Nutrition & Hypertension Flashcards
Week 2
What is the definition of BP? What 3 things is it physiological influenced by?
A measurement of the force exerted by the blood circulating in the arteries.
It is physiologically influenced by:
1. the force at which the heart pumps blood
2. the diameter of the blood vessels
3. the volume of circulating blood
What are the aetiologies and/or risk factors for hypertension? (11 answers)
- Obesity
- High sodium/salt intake
- High alcohol intake
- Insulin resistance or diabetes
- Ageing
- Sedentary lifestyle/Low physical activity
- Kidney diseases/Impaired kidney function
- Low potassium intake
- Stress
- Genetic predisposition
- Neuroendocrine imbalance
What is the pathophysiology of hypertension? (3 answers)
- Over-activation of renin-angiotension-aldosterone system
- Autonomic imbalance of central nervous system
3.Cardiac output and vascular resistance
*no clear single identifiable cause
What is the prevalence of hypertension? What population is most at risk? *facts (2 answers)
- 32% of men and 26.9% of women are hypertensive or are on hypertensive medication (HSE, 2009) (UK)
- Significantly more common in low-socioeconomic populations (Leng, 2015)
What is the significance of hypertension prognosis? (2 answers)
- Main risk factor for CVD, CHD and stroke. 3x more likely to die from these diseases (SACN 2003) so prompt prognosis = prompt treatment, reducing risk for these diseases
- In diabetic patients, hypertension treatment reduces risk of diabetic microvascular complications
What are the main management stratergies for hypertension? (individual) (6 answers)
- Weight reduction (sometimes suffiecient to avoid hypertensive medication.
- Increase in aerobic PA - has anti-hypotensive effects. Reduces both SBP and DBP.
- Reduction or complete cessation of alcohol. Dose dependent relationship.
- Reduce salt intake - positive relationship consistently seen between dietary sodium intake and BP.
- Potassium supplementation (meta-analyses: lowers BP (Houston et al., 2012)). Could decrease BP by 17% (Roger et al., 2012)
- Management of other associated aetiologies or risk factors.
What is the current recommendation for salt/sodium intake and by who?
No more than 6g/day salt (2.4g sodium) (SACN, 2003)
Give an account of short-term BP regulation systems and their regulatory impacts? (3 answers)
- Chemoreceptor reflex - Regulates cardiac output and blood flow.
- Barorecpetor reflex - Regulation of arterial pressure.
- Hormonal regualtions - atrial natriuretic peptide (ANP) lowers BP by vasodilation and promotion of sodium excretion.
Give an account of long-term BP regulation systems and their regulatory impacts?
Renin angiotensin-aldosterone system - regulates blood volume, electrolyte balance and vascular resistance
What are the guidelines for hypertension?
Normal - <130/<85
HT (grade 1) - 140/90
HT (grade 2) - 160/100
HT (grade 3) - >180/>110
The pathogenesis of hypertension?
Hypertension occurs when vessels through which the blood flows become too narrow or the volume of circulating blood becomes too high.
Raised BP increases the workload on the heart and can damage the endothelial lining of blood vessels.
It also increases the infiltration of blood components such as lipids into the arterial wall, exacerbating endothelial damage, enhancing atherosclerotic and ultimately increasing cardiovascular risk.
What are the 4 main lifestyle/diet influences/risk factors for hypertension? (4 answers)
1- Overweight/obesity
2- Lack of PA
3- Excess alcohol consumption
4- Excess salt intake
What are the main management strategies for hypertension? (public health) (2 answers)
- Governmental set targets for reduction of salt in processed foods (e.g. cured and processed meats, breads and cheeses etc)
- Physical activity recommendations
What are the optimal BP goals?
For most individuals: BP 120/80. For individuals with diabetes, renal impairment or CVD, a lower target is recommended.
