Hypertension and Nutrition
Hypertension and Nutrition
How nutrition impacts blood pressure and the risk of hypertension.
Content
6.44 -> High blood pressure, which is also known
as hypertension, is a serious health
10.8 -> condition that causes complications
throughout the body from heart attacks and
15.089 -> headaches to eye and kidney damage. Let's review what blood pressure is and then
19.65 -> how diet is related. Blood pressure is
actually the pressure that blood exerts
25.56 -> on an artery wall. I'm going to draw here schematic of an artery. We think about blood
33.809 -> flowing through this. When the heart is
beating, it will actually have a higher
40.23 -> amount of pressure going up against
those artery walls. Then when that
44.16 -> heart is at rest, there is a smaller
amount of pressure. So when
48.93 -> get your blood pressure taken, with that
cuff around your arm, they are measuring
52.53 -> that difference between when that heart
is beating, and they'll call that
57.059 -> pressure the systolic pressure. And then
when that heart is at rest, and they call
61.739 -> that the diastolic. The unit being
used here for that measurement is
65.82 -> millimeters of mercury (mmHg). Now when they report it, they'll give the systolic over
70.26 -> the diastolic. So, you will get a blood
pressure of 120 over 80. If we are above
75.659 -> that, we have hypertension. They have
stages of that. Stage one is when you
81.06 -> have a blood pressure of 130 to 139 of a
systolic and 80 to up to 90 for diastolic.
87.03 -> This stage one is considered the level
of which when lifestyle can still make a
92.46 -> difference and get your blood pressure
back down to normal levels. It still has
96.39 -> negative consequences, so we want to reduce it. But it is not
101.43 -> so severe that they're going to force
medication on that individual. Once
105.42 -> you have a blood pressure with
systolic above 140 or above 90 for the
110.07 -> diastolic, you really need to take
medication to get it back down. If we
114.689 -> look at the incidence... how much do we
have this in the U.S. population...here is
119.67 -> data reported by the National Health and
Nutrition Examination Survey. They
124.799 -> look at the overall incidence of
hypertension. It is about 30 percent
129.72 -> of adults in United States, so about one
in three
132.34 -> individuals have pre or hypertension,
stage one and stage two and beyond.
137.41 -> Look at the difference between the sexes. There is not a huge difference between
140.62 -> them, but this data is a little bit
misleading because it is for everyone and
144.76 -> in reality men tend to get it at an
earlier age but we women catch up when
149.11 -> we get into our 50's and 60's. Looking
at age, we can see the difference and
153.67 -> what is happening here. For all you young
students out there, less than
157.15 -> 10% of people before the age of 40 have
hypertension. By the time you are over 60 years of age,
163.12 -> 65 percent, or two out of three people,
have hypertension. When we take a look at
168.97 -> race, what you can see there is that the
the group of individuals who have the
173.56 -> highest incidence are going to be those
of non-Hispanic black heritage. Not
178.54 -> only do they have a higher percent
overall, but they tend to get it earlier
182.41 -> in life and to have more severe
consequences. If that is your heritage,
185.799 -> you are going to get your blood pressure
checked and you are going to maintain
188.08 -> medical care around that. So, these are
incidences and we are looking at risk
193.36 -> factors associated with development, but
these are risk factors we cannot change.
196.959 -> But lifestyle can also make a difference and part of that is diet so let's take a look at
201.1 -> what we can do to lower our risk.
Lifestyle changes that can help reduce
204.97 -> blood pressure include the usual
suspects of maintaining a healthy weight
208.84 -> and being physically active. Both of
those have been shown to be able to
212.98 -> reduce blood pressure by about three to
seven mmHg each and then, of
217.48 -> course, having a healthy diet. Research
linking diet with blood pressure has
221.829 -> looked at many different variables, some
of them foods, some of them nutrients.
225.489 -> Foods have include coffee, tea, soybeans
fish oil, chocolate, alcohol and then all
232.06 -> kinds of different nutrients. Sometimes it
can actually seem overwhelming. But
236.29 -> sodium is the one that probably has had
the most research and probably is the
240.04 -> most impactful so we are going to review
that. Then we are going to take a look at
243.94 -> the dietary recommendations associated
with blood pressure. They actually
248.29 -> have a specific dietary recommendation
called the Dietary Approach to Stop Hypertension
252.37 -> which tries to incorporate
as much as that research as possible.
256.2 -> First,we need to understand how sodium
is regulated. It is not regulated at the
261.459 -> GI (gastrointestinal) tract. If you consume more sodium or
salt, you are going to absorb it.
265.669 -> Rather, sodium is going to be regulated at
the kidneys. If we are healthy
270.65 -> individuals, we will generally be it at
equilibrium. That means if we consume
274.999 -> more salt or sodium, w are going to excrete more sodium, and vice versa;
279.199 -> we consume less, we excrete less. But there are some individuals we call salt or
283.999 -> sodium sensitive. For those individuals,
their kidneys are less efficient at
296.24 -> removing excess sodium and
therefore, they may experience
299.539 -> hypertension when they have a higher
sodium intake. This graph really
304.099 -> demonstrates that. Let's take a look
at what this graph is showing. It is
308.12 -> looking at changes in systolic blood
pressure here at the top and the
311.659 -> diastolic blood pressure on the bottom
part. Coming across the right
316.49 -> of this, we are looking at changes in
urinary sodium, which is the first line
322.4 -> - variables, and also the change
in the grams of salt in the day. Now what
328.099 -> this represents is the amount removed
from the diet so it looks odd because
333.259 -> it is going up in numbers where the
amount that is coming out in the sodium
336.529 -> but what that is again is the amount of
salt they removed from the diet.
340.639 -> To understand the numbers, the average intake of salt was about 9 to 12 grams a day.
346.46 -> Let's compare that to sodium. So, 9 to 12
grams of salt equals about 3,500 to
354.46 -> 5,000 milligrams of sodium. Recall the Dietary Guidelines is
362.539 -> recommending we keep that to less
than 2300 milligrams.
366.77 -> So, this group of individual
has definitely above the dietary
369.86 -> guidelines. As they were taking out the
salt, you can see what was happening to their
375.199 -> blood pressure. We have two groups
here. They were looking at healthy
379.49 -> individuals and individuals who have
high blood pressure. For both the
386.509 -> systolic and diastolic, we can see that
for those individuals who had
390.05 -> hypertension their blood pressure
was being impacted more. When they took
395.33 -> out more sodium their blood pressure was dropping more.
399.08 -> For those individuals who were healthy
though, it did not have a big impact...
404.03 -> a slight impact, but not dramatic. So again, those individuals if they had more
408.65 -> sodium in their diet, they actually just
excreted more. it was those individuals
412.789 -> who were sodium or salt sensitive that
had the bigger impact. Now it's estimated
417.229 -> that between 30 - 40% of
the general population are salt or
421.699 -> sodium sensitive. It is not easy though to
identify an individual, specific
426.08 -> individual, that is likely to have that. We do know that certain
431.27 -> certain population groups will have a higher incidence. In fact individuals who are
435.68 -> hypertensive probably 50 to 70 % of them will have be salt sensitive.
440.78 -> Other population groups include
individuals who are obese, individuals who
445.099 -> have diabetes and individuals with black
or African-American heritage. So now we
451.129 -> understand for those individuals who are
salt or sodium sensitive if you reduce
455.659 -> the salt and sodium in your diet you
will have a lower blood pressure.
460.49 -> Let's take a look at the DASH diet
remember - stands for the
463.52 -> Dietary Approach to Stop Hypertension.
It doesn't just look at sodium. It also
467.659 -> takes a look at those other nutrients. Things like potassium, calcium, magnesium,
471.789 -> protein and fiber. All of the ones we need to increase in
475.31 -> our diet, not just the reduction in
sodium. It is very similar to MyPlate but
479.659 -> it's a little bit richer in those grains,
it's going to be low fats, also
484.25 -> include those nuts and seeds that
research has shown to be helpful.
488.84 -> So lifestyle change can help reduce one's
risk for hypertension,
491.539 -> especially for those individuals in that
prehypertension values, that are
495.74 -> just modestly above high blood pressure
levels and we can get it back down to normal
499.31 -> and help reduce our risk for chronic
disease.
Source: https://www.youtube.com/watch?v=vozXeKhDL3w