HYPERTENSION
Hypertension is an increasingly important medical and public health issue. For every 20 mm Hg systolic or 10 mm Hg diastolic increase in blood pressure, the mortality from ischemic heart disease and stroke doubles. It develops at an earlier age and leads to more clinical complications.
Classification of Blood Pressure:
Classification of Blood Pressure for Adults Aged 18 Years and Older (2)
| Category | Systolic (mm Hg) | Diastolic (mm Hg) |
| Optimal | <120 | and <80 |
| Prehypertension | 120‐139 | or 80‐89 |
| Stage 1 hypertension | 140‐159 | or 90‐99 |
| Stage 2 hypertension | >160 | or ≥ 100 |
Nutritional Assessment and Evaluation:
Routine nutritional assessment should include blood pressure evaluation assessment for signs of edema; and review of laboratory tests that assess blood glucose, hematocrit, serum potassium, calcium, creatinine or glomerular filtration rate, and lipid profiles. The patient’s height and weight should be measured, and the patient’s body mass index should be evaluated to assess the need for weight management as an adjunct to treatment. These parameters should be assessed to estimate risk for disease and to identify treatment options (Grade IV). The food and nutrition history should assess the patient’s intake of sodium, potassium, and calcium and the frequency at which the patient consumes fruits, vegetables, low‐fat dairy products, and processed food items.
Benefits of Lowering Blood Pressure:
Benefits of Lowering Blood Pressure and Lifestyle Modification Intervention: Major lifestyle modifications that lower blood pressure include limiting sodium intake to no more than 2,300 mg/day (Grade I), weight reduction for individuals who are overweight or obese (Grade IV) adoption of the Dietary Approaches to Stop Hypertension (DASH) eating plan, which is a diet rich in potassium and calcium and lower in sodium, dietary cholesterol, saturated fat, and total fat (<27% of total energy) (Grade IV), physical activity (Grade IV) and moderation of alcohol consumption.
DASH eating plan:
The DASH clinical study demonstrated that a diet (referred to as a combination diet) that is rich in fruits and vegetables (five to ten servings) and low‐fat dairy food and reduces the intake of saturated fat (6%), total fats (<27% energy), and sodium (<2,400mg/day and 1,500 mg/day) significantly lowers blood pressure (Grade I). The DASH eating plan that limits sodium intake to 1,500 mg/day provides the greatest blood pressure reductions.
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