5 things you can do today to be heart healthy
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5 things you can do today to be heart healthyTRANSCRIPT
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Blood Pressure ControlWilliam Abide, M.D.
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Normal: < 120/<80 Pre-Hypertension: 120-139/80-89 Stage I Hypertension: 140-159/90-99 Stage II Hypertension: >160/>100
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Genetics If parents have it, 2x more likely
Increase sodium intake Obesity Physical inactivity Race High cholesterol
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Secondary Causes: Kidney disease Drug induced (NSAIDS) Renovascular Disease Endocrine disorders (hypo/hyperthyroidism) Sleep Apnea
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High Blood Pressure increases risk of: Kidney disease Stroke Heart failure
Mortality benefit with decreased BP starting at 115 mm Hg
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< 140/<90 ? With diabetes ? With CAD ? With CKD ACCORD Trial-5 years of follow up
BP in treatment group 119 mmHg vs 134 mm Hg
No difference in outcomes (MI, non-fatal stroke, death)
More adverse events (3.3% vs 1.3%) Hypotension, syncope, bradycardia, angioedema,
renal failure
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Persistently above 140/90 medications
> 160/100 medications
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Weight Loss 0.5-2 mmHg for every 1 Kg weight loss Very effective with low sodium diet
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Aerobic Exercise Can lower BP as much as 5-15 mmHg Usually SBP decrease of 4-6 mmHg and
diastolic decrease of 3 mmHg Resistance Training
BP decrease of 4/4 Recommendations:
30 min of activity most days of the week
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Moderate salt restriction
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Diet of fruits, vegetables, low fat dairy products
DASH Trial: One of 3 diets:
Control diet: LOW in fruits, vegetables, and legumes and HIGH in snacks, sweets, meats and saturated fat
Trial diet: HIGH in fruits, vegetables, and legumes and LOW in snacks and sweets
Combination diet: HIGH in fruits, vegetables, legumes, and low fat dairy products and LOW in snacks, sweets, meats, and saturated fat
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Trial diet: Decrease in BP by 2.8/1.1 mmHg
Combination diet: Decrease in BP by 5.5/3 mmHg
If dx of HTN, even more benefit 11.4/5.5 mmHg
BP decrease was max at end of week 2 and continued until end of trial (week 8)
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Regardless of sodium, DASH diet lowered BP
Low sodium in either diet lowered BP Biggest benefit between high sodium
control diet and low sodium dash diet
11.5 mmHg
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Alcohol use Women with 2 or more drinks daily and men
with 3 or more drinks daily have higher chance of HTN
Dose related effect Is some alcohol good for me??
LOW to MODERATE amount may be 1 drink/day for women 1-2 drinks/day in men
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