics, to control hypertension?
Hydrochlorothiazide
Thiazides induce what which helps lower blood pressure?
vasodilation
Thiazides reduce what?
fluid volume, cardiac output, and BP
Side effects and adverse reactions of thiazide diuretics include?
*electrolyte imbalances (such as hypokalemia, hypercalcemia, and hypomagnesemia)
*Also causes hyperglycemia, hyperuricemia, and hyperlipidemia.
*Monitor serum potassium levels closely and potassium supplements are often nec.
*serum calcium and uric acid levels should be monitored
* affects carbohydrate metabolism leading to hyperglycemia
*may increase lipid levels
*dizziness, headaches, nausea, vomiting, and constipation
When are thiazides contraindicated?
in renal failure
Thiazides can increase the risk for what toxicity?
digitalis toxicity
symptoms of digitalis toxicity
bradycardia, nausea, vomiting, and visual disturbances
Thiazides enhance the effects of what medication?
Lithium, potentially leading to lithium toxicity
Thiazides amplify the effects of what type of drugs? Can this be beneficial in treating hypertension?
other antihypertensives: yes
What should you monitor in patients who take thiazides?
vital signs, weight, urine output, and serum chemistry values (electrolytes, glucose, and uric acid)
What should you examine for patients taking Thiazides for edema?
peripheral extremities (noting pitting edema)
Potential problems you should assess for in patients who are taking Thiazides?
impaired elimination, fluid overload, disrupted fluid and electrolyte balance, hypokalemia, and hypernatremia
What are the goals in patients taking Thiazides?
reduce the patient’s BP to normal levels, reduce the patient’s edema, and ensure the patient’s serum chemistry levels remain within normal ranges
Why should you monitor the patient’s daily weight (every day- same time and in the same type of clothing)?
a weight increase of 2.2 lbs corresponds to an accumulation of 1 liter of body fluid
Track urine output to assess for what?
fluid loss or retention
Recommend taking Thiazides at what time of day and why?
early in the mornings to prevent disruptions in sleep due to nocturia
Why should you advise patients taking Thiazides to change positions slowly from lying down to standing?
to avoid dizziness from orthostatic hypotension
Why should you recommend blood glucose monitoring to patients taking Hydrochlorothiazide?
they may be pre-diabetic and high doses of this med can increase blood glucose levels
Why should you recommend a patient wear sunscreen while taking Thiazides?
photosensitivity
Why should you encourage consumption of potassium-containing foods &/ or supplements to patients taking Thazides?
hypokalemia
Why should you instruct patients to take Thiazide meds with food?
to reduce the risk of gastrointestinal upset
Loop diuretics are highly potent and significantly deplete what?
water and electrolytes
What are loop diuretics effective for?
fluid removal
example of loop diuretics
Furosemide
Bumetanide
Loop diuretics should not be used if what can manage fluid excess?
Thiazides
If furosemide alone does not sufficiently remove body fluid what should be added?
a thiazide
Furosemide is typically taken how?
orally in the morning or intravenously when rapid fluid removal is needed (such as in acute heart failure or pulmonary edema)
Loop Diuretics enhance renal blood flow by what percentage?
40%
Furosemide is often prescribed for patients with what disease?
end-stage renal disease
Loop diuretics increase excretion of what?
calcium
Which Loop Diuretics are both sulfonamide derivatives?
Furosemide and Bumetanide
Loop Diuretics typically start to work within how much time?
30 to 60 minutes
Intravenous furosemide begins acting with what?
5 minutes
Common side effects of Loop Diuretics
*fluid and electrolyte imbalances (such as hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and hypochloremia)
*orthostatic hypotension
A major drug interaction with Loop Diuretics is with what?
digitalis preparations (can lead to digitalis toxicity)
Interactions with Loop Diuretics
alcohol, aminoglycosides, anticoagulants, corticosteroids, lithium, amphotericin B, or digitalis
What should be monitored with patients taking Loop Diuretics
*vital signs
*serum electrolytes
*weight
*urine output (to establish baseline)
Determine if patients taking Loop Diuretics are sensitive to _________________
sulfonamides
Priority problems that should be monitored for in patients taking Loop Diuretics
fluid overload, hypernatremia, hypokalemia, and disrupted fluid and electrolyte balance
Possible goals for patients taking Loop Diuretics
- reduced edema
*reduced blood pressure
*serum chemistry levels will stay within normal ranges
IV furosemide should be administered slowly to avoid what?
potential hearing loss
Signs of hypokalemia
muscle weakness, abdominal distention. leg cramps, and cardiac dysrhythmias
When should patients be educated to take Furosemide a loop diuretic?
in the morning to avoid sleep disturbances because of nocturia
recommend taking furosemide with food to avoid what?
risk of nausea
advise patients to rise slowly from lying or sitting position to standing to reduce the risk of what?
dizziness caused by fluid loss, orthostatic hypotension
Example of an Osmotic Diuretics
Mannitol
This class of medication is used to lower intracranial pressure, such as in cases of cerebral edema, reduce intraocular pressure, as seen in glaucoma, and promote the elimination of toxic substances
Osmotic Diuretics
A potent osmotic and potassium-wasting diuretic that is commonly used in emergencies involving ICP and IOP
Mannitol (osmotic diuretic)
Used alongside Cisplatin and Carboplatin in cancer chemotherapy to induce significant diuresis and mitigate treatment side effects
Mannitol
What is the most frequently prescribed osmotic diuretic?
Mannitol
Side effects and adverse reactions of Mannitol
fluid and electrolyte imbalances; pulmonary edema due to the rapid shift of fluids
Examples of potassium-sparing diuretics
Spironolactone; Amiloride
Potassium-sparing diuretics are often used as mild diuretics or in combo with other diuretics like ___________?
Hydrochlorothiazide or antihypertensive medications
Commonly prescribed potassium-sparing diuretics include which meds?
spironolactone, amiloride, triamterene, and eplerenone.
Potassium-sparing diuretics should not be taken with what class of meds because of a risk for what?
ACE inhibitors or angiotensin II receptor blockers (ARBS) due to risk of increased serum potassium levels
When used alone, potassium-sparing diuretics are less effective at reducing body fluid and sodium compared to when they are combined with potassium-wasting diuretics. What are possible combinations?
Such combinations, like spironolactone with hydrochlorothiazide, amiloride with hydrochlorothiazide, or triamterene with hydrochlorothiazide, enhance diuretic effects and prevent potassium loss.
The primary side effect of potassium-sparing diuretics is hyperkalemia, but what are some other side effects?
headaches, dizziness, weakness, gastrointestinal disturbances, hyperuricemia, muscle cramps, and numbness and tingling of the hands and feet
Potassium-sparing diuretics should be used cautiously in what type of patients?
patients with impaired renal function
Why should a patient avoid direct sunlight while taking Spironolactone?
photosensitivity
side effects of potassium-sparing diuretics
hyperkalemia, rash, dizziness, weakness, or gastrointestinal upset
Sympatholytics
*Beta- adrenergic blockers
*centrally acting alpha2 agonist
*alpha-adrenergic blockers
*adrenergic neuron blockers
*alpha1- and beta1-adrenergic blockers
Beta-blockers reduce and lower what by decreasing heart rate, contractility, and renin release
reduce vascular resistance, lower BP
Beta-Blockers alone are ineffective in which ethnicity?
African-Americans
What effectively manages hypotension in this population?
beta-blockers combined with diuretics
Examples of Beta-Adrenergic Blockers (aka: Beta Blockers)
*Nonselective-
Propranolol
Carvedilol
*Cardio-selective
Acebutolol
Atenolol
Metoprolol
Nonselective Beta-Blockers such as Propranolol and Carvedilol may cause what?
*slower heart rate
*reduce blood pressure
*and potential bronchoconstriction
Why are Cardio-selective Beta-Blockers such as Acebutolol, Atenolol, and Metoprolol preferred?
they are less likely to cause bronchoconstriction
Beta- Blockers should be used cautiously in which patients?
with existing bronchospasms or pulmonary conditions even cardio-selective ones
Patients with 2nd or 3rd degree AV block or sinus bradycardia should avoid what?
Beta-Blockers
COPD should not take which Beta-Blocker?
nonCardio-selective Beta-Blockers- Propranolol
Common side effects and adverse reactions of Beta-Adrenergic Blockers (cardio-selective beta blockers)
bradycardia, hypotension, bronchospasm
Abrupt discontinuation of beta blockers can lead to what?
rebound hypertension, angina, dysrhythmias, and heart attack
additional side effects of beta-blockers
dizziness, insomnia, depression, fatigue, nightmares, and erectile dysfunction
Noncardioselective Beta-Blockers can impair the liver’s ability to what?
convert glycogen to glucose, which is particularly concerning for patients with diabetes mellitus
examples of centrally acting alpha2 agonists
Methyldopa
Clonidine
Guanfacine
How do Centrally Acting Alpha2 Agonists work?
By reducing the sympathetic signals to the peripheral blood vessels which leads to decreased peripheral vascular resistance and increased vasodilation
Why shouldn’t Centrally Acting Alpha2 Agonists should be used in combo with beta-blockers?
due to the risk of exacerbating bradycardia, and causing rebound hypertension if therapy is discontinued abruptly
Common side effects of centrally acting alpha2 agonists
drowsiness, dry mouth, dizziness, and bradycardia
Methyldopa should be avoided in patients with what impairment?
Liver impairment and liver enzyme levels should be monitored regularly for all patients on this medication
Centrally acting alpha2 agonists may cause retention of what?
sodium and water potentially leading to peripheral edema
Examples of Alpha-Adrenergic Blockers
Terazosin
Doxazosin
Prazosin
Alpha-Adrenergic Blockers cause what?
vasodilation and a reduction in BP
example of a thiazide/ thiazide-like diuretic
Hydrochlorothiazide
Uses for Thiazide/ Thiazide-Like Diuretics
Hypertension; Peripheral Edema
NOTED Side Effects of Thiazide/ Thiazide-Like Diuretics
Electrolyte Imbalances
Contraindications for Thiazide/ Thiazide-Like Diuretics
Renal Failure
Drugs that Interact with Thiazides/ Thiazide-Like Diuretics
Digitalis; Lithium; Hypertensive drugs
Examples of Loop Diuretics
Furosemide; Bumetanide
Uses of Loop Diuretics
Fluid Removal
NOTED Side Effects of Loop Diuretics
Fluid and electrolyte imbalances; orthostatic hypotension
Drugs that interact with Loop Diuretics
Digitalis
Uses for Osmotic Diuretics
Reduction of intracranial pressure; Reduction of intraocular pressure
NOTED Side Effects of Osmotic Diuretics
Fluid and Electrolyte imbalances; Pulmonary Edema
Uses of Potassium- Sparing Diuretics
Hypertension
NOTED Side Effects of Potassium- Sparing Diuretics
Hyperkalemia
Contraindications for Potassium- Sparing Diuretics
Renal Failure
Drugs that interact with Potassium- Sparing Diuretics
ACE inhibitors; ARBS
Examples of NonSelective BETA- Adrenergic Blockers (Beta Blockers)
Propranolol; Carvedilol
Example of CardioSelective BETA- Adrenergic Blockers
Acebutolol; Atenolol; Metoprolol
NOTED Side Effects of BETA- Adrenergic Blockers
Bradycardia; Hypotension
Contraindications for BETA- Adrenergic Blockers
Heart block; COPD
NOTED Side Effects of Centrally Acting Alpha2 Agonists
Drowsiness; Dry mouth; Bradycardia
Contraindications for Centrally Acting Alpha2 Agonists
Liver Disease
Drugs that interact with Centrally Acting Alpha2 Agonists
Beta-Blockers
Uses for Alpha- Adrenergic Blockers
Hypertension with Hyperlipidemia; BPH
NOTED Side Effects of Alpha- Adrenergic Blockers
Orthostatic Hypotension; Nasal congestion
Drugs that interact with Alpha- Adrenergic Blockers
Anti-inflammatory drugs; Nitrates
Example of Alpha1- and Beta1 Adrenergic Blockers
Labetalol
NOTED Side Effects of Alpha1 & Beta1 Adrenergic Blockers
Orthostatic hypotension; dry mouth; GI disturbances
Contraindications for Alpha1 & Beta1 Adrenergic Blockers
Asthma
Examples of Direct- Acting Arteriolar Vasodilators
Hydralazine; Minoxidil; Nitroprusside
NOTED Side Effects of Direct- Acting Arteriolar Vasodilators
Edema; Reflex tachycardia
Examples of Angiotensin- Converting Enzyme (ACE) Inhibitors
Benazepril; Captopril; Enalapril; Lisinopril
Use for ACE Inhibitors
Hypertension; Heart Failure
NOTED Side Effects of ACE Inhibitors
DRY COUGH; Angioedema; Hyperkalemia
Contraindications for ACE Inhibitors
Pregnancy
Drugs that interact with ACE Inhibitors
Potassium- Sparing Diuretics
Example of Angiotensin II Receptor Blockers (ARBs)
Losartan; Valsartan
Contraindications for ARBS
Pregnancy
Examples of Calcium Channel Blockers
Verapamil; Nifedipine; Amlodipine
Uses for Calcium Channel Blockers
Hypertension; Angina; Dysrhythmias
NOTED Side Effects for Calcium Channel Blockers
Reflex tachycardia; Edema; Flushing
Examples of Sympatholytics
Beta- Adrenergic Blockers; Centrally-Acting Alpha2 Agonists; Alpha- Adrenergic Blockers; Adrenergic Neuron Blockers; Alpha1 & Beta1 Adrenergic Blockers
- olol
Beta Blockers
Which med class is cautioned for Asthmatics?
Beta Blockers
-pril
ACE inhibitors
-pril
ACE inhibitors
-sartan
ARBS (ANGIOTENSIN II RECEPTOR BLOCKERS)
DASH DIET
Following the Dietary Approaches to Stop Hypertension or DASH diet, which emphasizes fruits, vegetables, and low-fat dairy products and increases the intake of potassium, calcium, magnesium, and fiber
DASH DIET
Following the Dietary Approaches to Stop Hypertension or DASH diet, which emphasizes fruits, vegetables, and low-fat dairy products and increases the intake of potassium, calcium, magnesium, and fiber
Recommended daily sodium intake for patients with hypertension
Reducing dietary sodium intake, aiming for an optimal goal of less than 1500 mg daily.
Possible Erectile Dysfunction is a side effect of which classes of hypertensive medications?
Thiazide Diuretics & Beta Blockers
-zosin
Alpha-Adrenergic Blockers
