yulius hermanto
Dietary approach in Hypertension Management
Introduction
Hypertension or elevated blood pressure has been associated with cardiovascular and renal diseases, thus become important risk factor of having vascular related diseases such as stroke, heart-attack, heart failure and renal failure.
According to epidemiological survey (1999 to 2000) in US, about 27% of adult Americans have hypertension, and another 31% have prehypertension. This situation is not happen only in USA, from my experience with patient in certain village population in Indonesia, hypertension is major health problem especially in elderly.
Prehypertensive individuals have a high probability of developing hypertension and carry an excess risk of cardiovascular disease as compared with those with a normal BP. Recent data indicates that the prevalence of hypertension is increasing and that control rates among those with hypertension remain low.
Hypertension can be resulted from environmental factors, genetic factors, and interactions among these factors. The environmental factors that affect BP (diet, physical inactivity, toxins, and psychosocial factors), dietary factors have a prominent, and likely predominant, role in BP homeostasis. In nonhypertensive individuals, including those with prehypertension, dietary changes that lower BP have the potential to prevent hypertension and more broadly to reduce BP and thereby lower the risk of BP-related clinical complications. Indeed, even an apparently small reduction in BP, if applied to an entire population, could have an enormous beneficial impact. Dietary modifications serve as initial treatment before the start of drug therapy. Among hypertensive individuals who are already on drug therapy, dietary changes, particularly a reduced salt intake, can further lower BP and facilitate medication step-down. In general, the extent of BP reduction from dietary therapies is greater in hypertensive than in nonhypertensive individuals.
Dietary Factors that Lowers Blood Pressure
Weight Loss
Most clinical trials have documented that weight loss in patients with overweight and obese lowers BP. Importantly, reductions in BP occur before, and without, attainment of a desirable body weight. Mean systolic and diastolic BP reductions from an average weight loss of 5.1 kg were 4.4 and 3.6 mm Hg, respectively.17 In subgroup analyses, BP reductions were similar for nonhypertensive and hypertensive subjects but were greater in those who lost more weight.
In other words, obesity and overweight are not good for your vessels, so it's better to have ideal body weight.
Reduced Salt Intake
Salt intake, especially sodium intake is associated blood pressure, Hypertension is often found in person with high sodium intake compare with low sodium intake. Also, lowering daily sodium intake is associated with lower blood pressure in person that previously hypertension. In one of the most recent meta-analyses, a median reduction in urinary sodium of 1.8 g/d (78 mmol/d) lowered systolic BP and diastolic BP by 2.0 and 1.0 mm Hg in nonhypertensive and by 5.0 and 2.7 mm Hg in hypertensive individuals.
Some salt intake is required. Recently, an Institute of Medicine committee set 1.5 g/d (65 mmol/d) sodium as an adequate intake level, primarily to ensure nutrient adequacy. Although a sodium intake below this level is associated with lower BP, little information is available about the nutrient content of diets that provide <1.5 g/d of sodium.
To reduce salt intake, consumers should choose foods low in salt and limit the amount of salt added to food.
Vegetarian Diets
Vegetarian diets have been associated with low BP. In industrialized countries, where elevated BP is commonplace, individuals who consume a vegetarian diet have markedly lower BPs than do nonvegetarians. In these observational studies, vegetarians also experience a lower age-related rise in BP.
Fish Oil Supplementation
Several predominantly small clinical trials have documented that high-dose omega-3 polyunsaturated fatty acid (commonly called fish oil) supplements can lower BP in hypertensive individuals. In nonhypertensive individuals, BP reductions tend to be small or nonsignificant. The effect of fish oil appears to be dose dependent, with BP reductions occurring at relatively high doses—namely, 3 g/d. In hypertensive individuals, average systolic and diastolic BP reductions were 4.0 and 2.5 mm Hg, respectively.
Important Message
Hypertension is a serious health problem, because of its quantity and quality, The quantity of the problems, we can see from amount of people having hypertension nearly 30% in adults populations. And about the quality, hypertension is also called the silent killer since it doesn't give a certain symptoms of the problem but it can cause significant health problems such as stroke, heart attack, renal failure, etc.
Hypertension should be treated comprehensively in order to achieve the target of blood pressure and maintain it.
Dietary modification is part of comprehensive hypertension management, and become first line of therapy before drug in patient with pre-hypertension and no-comorbidity.
It's important to remember or keep in mind, eventhough most clinical trials shows that certain modification in diet can lower blood pressure but maybe not all people get the same benefit or same responses, since there are some others factors involve in hypertension besides diet such as genetic (racial, age, etc.), physical activity, and so on.
So to be healthy, we should have a good diet and not forget to do exercise regularly.
Hypertension or elevated blood pressure has been associated with cardiovascular and renal diseases, thus become important risk factor of having vascular related diseases such as stroke, heart-attack, heart failure and renal failure.
According to epidemiological survey (1999 to 2000) in US, about 27% of adult Americans have hypertension, and another 31% have prehypertension. This situation is not happen only in USA, from my experience with patient in certain village population in Indonesia, hypertension is major health problem especially in elderly.
Hypertension can be resulted from environmental factors, genetic factors, and interactions among these factors. The environmental factors that affect BP (diet, physical inactivity, toxins, and psychosocial factors), dietary factors have a prominent, and likely predominant, role in BP homeostasis. In nonhypertensive individuals, including those with prehypertension, dietary changes that lower BP have the potential to prevent hypertension and more broadly to reduce BP and thereby lower the risk of BP-related clinical complications. Indeed, even an apparently small reduction in BP, if applied to an entire population, could have an enormous beneficial impact. Dietary modifications serve as initial treatment before the start of drug therapy. Among hypertensive individuals who are already on drug therapy, dietary changes, particularly a reduced salt intake, can further lower BP and facilitate medication step-down. In general, the extent of BP reduction from dietary therapies is greater in hypertensive than in nonhypertensive individuals.
Dietary Factors that Lowers Blood Pressure
Weight Loss
Most clinical trials have documented that weight loss in patients with overweight and obese lowers BP. Importantly, reductions in BP occur before, and without, attainment of a desirable body weight. Mean systolic and diastolic BP reductions from an average weight loss of 5.1 kg were 4.4 and 3.6 mm Hg, respectively.17 In subgroup analyses, BP reductions were similar for nonhypertensive and hypertensive subjects but were greater in those who lost more weight.
In other words, obesity and overweight are not good for your vessels, so it's better to have ideal body weight.
Reduced Salt Intake
Salt intake, especially sodium intake is associated blood pressure, Hypertension is often found in person with high sodium intake compare with low sodium intake. Also, lowering daily sodium intake is associated with lower blood pressure in person that previously hypertension. In one of the most recent meta-analyses, a median reduction in urinary sodium of 1.8 g/d (78 mmol/d) lowered systolic BP and diastolic BP by 2.0 and 1.0 mm Hg in nonhypertensive and by 5.0 and 2.7 mm Hg in hypertensive individuals.
Some salt intake is required. Recently, an Institute of Medicine committee set 1.5 g/d (65 mmol/d) sodium as an adequate intake level, primarily to ensure nutrient adequacy. Although a sodium intake below this level is associated with lower BP, little information is available about the nutrient content of diets that provide <1.5 g/d of sodium.
To reduce salt intake, consumers should choose foods low in salt and limit the amount of salt added to food.
Vegetarian Diets
Vegetarian diets have been associated with low BP. In industrialized countries, where elevated BP is commonplace, individuals who consume a vegetarian diet have markedly lower BPs than do nonvegetarians. In these observational studies, vegetarians also experience a lower age-related rise in BP.
Fish Oil Supplementation
Several predominantly small clinical trials have documented that high-dose omega-3 polyunsaturated fatty acid (commonly called fish oil) supplements can lower BP in hypertensive individuals. In nonhypertensive individuals, BP reductions tend to be small or nonsignificant. The effect of fish oil appears to be dose dependent, with BP reductions occurring at relatively high doses—namely, 3 g/d. In hypertensive individuals, average systolic and diastolic BP reductions were 4.0 and 2.5 mm Hg, respectively.
Important Message
Hypertension is a serious health problem, because of its quantity and quality, The quantity of the problems, we can see from amount of people having hypertension nearly 30% in adults populations. And about the quality, hypertension is also called the silent killer since it doesn't give a certain symptoms of the problem but it can cause significant health problems such as stroke, heart attack, renal failure, etc.
Hypertension should be treated comprehensively in order to achieve the target of blood pressure and maintain it.
Dietary modification is part of comprehensive hypertension management, and become first line of therapy before drug in patient with pre-hypertension and no-comorbidity.
It's important to remember or keep in mind, eventhough most clinical trials shows that certain modification in diet can lower blood pressure but maybe not all people get the same benefit or same responses, since there are some others factors involve in hypertension besides diet such as genetic (racial, age, etc.), physical activity, and so on.
So to be healthy, we should have a good diet and not forget to do exercise regularly.
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