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stringlengths 12
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listlengths 384
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includes\tlow-fat\tdairy\tproducts,\tpoultry,\tfish,\tlegumes,\tnontropical\tvegetable\toils\tand\tnuts;\nand\tlimits\tintake\tof\tsweets,\tsugar-sweetened\n\tbeverages,\tand\tred\tmeats.
|
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a.\n\tAdapt\tthis\tdietary\tpattern\tto\tappropriate\tcalorie\trequirements,\tpersonal\tand\tcultural\nfood\tpreferences,\tand\tnutrition\ttherapy\tfor\tother\tmedical\tconditions\t(including\ndiabetes\tmellitus).\nb.\n\tAchieve\tthis\tpattern\tby\tfollowing\tplans\tsuch\tas\tthe\tDASH\tdietary\tpattern,\tthe\tUSDA\nFood\tPattern,\tor\tthe\tAHA\tDiet.\n2.
|
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] |
Food\tPattern,\tor\tthe\tAHA\tDiet.\n2.\t\nAim\tfor\ta\tdietary\tpattern\tthat\tachieves\t5%-6%\tof\tcalories\n\tfrom\tsaturated\tfat.\n3.\t\nReduce\tpercent\tof\tcalories\tfrom\tsaturated\tfat.\n4.\t\nReduce\tpercent\tof\tcalories\tfrom\ttrans\tfat.\nBlood\tpressure\nAdvise\tadults\twho\twould\tbenefit\tfrom\tblood\tpressure\tlowering\tto\n1.
|
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] |
Advise\tadults\twho\twould\tbenefit\tfrom\tblood\tpressure\tlowering\tto\n1.\t\nConsume\ta\tdietary\tpattern\tthat\temphasizes\tintake\tof\tvegetables,\tfruits,\tand\twhole\tgrains;\nincludes\tlow-fat\tdairy\tproducts,\tpoultry,\tfish,\tlegumes,\tnontropical\tvegetable\toils\tand\tnuts;\nand\tlimits\n\tintake\tof\tsweets,\tsugar-sweetened\tbeverages,\tand\tred\tmeats.\na.
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intake\tof\tsweets,\tsugar-sweetened\tbeverages,\tand\tred\tmeats.\na.\n\tAdapt\tthis\tdietary\tpattern\tto\tappropriate\tcalorie\trequirements,\tpersonal\tand\tcultural\nfood\tpreferences,\tand\tnutrition\ttherapy\tfor\tother\tmedical\tconditions\t(including\ndiabetes\tmellitus).\nb.\n\tAchieve\tthis\tpattern\tby\tfollowing\tplans\tsuch\tas\tthe\tDASH\tdietary\tpattern,\tthe\tUSDA
|
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Food\tPattern,\tor\tthe\tAHA\tDiet.\n2.\t\nLower\tsodium\tintake.\n3.\t\na.\tConsume\tno\tmore\tthan\t2400\tmg\tof\tsodium/day.\nb.\n\tFurther\treduction\tof\tsodium\tintake\tto\t1500\tmg/day\tis\tdesirable\tbecause\tit\tis\nassociated\twith\teven\tgreater\treduction\tin\tblood\tpressure.\nc.\n\tReduce\tintake\tby\tat\tleast\t1000\tmg/day\tbecause\tthat\twill\tlower\tblood\tpressure,\teven
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vigorous-intensity\tphysical\tactivity.\nBlood\tpressure\nIn\tgeneral,\tadvise\tadults\tto\tengage\tin\taerobic\tphysical\tactivity\tto\tlower\tblood\tpressure:\t3-4\nsessions\ta\tweek,\tlasting\ton\taverage\t40\tminutes\n\tper\tsession,\tand\tinvolving\tmoderate-to-vigorous-\nintensity\tphysical\tactivity.
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0.06702928245067596,
0.03987865149974823,
0.04145118221640587,
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] |
intensity\tphysical\tactivity.\nEckel\tRH,\tJakicic\tJM,\tArd\tJD,\tet\tal.\t2013\tAHA/ACC\tguideline\ton\tlifestyle\tmanagement\tto\treduce\ncardiovascular\trisk:\tA\treport\tof\tthe\tAmerican\tCollege\tof\tCardiology\t/American\tHeart\tAssociation\tTask\nForce\ton\tPractice\tGuidelines.\tCirculation\t129:\tS76-S99,\t2014.\nDiet\nThe\timportance\tof\tdiet\tand\tnutrition\tin\tmodifying
|
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] |
Diet\nThe\timportance\tof\tdiet\tand\tnutrition\tin\tmodifying\n\tthe\trisk\tof\tCVD\thas\tbeen\tknown\tfor\tsome\ttime.\nHowever,\tin\tgeneral,\tindividual\tdietary\tcomponents\thave\tbeen\tthe\tpredominant\tfocus.\tBecause\tfoods\nare\tconsumed\ttypically\tin\tcombinations\trather\tthan\tindividually\tand\tbecause\tof\tthe\tpossibility\tof
|
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synergist\trelationships\tbetween\tnutrients,\tthere\thas\tbeen\tincreasing\tattention\tto\tdietary\tpatterns\nand\ttheir\trelationship\tto\thealth\toutcomes\tsuch\tas\tCVD.\nThe\tmediterranean\tdiet\nThere\tis\tno\tuniform\tdefinition\tof\tthe\t\nMediterranean\tdiet\t(MeD)\n\tin\tthe\tpublished\tstudies,\twhich
|
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Mediterranean\tdiet\t(MeD)\n\tin\tthe\tpublished\tstudies,\twhich\nmakes\tit\tdifficult\tto\tpool\tdata.\tThere\tare\tcommon\tfeatures\tof\tthe\tdiet,\tsuch\tas\tgreater\tnumber\tof\nservings\tof\tfruits\tand\tvegetables\t(mostly\tfresh)\twith\tan\temphasis\ton\troot\tvegetables\tand\tgreens,\nwhole\tgrains,\tfatty\tfish\t(rich\tin\tomega-3\tfatty\tacids),\tlower\tamounts\tof\tred\tmeat\tand\n\twith\tan
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] |
with\tan\nemphasis\ton\tlean\tmeats,\tlower\tfat\tdairy\tproducts,\tabundant\tnuts\tand\tlegumes,\tand\tuse\tof\tolive\toil,\ncanola\toil,\tnut\toil,\tor\tmargarine\tblended\twith\trapeseed\toil\tor\tflaxseed\toil\t(see\t\nAppendix\t23\n).\tThe\nMeD\tdietary\tpatterns\tthat\thave\tbeen\tstudied\twere\tmoderate\tin\ttotal\tfat\t(32%\tto\t35%),\trelatively\tlow
|
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] |
in\tsaturated\tfat\t(9%\tto\t10%),\thigh\tin\tpolyunsaturated\tfatty\tacids\t(especially\tomega-3),\tand\n\thigh\tin\nfiber\t(27\tto\t37\tg\tper\tday).\tThe\tPrevención\tcon\tDieta\tMediterránea\t(PREDIMED)\ttrial\twas\ta\nrandomized\tcontrolled\ttrial\t(RCT)\tlooking\tat\tthe\teffect\tof\ta\tMeD\ton\tCVD\toutcomes.\tThose\tpatients\nrandomized\tto\tthe\tMeD\thad\ta\t30%\treduced\trisk\tof\tCVD\tevents\t(
|
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] |
randomized\tto\tthe\tMeD\thad\ta\t30%\treduced\trisk\tof\tCVD\tevents\t(\nEstruch\tet\tal,\t2013\n).\nThe\tdietary\tapproaches\tto\tstop\thypertension\t(DASH)\tdiet\nThe\tDASH\tdietary\tpattern\tis\thigh\tin\tfruits\tand\tvegetables,\tlow-fat\n\tdairy\tproducts,\twhole\tgrains,\tfish,\nand\tnuts\tand\tlow\tin\tanimal\tprotein\tand\tsugar.\tTwo\tDASH\tvariations\twere\tstudied\tin\tthe\tOptimal
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] |
Macronutrient\tIntake\tTrial\tfor\tHeart\tHealth\t(OmniHeart)\ttrial,\tone\tthat\treplaced\t10%\tof\ttotal\tdaily\nenergy\tfrom\tcarbohydrate\twith\tprotein;\tthe\tother\tthat\treplaced\tthe\tsame\tamount\tof\tcarbohydrate\nwith\tunsaturated\tfat.\tThe\tformer\tshowed\tbetter\tresults\tthan\tthe\tlatter\n\tin\tlowering\tCVD\trisk\t(\nSwain\net\tal,\t2008\n;\tsee\t\nAppendix\t17
|
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0.08095026761293411,
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] |
in\tlowering\tCVD\trisk\t(\nSwain\net\tal,\t2008\n;\tsee\t\nAppendix\t17\n).\tThe\t2013\tACC/AHA\tlifestyle\tguidelines\trecommend\tthe\tDASH\tdiet\tas\nbest\tfor\tprevention\tof\tCVD,\tbut\talso\tsuggest\tthat\ta\tMeD\tpattern\tis\tcardioprotective.\nVegan\tdiet\nA\tvegan\tdiet\tis\ta\tstrict\tvegetarian\tdiet\tthat\tincludes\tno\tdietary\tsources\tfrom\tanimal\torigins\t(see
|
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] |
Appendix\t30\n).\tThere\tis\tongoing\tresearch\tto\tsuggest\tonly\tthis\ttype\tof\tvery\n\trestricted\tdiet\tcan\tactually\nreverse\tASCVD\t(\nEsselstyn\tand\tGoulubic´,\t2014\n;\t\nTuso,\t2015\n).\nPhysical\tinactivity\nPhysical\tinactivity\tand\ta\tlow\tlevel\tof\tfitness\tare\tindependent\trisk\tfactors\tfor\tASCVD.\tPhysical\tactivity
|
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] |
is\tassociated\twith\tASCVD,\tindependent\tof\tthe\tcommon\tcardiometabolic\trisk\tfactors\tof\tobesity,\tserum\nlipids,\tserum\tglucose,\tand\thypertension,\tin\tmen\tand\twomen.\tWith\tthe\thigh\tprevalence\n\tof\tobesity,\nphysical\tactivity\tis\ta\thigh\tpriority.\tPhysical\tactivity\tlessens\tASCVD\trisk\tby\treducing\tatherogenesis,
|
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] |
increasing\tvascularity\tof\tthe\tmyocardium,\tincreasing\tfibrinolysis,\tincreasing\tHDL\tcholesterol,\nimproving\tglucose\ttolerance\tand\tinsulin\tsensitivity,\taiding\tin\tweight\tmanagement,\tand\treducing\nblood\tpressure.\nThe\tmost\trecent\tAHA\trecommendations\tfor\texercise\tfor\tadults\tare\tthe\tfollowing:\n•
|
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] |
•\t\nGet\tat\tleast\t150\tminutes\tper\tweek\tof\tmoderate-intensity\taerobic\tactivity\tor\t75\tminutes\tper\nweek\tof\tvigorous\taerobic\tactivity,\tor\ta\tcombination\tof\tboth,\tpreferably\tspread\tthroughout\nthe\tweek.\n•\t\nAdd\tmoderate-\tto\thigh-intensity\tmuscle-strengthening\tactivity\t(such\tas\tresistance\tor\nweights)\ton\tat\tleast\t2\tdays\tper\tweek.\n•
|
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] |
weights)\ton\tat\tleast\t2\tdays\tper\tweek.\n•\t\nSpend\tless\ttime\tsitting.\tEven\tlight-intensity\tactivity\tcan\toffset\tsome\n\tof\tthe\trisks\tof\tbeing\nsedentary.\n•\t\nGain\teven\tmore\tbenefits\tby\tbeing\tactive\tat\tleast\t300\tminutes\t(5\thours)\tper\tweek.\n•\t\nIncrease\tamount\tand\tintensity\tgradually\tover\ttime.\nThe\tAHA\trecommendations\tfor\tchildren\tare\tthe\tfollowing:\n•
|
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] |
The\tAHA\trecommendations\tfor\tchildren\tare\tthe\tfollowing:\n•\t\nChildren\t3\tto\t5\tyears\told\tshould\tbe\tphysically\tactive\tand\thave\tplenty\tof\topportunities\tto\nmove\tthroughout\tthe\tday.\n•\t\nKids\t6\tto\t17\tyears\told\tshould\tget\tat\tleast\n\t60\tminutes\tper\tday\tof\tmoderate-\tto\tvigorous-\nintensity\tphysical\tactivity,\tmostly\taerobic.\n•
|
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intensity\tphysical\tactivity,\tmostly\taerobic.\n•\t\nInclude\tvigorous-intensity\tactivity\ton\tat\tleast\t3\tdays\tper\tweek.\n•\t\nInclude\tmuscle-\tand\tbone-strengthening\t(weight-bearing)\tactivities\ton\tat\tleast\t3\tdays\tper\nweek.\n•\t\nIncrease\tamount\tand\tintensity\tgradually\tover\ttime.\nStress
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week.\n•\t\nIncrease\tamount\tand\tintensity\tgradually\tover\ttime.\nStress\nStress\tactivates\ta\tneurohormonal\tresponse\tin\tthe\tbody\tthat\tresults\tin\tincreased\n\theart\trate,\tblood\npressure,\tand\tcardiac\texcitability.\tThe\tstress\thormone\tangiotensin\tII\tis\treleased\tafter\tstimulation\tof
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the\tsympathetic\tnervous\tsystem\t(SNS);\texogenous\tinfusion\tof\tangiotensin\tII\taccelerates\tthe\nformation\tof\tplaque.\tThe\tINTERHEART\tstudy\tfound\tthat\tthe\teffect\tof\tstress\ton\tCVD\trisk\tis\ncomparable\tto\tthat\tof\thypertension.\tStress\tmanagement\twas\tnot\tpart\tof\tthe\t2013\tACC/AHA\tlifestyle\nmodification\tguidelines.\nDiabetes
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] |
modification\tguidelines.\nDiabetes\nDiabetes\tis\ta\tdisease\tthat\tis\tan\tindependent\trisk\tfactor.\tThe\tprevalence\tof\tdiabetes\tmirrors\tthat\tof\nobesity\tin\tthe\tUnited\tStates.\tType\t2\tdiabetes\thas\tcontinued\tto\tincrease\tin\tincidence\t(see\t\nChapter\n29\n).\tAny\tform\tof\tdiabetes\tincreases\tthe\trisk\tfor\tASCVD,\twith\toccurrence\tat\tyounger\tages.\tMost
|
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] |
people\twith\tdiabetes\tactually\tdie\tof\tCVD.\tSome\tof\tthe\tincreased\trisk\n\tseen\tin\tpatients\twith\tdiabetes\tis\nattributable\tto\tthe\tconcurrent\tpresence\tof\tother\trisk\tfactors,\tsuch\tas\tdyslipidemia,\thypertension,\tand\nobesity.\tThus\tdiabetes\tis\tnow\tconsidered\tan\tASCVD\trisk\tfactor\t(see\t\nChapter\t29\n).
|
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] |
Chapter\t29\n).\nThe\tLook\tAHEAD\t(Action\tfor\tHealth\tin\tDiabetes)\tstudy,\tconducted\tfrom\t2001\tto\t2012,\tprovided\nextensive\tlongitudinal\tdata\ton\tthe\teffect\tof\tan\tintensive\tlifestyle\tintervention,\ttargeting\n\tweight\nreduction\tthrough\tcaloric\trestriction\tand\tincreased\tphysical\tactivity,\ton\tCVD\trates\t(the\tprimary
|
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outcome)\tand\tCVD\trisk\tfactors\tamong\tadults\twith\ttype\t2\tdiabetes\tmellitus.\tConclusions\tfrom\tthe\nstudy\twere\tthat\tincreased\tphysical\tactivity\tand\timprovements\tin\tdiet\tbased\ton\ta\tMeD\tor\tDASH\npattern\tcan\tsafely\tlead\tto\tweight\tloss\tand\treduced\trequirement\tfor\tmedication\tto\tcontrol\tCVD\trisk\nfactors
|
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] |
factors\n\twithout\ta\tconcomitant\tincrease\tin\tthe\trisk\tof\tcardiovascular\tevents\t(\nFox\tet\tal,\t2015\n).\nMetabolic\tsyndrome\nSince\tthe\tearly\tfindings\tof\tthe\tFramingham\tHeart\tStudy,\tit\thas\tbeen\tknown\tthat\ta\tclustering\tof\trisk\nfactors\tmarkedly\tincreases\tthe\trisk\tof\tCVD\t(see\t\nChapter\t20\n\tfor\tan\tin-depth\tdiscussion\tof\tmetabolic\nsyndrome).\nObesity
|
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for\tan\tin-depth\tdiscussion\tof\tmetabolic\nsyndrome).\nObesity\nObesity\thas\tnow\treached\tepidemic\tlevels\tin\tchildren\tand\tadults\tin\n\tmany\tdeveloped\tcountries.\tBody\nmass\tindex\t(BMI)\tand\tCVD\tare\tpositively\trelated;\tas\tBMI\tgoes\tup,\tthe\trisk\tof\tCVD\talso\tincreases.
|
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] |
The\tprevalence\tof\toverweight\tand\tobesity\tis\tthe\thighest\tthat\tit\thas\tever\tbeen\tin\tthe\tUnited\tStates\n(see\t\nChapter\t20\n).\tObesity\trates\tvary\tby\trace\tand\tethnicity\tin\twomen.\tNon-Hispanic\tblack\twomen\nhave\tthe\thighest\tprevalence,\tfollowed\tby\tMexican\tAmerican\twomen,\tAmerican\tIndians,\n\tAlaskan\nnatives,\tand\tnon-Hispanic\twhites.
|
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] |
Alaskan\nnatives,\tand\tnon-Hispanic\twhites.\nAn\tobese-years\tmetric\twas\tdeveloped\tusing\tmore\tthan\t5000\tparticipants\tof\tthe\tFramingham\tHeart\nStudy\tthat\tcaptures\tthe\tcumulative\tdamage\tof\tobesity\tover\tyears.\tThe\tobese-years\tmetric\tis\ncalculated\tby\tmultiplying\tthe\tnumber\tof\tBMI\tunits\tabove\t29\tkg/m\n2\n\tby\tthe\tnumber\tof\tyears\tlived\tat
|
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2\n\tby\tthe\tnumber\tof\tyears\tlived\tat\nthat\tBMI.\tHigher\tobese\tyears\twere\tassociated\twith\thigher\tCVD\trisk\tin\tthe\n\tstudy.\tThe\tmetric\twas\nfound\tto\tprovide\ta\tslightly\tmore\taccurate\tmeasure\tof\tCVD\trisk\tthan\tobesity\talone\t(\nAbdullah\tet\tal,\n2014\n).
|
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Carrying\texcess\tadipose\ttissue\tgreatly\taffects\tthe\theart\tthrough\tthe\tmany\trisk\tfactors\tthat\tare\noften\tpresent:\thypertension,\tglucose\tintolerance,\tinflammatory\tmarkers\t(IL-6,\ttumor\tnecrosis\tfactor\nalpha\t[TNF-α],\ths-CRP),\tobstructive\tsleep\tapnea,\tprothrombotic\tstate,\tendothelial\n\tdysfunction,\tand
|
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dysfunction,\tand\ndyslipidemia\t(small\tdense\tLDL,\tincreased\tapo\tB,\tlow\tHDL,\thigh\ttriglyceride\tlevels).\tMany\ninflammatory\tproteins\tare\tnow\tknown\tto\tcome\tfrom\tthe\tadipocyte\t(see\t\nChapters\t7\n\tand\t\n20\n).\tThese\nconcurrent\trisk\tfactors\tmay\thelp\tto\texplain\tthe\thigh\tmorbidity\tand\tmortality\trates\tobserved\tin\npeople\twho\tare\tobese.
|
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] |
people\twho\tare\tobese.\nWeight\tdistribution\t(abdominal\tversus\tgynoid)\tis\talso\tpredictive\tof\tCVD\trisk,\n\tglucose\ttolerance,\nand\tserum\tlipid\tlevels.\tCentral\tor\tabdominal\tlength\tof\tadiposity\talso\thas\tbeen\tstrongly\trelated\tto\nmarkers\tof\tinflammation,\tespecially\ths-CRP.\tTherefore\ta\twaist\tcircumference\tof\tless\tthan\t35\tinches
|
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] |
for\twomen\tand\t40\tinches\tfor\tmen\tis\trecommended\t(see\t\nChapter\t20\n).\nSmall\tweight\tlosses\t(10\tto\t20\tlb)\tcan\timprove\tLDL\tcholesterol,\tHDL\tcholesterol,\ttriglycerides,\thigh\nblood\tpressure,\n\tglucose\ttolerance,\tand\ths-CRP\tlevels,\teven\tif\tan\tideal\tBMI\tis\tnot\tachieved.\tWeight
|
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loss\talso\thas\tbeen\tcorrelated\twith\tlower\ths-CRP\tlevels.\tHowever,\tto\trestore\tvascular\tfunction,\tthe\namount\tof\tweight\tthat\tmust\tbe\tlost,\tthe\ttime\tof\tweight\tmaintenance,\tor\tthe\tamount\tof\timprovement\nin\tendothelial\tfunction\tthat\tlessens\tcardiovascular\tevents\tis\tstill\tunknown.\nNonmodifiable\trisk\tfactors\nAge\tand\n\tsex
|
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0.0338272750377655,
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0.06642183661460876,
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0.05335841327905655,
0.07173944264650345,
0.08530644327402115,
0.0001824260107241571
] |
Nonmodifiable\trisk\tfactors\nAge\tand\n\tsex\nWith\tincreasing\tage,\thigher\tmortality\trates\tfrom\tCVD\tare\tseen\tin\tboth\tgenders.\tHowever,\tgender\tis\ta\nfactor\tfor\tthe\tassessment\tof\trisk.\tThe\tincidence\tof\tpremature\tdisease\tin\tmen\t35\tto\t44\tyears\tof\tage\tis\nthree\ttimes\tas\thigh\tas\tthe\tincidence\tin\twomen\tof\tthe\tsame\tage.\tTherefore\tbeing\tolder\tthan\t45\tyears
|
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] |
of\tage\tis\tconsidered\ta\trisk\tfactor\tfor\tmen.\tFor\twomen\tthe\tincreased\trisk\tcomes\tafter\tthe\tage\n\tof\t55\nyears,\twhich\tis\tafter\tmenopause\tfor\tmost\twomen.\tOverall\tthe\tincreased\trisk\tfor\tCVD\tparallels\tage.\nFamily\thistory\tand\tgenetics\nA\tfamily\thistory\tof\tpremature\tdisease\tis\ta\tstrong\trisk\tfactor,\teven\twhen\tother\trisk\tfactors\tare
|
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0.1359911412000656,
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0.08682459592819214,
0.020277438685297966
] |
considered.\tA\tfamily\thistory\tis\tconsidered\tto\tbe\tpositive\twhen\tMI\tor\tsudden\tdeath\toccurs\tbefore\tthe\nage\tof\t55\tyears\tin\ta\tmale\tfirst-degree\trelative\tor\tthe\tage\tof\t65\n\tin\ta\tfemale\tfirst-degree\trelative\n(parents,\tsiblings,\tor\tchildren).\tThe\tpresence\tof\ta\tpositive\tfamily\thistory,\talthough\tnot\tmodifiable,
|
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] |
influences\tthe\tintensity\tof\trisk\tfactor\tmanagement.\nMenopausal\tstatus\nEndogenous\testrogen\tconfers\tprotection\tagainst\tASCVD\tin\tpremenopausal\twomen,\tprobably\tby\npreventing\tvascular\tinjury.\tLoss\tof\testrogen\tafter\tnatural\tor\tsurgical\tmenopause\tis\tassociated\twith\nincreased\tASCVD\trisk.\tRates\tof\tASCVD\tin\tpremenopausal\twomen\tare\tlow\texcept\tin\twomen\twith
|
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] |
multiple\trisk\tfactors.\tDuring\tthe\tmenopausal\tperiod\ttotal\tcholesterol,\tLDL\tcholesterol,\tand\ntriglyceride\tlevels\tincrease;\tHDL\tcholesterol\tlevel\tdecreases,\tespecially\tin\twomen\twho\tgain\tweight.\nMedical\tnutrition\ttherapy\nMedical\tnutrition\ttherapy\t(MNT),\twhich\tincludes\tdiscussion\tof\tphysical\tactivity,\tis\n\tthe\tprimary
|
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] |
the\tprimary\nintervention\tfor\tpatients\twith\televated\tLDL\tcholesterol\t(see\t\nBox\t32.4\n).\tPhysicians\tare\tencouraged\tto\nrefer\tpatients\tto\tregistered\tdietitian\tnutritionists\t(RDNs)\tto\thelp\tpatients\tmeet\tgoals\tfor\ttherapy\nbased\ton\tLDL\tcholesterol\tlevels.\nWith\tdiet,\texercise,\tand\tweight\treduction,\tpatients\tcan\tdecrease\tLDL\tcholesterol\tand\treduce\tbody
|
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] |
inflammation.\tThe\tcomplexity\tof\tchanges,\tnumber\tof\tchanges,\n\tand\tmotivation\tof\tthe\tpatient\twill\ndictate\thow\tmany\tpatient\tvisits\tit\twill\ttake\tfor\tthe\tadherent\tto\tbe\tsuccessful.\tAn\tinitial\tvisit\tof\t45\tto\n90\tminutes\tfollowed\tby\ttwo\tto\tsix\tvisits\tof\t30\tto\t60\tminutes\teach\twith\tthe\tRDN\tis\trecommended
|
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] |
(Academy\tof\tNutrition\tand\tDietetics\tEvidence\tAnalysis\tLibrary\t[EAL],\t2011).\tConsequently\tthese\ninterventions\tare\ttried\tbefore\tdrug\ttherapy\tand\talso\tcontinue\n\tduring\tpharmacologic\ttreatment\tto\nenhance\teffectiveness\tof\tthe\tmedication\t(see\t\nPathophysiology\tand\tCare\tManagement\tAlgorithm:\nAtherosclerosis\n).
|
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Lifestyle\trecommendations\nThe\tACC/AHA\trecommends\tdiet\tand\tlifestyle\tchanges\tto\treduce\tASCVD\trisk\tin\tall\tpeople\tolder\tthan\nthe\tage\tof\t2\t(\nEckel\tet\tal,\t2014\n).\tThe\tACC/AHA\trecommendations\tare\tfor\ta\tdiet\thigh\tin\tvegetables,\nfruits,\twhole\tgrains,\tlow-fat\tpoultry,\tfish,\tnontropical\tvegetable\toils,\tnuts,\tand\tlow-fat\tdairy\tand\tlow
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in\tsweets,\tsugar-sweetened\tbeverages,\tand\tred\tmeat.\tThe\tDASH\tdiet\n\tpattern\tor\tU.S.\tDepartment\tof\nAgriculture\t(USDA)\tfood\tpattern\t(MyPlate)\tis\trecommended\tto\tachieve\tthis\tdiet.\tThe\tMeD\twas\tnot\nspecifically\trecommended\tbecause\tin\tthe\tevidence\tevaluated\tthe\tdiet\twas\tnot\tspecific\tor\tconsistent\nenough\tto\tdraw\tconclusions.\tIn\tgeneral,\tthe\tMeD\tpattern\t(
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] |
enough\tto\tdraw\tconclusions.\tIn\tgeneral,\tthe\tMeD\tpattern\t(\nFig.\t32.5\n)\tfits\tthe\trecommendations.\tA\nstudy\trecently\tpresented\tat\tthe\tACC\tsupports\tthe\tMeD\tpattern\tfor\tCVD\trisk\treduction\n\t(\nACC,\t2015\n).\nThe\tstudy\tincluded\tmore\tthan\t2500\tGreek\tadults\tover\tmore\tthan\t10\tyears.\tNearly\t20%\tof\tmen\tand
|
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] |
12%\tof\twomen\tin\tthe\tstudy\tdeveloped\tor\tdied\tfrom\theart\tdisease.\tPeople\twho\tclosely\tfollowed\tthe\nMeD\twere\t47%\tless\tlikely\tto\tdevelop\theart\tdisease\tthan\tthose\twho\tdid\tnot\tfollow\tthe\tdiet.\tThe\tMeD\nScore\tTool\twas\tused\t(see\t\nFig.\t32.5\n)\tto\tvalidate\tthe\tdietary\tpattern.\tA\tMeD\tmay\talso\treduce\trecurrent
|
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)\tto\tvalidate\tthe\tdietary\tpattern.\tA\tMeD\tmay\talso\treduce\trecurrent\nCVD\tby\t50%\tto\t70%\tand\thas\tbeen\tshown\tto\taffect\tlipoprotein\tlevels\tpositively\tin\thigh-risk\npopulations\t(\nCarter\tet\tal,\t2010\n).
|
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] |
FIG.\t32.5\nMediterranean\tDiet\tScore\tTool.\n\tSource:\t(Courtesy\tAlison\tHornby\tand\tKatherine\tPaterson.)\nSaturated\tfatty\tacids.\nCurrently\tin\tthe\tUnited\tStates\tthe\taverage\tintake\tof\tsaturated\tfat\tis\t11%\tof\tcalories.\tThe\nrecommendation\tfor\tdecreasing\tLDL\tcholesterol\tis\t5%\tto\t6%.\tThe\tguidelines\thave\tno\tspecific
|
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] |
recommendation\tfor\ttrans\tfatty\tacid\tintake\tbut\trecommend\tit\tbe\tdecreased\twith\tthe\tsaturated\n\tfat.\nSaturated\tfat\tis\tgenerally\tfound\tin\tanimal\tproteins.\tIt\tis\trecommended\tthat\tintake\tof\tanimal\tprotein,\nespecially\tred\tmeat\tand\thigh-fat\tdairy,\tbe\tdecreased.\nTrans\tfatty\tacids.\nTrans\tfatty\tacids
|
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Trans\tfatty\tacids.\nTrans\tfatty\tacids\n\t(stereoisomers\tof\tthe\tnaturally\toccurring\tcis-linoleic\tacid)\tare\tproduced\tin\tthe\nhydrogenation\tprocess\tused\tin\tthe\tfood\tindustry\tto\tincrease\tshelf\tlife\tof\tfoods\tand\tto\tmake\nmargarines,\tmade\tfrom\n\toil,\tfirmer.\tMost\ttrans\tfatty\tacids\tintake\tcomes\tfrom\tthese\tpartially
|
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0.06742699444293976,
0.12526653707027435,
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] |
hydrogenated\toils\t(PHOs).\tIn\t2013\tthe\tFDA\tmade\ta\tdecision\tto\tremove\tPHOs\tfrom\tthe\t“generally\nrecognized\tas\tsafe”\tlist.\tThis\twas\tbased\ton\tthe\tmounting\tevidence\tthat\ttrans\tfats\tcontributed\tto\nASCVD\tand\twas\tassociated\twith\tincreased\tLDL\tcholesterol\tlevels.\tTrans\tfat\tintake\tis\tinversely\nassociated\twith\tHDL\tlevels\t(\nYanai\tet\tal,\t2015\n).
|
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] |
associated\twith\tHDL\tlevels\t(\nYanai\tet\tal,\t2015\n).\nMonounsaturated\tfatty\tacids.\nOleic\tacid\t(C18:1)\tis\tthe\tmost\tprevalent\tmonounsaturated\tfatty\tacid\t(MUFA)\tin\tthe\tAmerican\tdiet.\nSubstituting\toleic\tacid\tfor\tcarbohydrate\thas\talmost\tno\tappreciable\teffect\ton\tblood\tlipids.\tHowever,
|
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] |
replacing\tsaturated\tfatty\tacids\t(SFAs)\twith\tMUFAs\t(as\twould\thappen\twhen\tsubstituting\tolive\toil\tfor\nbutter)\tlowers\tserum\tcholesterol\tlevels,\tLDL\tcholesterol\tlevels,\n\tand\ttriglyceride\tlevels.\tOleic\tacid\tas\npart\tof\tthe\tMeD\t(\nFig.\t32.6\n)\thas\tbeen\tshown\tto\thave\tantiinflammatory\teffects.
|
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] |
FIG.\t32.6\nThe\tTraditional\tHealthy\tMediterranean\tDiet\tPyramid.\n\tSource:\t(Courtesy\tOldways\tPreservation\tand\tExchange\nTrust,\t\t\nhttps://www.oldwayspt.org\n.)\t(\t\nhttp://www.cardiacrehabilitation.org.uk/docs/Mediterranean-Diet-Score.pdf\n.)\nPolyunsaturated\tfatty\tacids.
|
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effects\ton\tthe\tfunction\tof\tvascular\tendothelium\tor\tstimulate\tproduction\tof\tproinflammatory\tcytokines\n(\nHarris\tet\tal,\t2009\n).\tThe\tAHA\tdoes\tnot\tsupport\tconcern\tfor\tomega-6\tPUFAs\tas\tproinflammatory.\nHowever,\tthis\tposition\thas\tbeen\tchallenged\n\tby\tresearchers\tin\tthe\tfield.\tA\trecent\treview\tof\tthe
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intervention\t(\nKhandelwal\tet\tal,\t2013\n).\nOmega-3\tfatty\n\tacids.\nThe\tmain\tomega-3\tfatty\tacids\t(eicosapentaenoic\tacid\t[EPA]\tand\tdocosahexaenoic\tacid\t[DHA])\tare\nhigh\tin\tfish\toils,\tfish\toil\tcapsules,\tand\tocean\tfish.\tSome\tstudies\thave\tshown\tthat\teating\tfish\tis
|
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] |
associated\twith\ta\tdecreased\tASCVD\trisk.\tThe\tAHA\trecommendation\tfor\tthe\tgeneral\tpopulation\tis\tto\nincrease\tfish\tconsumption\tspecifically\tof\tfish\thigh\tin\tomega-3\tfatty\tacids\t(salmon,\ttuna,\tmackerel,\nsardines)\n\tand\teat\ta\t3.5-ounce\tserving\ttwice\ta\tweek.\tConsumption\tof\tomega-3\tfat\tin\tthe\tform\tof\tfish
|
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] |
oil\thas\tbeen\tassociated\twith\thigher\tlevels\tof\tHDL\tcholesterol\tand\tlower\tlevels\tof\tserum\ttriglycerides\n(\nYanai\tet\tal,\t2015\n;\tsee\t\nAppendix\t26\n).\tThe\tAHA\trecommends\ta\tdiscussion\twith\ta\tphysician\tbefore\ntaking\tfish\toil\tsupplements.\nAn\tomega-3\tfatty\tacid\tfrom\tvegetables,\talpha-linolenic\tacid\t(ALA),\thas\tantiinflammatory\n\teffects\n(see\t\nChapter\t7
|
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] |
effects\n(see\t\nChapter\t7\n).\tOmega-3\tfatty\tacids\tare\tthought\tto\tbe\tcardioprotective\tbecause\tthey\tinterfere\twith\nblood\tclotting\tand\talter\tprostaglandin\tsynthesis.\tOmega-3\tfat\tstimulates\tproduction\tof\tNO,\ta\nsubstance\tthat\tstimulates\trelaxation\tof\tthe\tblood\tvessel\twall\t(vasodilation).\tUnfortunately,\thigh
|
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] |
intakes\t(above\t3\tg\tEPA/DHA)\tprolong\tbleeding\ttime,\ta\tcommon\tcondition\tamong\tArctic\tNative\npopulations\n\twith\thigh\tomega-3\tfat\tdietary\tintakes\tand\tlow\tincidence\tof\tASCVD.\nDietary\tcholesterol.\nPrevious\trecommendations\thave\tbeen\tto\tdecrease\tdietary\tcholesterol\tto\tdecrease\tLDL\tcholesterol
|
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] |
and\treduce\tASCVD\trisk.\tThe\tACC/AHA\t2013\tguidelines\tno\tlonger\tmake\tthis\trecommendation,\tand\nthey\tspecifically\tstate\tthat\tdietary\tcholesterol\tdoes\tnot\traise\tLDLs\t(see\t\nChapter\t9\n).\tThe\t2015\tU.S.\nDietary\tGuidelines\n\talso\teliminate\tthe\trecommendation\tto\trestrict\tcholesterol.\tHowever\tit\tis
|
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] |
important\tto\tremember\tthat\tmost\thigh\tcholesterol\tfoods\tare\talso\thigh\tin\tsaturated\tfats\tthat\tdo\traise\nLDL\tcholesterol.\nFiber.
|
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] |
High\tintake\tlevels\tof\tdietary\tfiber\tare\tassociated\twith\tsignificantly\tlower\tprevalence\tof\tASCVD\tand\nstroke\t(\nAnderson\tet\tal,\t2009\n).\tThe\tUSDA\tMyPlate,\tthe\tDASH\tdiet,\tand\tthe\tMeD\tpattern\temphasize\nfruits,\tvegetables,\tlegumes,\tand\twhole\tgrains,\tso\tthey\tare\tinnately\thigh\tin\tfiber.\tThis\tcombination\tof
|
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] |
vitamin\tE\tsupplementation\tfor\tCVD\tprevention.\tA\tdietary\tpattern\tthat\tincludes\tincreased\tamounts\tof\nwhole\tgrains,\tnuts,\tand\tseeds\t(especially\tsunflower\tseeds)\thas\tincreased\tamounts\tof\tvitamin\tE.\nFoods\twith\tconcentrated\tamounts\tof\tantioxidants\tare\n\tfound\tin\tphytochemicals\tknown\tas\tcatechins
|
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] |
found\tin\tphytochemicals\tknown\tas\tcatechins\nand\thave\tbeen\tfound\tto\timprove\tvascular\treactivity.\tRed\tgrapes,\tred\twine,\ttea\t(especially\tgreen\ttea),\nberries,\tand\tbroad\tbeans\t(fava\tbeans)\tare\tpart\tof\tthe\tMeD\t(see\t\nFigs.\t32.5\n\tand\t\n32.6\n).\nStanols\tand\tsterols.
|
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] |
Figs.\t32.5\n\tand\t\n32.6\n).\nStanols\tand\tsterols.\nSince\tthe\tearly\t1950s,\tplant\tstanols\tand\tsterols\tisolated\tfrom\tsoybean\toils\tor\tpine\ttree\toil\thave\tbeen\nknown\tto\tlower\tblood\tcholesterol\tby\tinhibiting\n\tabsorption\tof\tdietary\tcholesterol.\tStanols\tand\tsterols\nhave\tbeen\tshown\tto\tlower\tLDL\tcholesterol\tin\tadults\t(\nYanai\tet\tal,\t2015
|
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] |
Yanai\tet\tal,\t2015\n).\tBecause\tthese\testers\talso\ncan\taffect\tthe\tabsorption\tof\tand\tcause\tlower\tbeta-carotene,\talpha-tocopherol,\tand\tlycopene\tlevels,\nfurther\tsafety\tstudies\tare\tneeded\tfor\tuse\tin\tnormocholesterolemic\tindividuals,\tchildren,\tand\npregnant\twomen.\nWeight\tloss.\nAccording\tto\tthe\tCenters
|
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pregnant\twomen.\nWeight\tloss.\nAccording\tto\tthe\tCenters\n\tfor\tDisease\tControl\tand\tPrevention\t(CDC),\tin\t2015\tto\t2016\t39.8%\tof\tadults\nand\t18.5%\tof\tchildren\tin\tthe\tUnited\tStates\twere\tclassified\tas\tobese.\tObesity\traises\tthe\trisk\tof\nhypertension,\tdyslipidemia,\ttype\t2\tdiabetes,\tASCVD,\tand\tstroke.\tObesity\tis\tassociated\twith\tincreased
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] |
risk\tin\tall-cause\tand\tCVD\tmortality\t(\nStone\tet\tal,\t2014\n).\tRecommendations\tof\tthe\tpanel\tare\nsummarized\tin\t\nBox\t32.5\n.\nBOX\t32.5\nRecommendations\tfrom\tThe\tObesity\tSociety\t(TOS)\tObesity\nGuideline\n1.\t\nPatient/provider\tencounter\tfor\tobesity\tprevention\tand\tmanagement:\tA\tpatient\tencounter\tis
|
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defined\tas\tan\tinteraction\twith\ta\tprimary\tcare\tprovider\twho\tassesses\tweight\tstatus\tto\ndetermine\tneed\tfor\tfurther\tassessment\tand\ttreatment.\n2.\t\nMeasure\tweight\tand\theight\tand\tcalculate\tbody\tmass\tindex\t(BMI).\n3.\t\nBMI\t25<30\t(overweight)\tor\n\tBMI\t30<35\t(class\tI\tobese)\tor\tBMI\t35<40\tclass\tII\tobese\tor\tBMI
|
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BMI\t30<35\t(class\tI\tobese)\tor\tBMI\t35<40\tclass\tII\tobese\tor\tBMI\n>40\t(class\tIII\tobese):\tthese\tBMI\tcutpoints\tdefine\toverweight\tand\tobese\tindividuals\twho\tare\nat\tincreased\trisk\tof\tcardiovascular\tdisease\t(CVD).\tWithin\tthese\tcategories,\tadditional\npersonal\trisk\tassessment\tis\tneeded.\n4.
|
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personal\trisk\tassessment\tis\tneeded.\n4.\t\nAssess\tand\ttreat\tCVD\trisk\tfactors\tand\tobesity-related\tcomorbidities:\tA\twaist\tcircumference\nmeasurement\tis\trecommended\n\tfor\tindividuals\twith\tBMI\t25-35\tto\tprovide\tadditional\ninformation\ton\trisk.\tIt\tis\tnot\tnecessary\tto\tmeasure\twaist\tcircumference\tin\tpatients\twith
|
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BMI\t>35\tbecause\tthe\twaist\tcircumference\twill\tlikely\tbe\televated\tand\tit\twill\tadd\tno\nadditional\tinformation.\tIncreased\tcardiometabolic\trisk\tis\tdefined\tas\t>88\tcm\tor\t>35\tin\tfor\nwomen\tand\t>102\tcm\tor\t>40\tin\tfor\tmen.\n5.\t\nAssess\tweight\tand\tlifestyle\thistories:\tAsk\n\tquestions\tabout\thistory\tof\tweight\tgain\tand\tloss
|
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] |
questions\tabout\thistory\tof\tweight\tgain\tand\tloss\nover\ttime,\tdetails\tof\tprevious\tweight\tloss\tattempts,\tdietary\thabits,\tphysical\tactivity,\tfamily\nhistory\tof\tobesity,\tand\tother\tmedical\tconditions\tand\tmedications\tthat\tmay\taffect\tweight.\n6.\t\nAssess\tneed\tto\tlose\tweight:\tWeight\tloss\ttreatment\tis\tindicated\tfor\t(1)\tobese\tand\t(2)
|
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] |
overweight\twith\tone\tor\tmore\tindicators\tof\tincreased\tCVD\trisk.\n7.\t\nAdvise\tto\n\tavoid\tweight\tgain\tand\taddress\tother\trisk\tfactors.\nJensen,\tet\tal:\t2013\tAHA/ACC/TOS\tguideline\tfor\tthe\tmanagement\tof\toverweight\tand\tobesity\tin\tadults.\nCirculation\n,\t129:S102,\t2014.\nMedical\tmanagement\nPharmacologic\tmanagement
|
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|
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] |
cholesterol\ttargets.\tThe\tprimary\ttreatment\tfor\tthose\tat\trisk\tof\tASCVD\tare\tthe\t3-hydroxy-3-\nmethylglutaryl–coenzyme\tA\t(HMG-CoA)\treductase\tinhibitors,\tof\twhich\tthere\tare\tmany\t(see\t\nAppendix\n13\n).\tThe\tclasses\tof\tdrugs\tinclude\tthe\tfollowing:\t(1)\t\nbile\tacid\tsequestrants\n\tsuch\tas\tcholestyramine\n(adsorbs\tbile\tacids);\t(2)\tnicotinic\tacid;\t(3)\tstatins,\tor
|
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] |
(adsorbs\tbile\tacids);\t(2)\tnicotinic\tacid;\t(3)\tstatins,\tor\t\n3-hydroxy-3-methylglutaryl–coenzyme\tA\n(HMG-CoA)\n\treductase\tinhibitors,\twhich\tinhibit\tthe\trate-limiting\tenzyme\tin\tcholesterol\tsynthesis;\t(4)\nfibric\tacid\tderivatives;\tand\t(5)\tprobucol.\nMedical\tintervention
|
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fibric\tacid\tderivatives;\tand\t(5)\tprobucol.\nMedical\tintervention\nMedical\tinterventions\tsuch\tas\tpercutaneous\tcoronary\tintervention\t(PCI)\tare\tnow\tperformed\tin\npatients\twith\tasymptomatic\tischemia\tor\n\tangina.\tPCI,\tpreviously\tknown\tas\tpercutaneous\ttransluminal
|
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0.12889818847179413,
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] |
angina.\tPCI,\tpreviously\tknown\tas\tpercutaneous\ttransluminal\ncoronary\tangioplasty,\tis\ta\tprocedure\tthat\tuses\ta\tcatheter\twith\ta\tballoon\tthat,\tonce\tinflated,\tbreaks\nup\tplaque\tdeposits\tin\tan\toccluded\tartery.\tCoronary\tstenting\tinvolves\ta\twire\tmesh\ttube\tinserted\tto\nhold\tan\tartery\topen;\tit\tcan\trelease\tmedication\tthat\tprevents\tclotting\t(\nThom\tet\tal,\t2006
|
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Thom\tet\tal,\t2006\n).\nPCI\tis\toften\tpossible\tbecause\tof\tearlier\tdetection\n\tof\tblockages.\tThe\tmost\tcommon\tproblem\twith\nPCI\tis\trestenosis\tof\tthe\tartery.\tA\trecent\tstudy\texamined\tmore\tthan\t2200\tpatients,\thalf\tof\twhom\nreceived\tintervention\tof\tmedication\tand\tlifestyle\tchanges\tsuch\tas\tquitting\tsmoking,\texercise,\tand
|
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nutrition,\tand\thalf\tof\twhom\treceived\tlifestyle\tchanges\tas\twell\tas\tangioplasty.\tAfter\t5\tyears\tit\twas\nobserved\tthat\tthe\tnumber\twho\thad\theart\tattacks,\twere\thospitalized,\n\tor\tdied\tbecause\tof\ttheir\theart\nproblems\twas\tvirtually\tidentical\tin\tboth\tgroups.\tAngioplasty\tdid\tnot\tappear\tto\tprovide\tan\tadditional
|
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] |
benefit\tversus\tlifestyle\tchanges\tcombined\twith\tmedication\t(\nBoden\tet\tal,\t2007\n).\nBecause\tPCI\tis\tperformed\twith\tthe\tpatient\tunder\tlocal\tanesthesia\tin\ta\tcardiac\tcatheterization\nlaboratory,\trecovery\tis\tquicker\tthan\twith\t\ncoronary\tartery\tbypass\tgraft\t(CABG)\n\tsurgery.\tIn\n\tCABG
|
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coronary\tartery\tbypass\tgraft\t(CABG)\n\tsurgery.\tIn\n\tCABG\nsurgery,\tan\tartery\tfrom\tthe\tchest\tis\tused\tto\tredirect\tblood\tflow\taround\ta\tdiseased\tvessel.\tCandidates\nfor\tCABG\tusually\thave\tmore\tthan\ttwo\toccluded\tarteries.\tCABG\tsurgeries\thave\tdecreased\tsince\t1995\nbecause\tmore\tPCI\tprocedures\tare\tbeing\tdone.\tThese\tsurgeries\timprove\tsurvival\ttime,\trelieve
|
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] |
symptoms,\tand\tmarkedly\timprove\tthe\tquality\tof\tlife\tfor\tpatients\twith\tASCVD.\tHowever,\tCABG\tdoes\nnot\tcure\tatherosclerosis;\n\tthe\tnew\tgrafts\tare\talso\tsusceptible\tto\tatherogenesis.\tConsequently,\nrestenosis\tis\tcommon\twithin\t10\tyears\tof\tsurgery.\nHypertension\nHypertension
|
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] |
Hypertension\nHypertension\n\tis\tpersistently\thigh\tarterial\tblood\tpressure,\tthe\tforce\texerted\tper\tunit\tarea\ton\tthe\nwalls\tof\tarteries.\tThe\t\nsystolic\tblood\tpressure\t(SBP)\n,\tthe\tupper\treading\tin\ta\tblood\tpressure\nmeasurement,\tis\tthe\tforce\texerted\ton\tthe\twalls\tof\tblood\tvessels\tas\tthe\n\theart\tcontracts\tand\tpushes
|
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heart\tcontracts\tand\tpushes\nblood\tout\tof\tits\tchambers.\tThe\tlower\treading,\tknown\tas\t\ndiastolic\tblood\tpressure\t(DBP)\n,\tmeasures\nthe\tforce\tas\tthe\theart\trelaxes\tbetween\tcontractions.\tBlood\tpressure\tis\tmeasured\tin\tmillimeters\t(mm)\nof\tmercury\t(Hg).\tAdult\tblood\tpressure\tis\tconsidered\tnormal\tat\t120/80\tmm\tHg.\tThe\tblood\tpressure
|
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0.11381260305643082,
0.01010003499686718,
-0.04780491814017296,
-0.053537510335445404,
0.002915313234552741,
0.01619848795235157,
0.034272827208042145,
-0.0189138725399971,
0.0153419878333807,
0.04112560302019119,
0.08145193010568619,
0.082238107919693,
0.0000786990494816564
] |
cutoffs\tfor\televated\tblood\tpressure\t(formerly\t\nprehypertension\n),\tstage\t1\tand\tstage\n\t2\thypertension\nare\tfound\tin\t\nTable\t32.1\n.\nTABLE\t32.1\nCategories\tof\tBlood\tPressure\tin\tAdults\nSBP\t(mm\tHg)\n*\nDBP\t(mm\tHg)\n*\nNormal\n<120\tmm\tHg\nand\n<80\tmm\tHg\nElevated\n120-129\tmm\tHg\nand\n<80\tmm\tHg\nHypertension\nStage\t1\n130-139\tmm\tHg\nor\n80-89\tmm\tHg\nStage\t2\n>130-139\tmm\tHg\nor
|
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0.0022274781949818134,
0.048842333257198334
] |
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