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Stage\t1\n130-139\tmm\tHg\nor\n80-89\tmm\tHg\nStage\t2\n>130-139\tmm\tHg\nor\n>90\tmm\tHg\nSBP\n,\tSystolic\tblood\tpressure;\t\nDBP\n,\tDiastolic\tblood\tpressure.\nWhelton\tPK,\tet\tal:\t2017\tACC/AHA/AAPA/ABC/ACPM/APhA/ASH/ASPC/NMA/PCNA\tguideline\tfor\tthe\tprevention,\tdetection,\tevaluation\tand\nmanagement\tof\thigh\tblood\tpressure\tin\tadults.\n\t\nJ\tAm\tColl\tCardiol\n\t71:\te127-e240,\t2018.
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J\tAm\tColl\tCardiol\n\t71:\te127-e240,\t2018.\n*\nIndividuals\twith\tSBP\tand\tDBP\tin\t2\tcategories\tshould\tbe\tdesignated\tto\tthe\thigher\tblood\tpressure\tcategory.\tBlood\tpressure\tis\tbased\ton\tan\taverage\nof\t≥2\tcareful\treadings\tobtained\ton\t≥2\toccasions.\nThe\tclinical\tpractice\tguidelines\tfrom\tthe\tACC/AHA\tTask\tForce\tfor\tthe\tPrevention,\tDetection,
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] |
Evaluation,\tand\tManagement\tof\tHigh\tBlood\tPressure\tin\tAdults\t(\nWhelton\tet\tal,\t2018\n)\tstate\tthat\tthe\ncombination\tof\tdiet\tand\tlifestyle\ttherapy\tis\tespecially\tuseful\tin\tadults\tfor\tthe\tprevention\tof\nhypertension\tand\tfor\tthe\tmanagement\tof\televated\tblood\tpressure\tand\tstage\t1\thypertension\twithout
|
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] |
clinical\tASCVD\tor\testimated\t10-year\tASCVD\trisk\tof\t≤10%\t(see\t\nhttp://tools.acc.org/ASCVD-Risk-\nEstimator-Plus/#!/calculate/estimate/\n).\tFor\tadults\twith\tstage\t1\thypertension\twith\tclinical\tASCVD\n\tor\nestimated\t10-year\trisk\tof\tASCVD\t≥10%\tor\tstage\t2\thypertension,\tthe\tACC/AHA\tguidelines
|
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recommends\tblood\tpressure–lowering\tmedication\tin\tcombination\twith\tnonpharmacotherapy\tfor\nprimary\tprevention\tof\tCVD.\tThe\tguidelines\talso\tcall\tfor\tindividuals\twith\tdiabetes,\tHF,\tand\tchronic\nkidney\tdisease\tto\tbe\ttreated\twith\tblood\tpressure–lowering\tmedication\twhen\ttheir\tblood\tpressure\nexceeds\t130/80\tmm\tHg.\tThe\trecommendations
|
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] |
exceeds\t130/80\tmm\tHg.\tThe\trecommendations\n\tare\tbased\ton\tclinical\tevidence\tshowing\tthat\tstricter\nguidelines\tfor\tthese\tpatients\tmay\tprevent\tacceleration\tof\ttarget\torgan\tdamage\t(kidney,\theart,\tand\npancreas)\tand\trelated\tcomorbidities.\tImportantly,\tthe\tguidelines\temphasize\tthat\tpeople\twith\thigh
|
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] |
blood\tpressure\tshould\tfollow\ta\thealthy\tdiet\tand\tlifestyle\talong\twith\tmedication\tmanagement.\tDiet
|
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] |
and\tlifestyle\tmodifications\tare\timportant\n\tparts\tof\tprimary\tprevention\tof\thypertension.\nHypertension\tis\ta\tcommon\tpublic\thealth\tproblem\tin\tdeveloped\tcountries.\tIn\tthe\tUnited\tStates\tone\nin\tthree\tadults\thas\thigh\tblood\tpressure\t(\nCDC,\t2017\n).\tUntreated\thypertension\tleads\tto\tmany
|
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] |
CDC,\t2017\n).\tUntreated\thypertension\tleads\tto\tmany\ndegenerative\tdiseases,\tincluding\tHF,\tend-stage\trenal\tdisease,\tand\tperipheral\tvascular\tdisease.\tIt\tis\noften\tcalled\ta\t“silent\tkiller”\tbecause\tpeople\twith\thypertension\n\tcan\tbe\tasymptomatic\tfor\tyears\tand\nthen\thave\ta\tfatal\tstroke\tor\theart\tattack.\tAlthough\tno\tcure\tis\tavailable,\thypertension\tis\teasily
|
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] |
detected\tand\tusually\tcontrollable.\tSome\tof\tthe\tdecline\tin\tCVD\tmortality\tduring\tthe\tlast\ttwo\tdecades\nhas\tbeen\tattributed\tto\tthe\tincreased\tdetection\tand\tcontrol\tof\thypertension.\tThe\temphasis\ton\tlifestyle\nmodifications\thas\tgiven\tdiet\ta\tprominent\trole\tin\tthe\tprimary\tprevention\n\tand\tmanagement\tof\nhypertension.
|
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] |
and\tmanagement\tof\nhypertension.\nOf\tthose\tpersons\twith\thigh\tblood\tpressure,\t90%\tto\t95%\thave\t\nessential\thypertension\n(hypertension\tof\tunknown\tcause)\tor\tprimary\thypertension.\tThe\tcause\tinvolves\ta\tcomplex\tinteraction\nbetween\tpoor\tlifestyle\tchoices\tand\tgene\texpression.\tLifestyle\tfactors\tthat\thave\tbeen\timplicated
|
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] |
include\tpoor\tdiet\t(i.e.,\thigh\tsodium,\tlow\tfruit\tand\tvegetable\tintake),\tsmoking,\tphysical\n\tinactivity,\nstress,\tand\tobesity.\tVascular\tinflammation\thas\talso\tbeen\timplicated\t(\nDe\tMiguel\tet\tal,\t2015\n).\tMany\ngenes\tplay\ta\trole\tin\thypertension;\tmost\trelate\tto\tthe\trenal\tor\tneuroendocrine\tcontrol\tof\tblood
|
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] |
pressure.\tGenome-wide\tassociation\tstudies\thave\trevealed\tmore\tthan\t100\tvariants\tassociated\twith\nblood\tpressure,\talthough\tcumulatively\tthese\texplain\tonly\ta\tsmall\tpercent\tof\tblood\tpressure\nvariability\n\t(\nSeidel\tand\tScholl,\t2017\n).\tThe\tmajority\tof\tthe\tgenetic\tcontributors\tto\tblood\tpressure\nregulation\tare\tcurrently\tunknown\t(see\t\nChapter\t6
|
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] |
regulation\tare\tcurrently\tunknown\t(see\t\nChapter\t6\n).\tHypertension\tthat\tarises\tas\tthe\tresult\tof\tanother\ndisease,\tusually\tendocrine,\tis\treferred\tto\tas\t\nsecondary\thypertension\n.\tDepending\ton\tthe\textent\tof\nthe\tunderlying\tdisease,\tsecondary\thypertension\tcan\tbe\tcured.\nPrevalence\tand\tincidence\nApproximately\t85.7\tmillion
|
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] |
Prevalence\tand\tincidence\nApproximately\t85.7\tmillion\n\tAmerican\tadults\tage\t20\tand\tolder\thave\thypertension\tor\tare\ttaking\nantihypertensive\tmedication\t(\nBenjamin\tet\tal,\t2018\n).\tProjections\tshow\tthat\tby\t2030,\tprevalence\tof\nhypertension\twill\tincrease\tby\t8.4%\tfrom\t2013\testimates.\tNon-Hispanic\tblack\tadults\thave\ta\thigher
|
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] |
age-adjusted\tprevalence\tof\thypertension\t(45.0%\tof\tmen;\t46.3%\tof\twomen)\tthan\tnon-Hispanic\twhites\n(34.5%\tof\tmen;\t32.3%\tof\twomen)\tand\tMexican\n\tAmericans\t(30.1%\tof\tmen;\t28.8%\tof\twomen)\n(\nBenjamin\tet\tal,\t2018\n).\tThe\tprevalence\tof\thigh\tblood\tpressure\tin\tblacks\tis\tone\tof\tthe\thighest\trates
|
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0.03599180281162262,
0.031167257577180862,
0.16358023881912231,
-0.010242083109915257,
0.024298787117004395,
-0.008306419476866722
] |
seen\tanywhere\tin\tthe\tworld.\tBecause\tblacks\tdevelop\thypertension\tearlier\tin\tlife\tand\tmaintain\thigher\nblood\tpressure\tlevels,\ttheir\trisk\tof\tfatal\tstroke,\theart\tdisease,\tor\tend-stage\tkidney\tdisease\tis\thigher\nthan\twhites\t(\nBenjamin\tet\tal,\t2018\n).\nA\tperson\tof\tany\n\tage\tcan\thave\thypertension.\tApproximately\t12.9%\tof\tboys\tand\t6.5%\tof\tgirls\thave
|
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] |
elevated\tblood\tpressure\t(\nMa\tet\tal,\t2016\n;\t\nXi\tet\tal,\t2016\n).\tWith\taging,\tthe\tprevalence\tof\thigh\tblood\npressure\tincreases\t(\nFig.\t32.7\n).\tBefore\tthe\tage\tof\t45\tmore\tmen\tthan\twomen\thave\thigh\tblood\npressure,\tand\tafter\tage\t65\tthe\trates\tof\thigh\tblood\tpressure\tamong\twomen\tin\teach\tracial\tgroup\nsurpass\tthose\tof\tthe\tmen\tin\ttheir\tgroup\n\t(\nGo\tet\tal,\t2014
|
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] |
surpass\tthose\tof\tthe\tmen\tin\ttheir\tgroup\n\t(\nGo\tet\tal,\t2014\n).\tBecause\tthe\tprevalence\tof\thypertension\nrises\twith\tincreasing\tage,\tmore\tthan\thalf\tthe\tolder\tadult\tpopulation\t(more\tthan\t65\tyears\tof\tage)\tin\nany\tracial\tgroup\thas\thypertension.\tAlthough\tlifestyle\tinterventions\ttargeted\tto\tolder\tpersons\tmay
|
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] |
reduce\tthe\tprevalence\tof\thypertension,\tearly\tintervention\tprograms\tprovide\tthe\tgreatest\tlong-term\npotential\tfor\treducing\toverall\tblood\tpressure-related\n\tcomplications\t(\nWhelton\tet\tal,\t2018\n).\nFIG.\t32.7\nAge-specific\tand\tage-adjusted\tprevalence\tof\thypertension\tin\tadults:\tUnited\tStates,\t2005\tto\n2006.\n\tSource:\t(Ostchega\tY,\tet\tal:
|
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] |
2006.\n\tSource:\t(Ostchega\tY,\tet\tal:\t\nHypertension\tawareness,\ttreatment,\tand\tcontrol—continued\tdisparities\tin\tadults:\tUnited\tStates,\n2005-2006.\n\tNCHS\tdata\tbrief\tno.\t3,\tHyattsville,\tMd,\t2008,\tNational\tCenter\tfor\tHealth\tStatistics.)\nThe\trelationship\tbetween\tblood\tpressure\tand\trisk\tof\tCVD\tevents\tis\n\tcontinuous\tand\tindependent\tof
|
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] |
continuous\tand\tindependent\tof\nother\trisk\tfactors.\tThe\thigher\tthe\tblood\tpressure,\tthe\tgreater\tis\tthe\tchance\tof\ttarget\torgan\tdamage,\nincluding\tleft\tventricular\thypertrophy\t(LVH),\tHF,\tstroke,\tchronic\tkidney\tdisease,\tand\tretinopathy\n(\nBenjamin\tet\tal,\t2018\n).\tAs\tmany\tas\t13%\tof\tadults\twith\thypertension\thave\ttreatment-resistant
|
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] |
hypertension,\twhich\tmeans\tthat\ttheir\tblood\tpressure\tremains\thigh\tdespite\tthe\n\tuse\tof\tthree\tor\tmore\nantihypertensive\tdrugs\tfrom\tdifferent\tclasses\t(\nWhelton\tet\tal,\t2018\n).\tTreatment-resistant\nhypertension\tputs\tan\tindividual\tat\tgreater\trisk\tof\ttarget\torgan\tdamage.\tOlder\tage\tand\tobesity\tare
|
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two\tof\tthe\tstrongest\trisk\tfactors\tassociated\twith\tthe\tcondition.\tIdentification\tand\treversal\tof\tlifestyle\nfactors\tcontributing\tto\ttreatment\tresistance,\talong\twith\tdiagnosis\tand\tappropriate\n\ttreatment\tof
|
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0.07162737101316452,
0.08475290238857269,
0.0294335950165987
] |
secondary\tcauses\tand\tuse\tof\teffective\tmultidrug\tregimens,\tare\tessential\ttreatment\tstrategies.\nThe\tprevalence\tof\thypertension\tamong\tadults\twith\tdiabetes\tis\t80%\tand\thypertension\tis\tat\tleast\ntwice\tas\tcommon\tamong\tpersons\twith\ttype\t2\tdiabetes\tas\tpersons\tof\tthe\tsame\tage\twithout\tdiabetes\n(\nWhelton\tet\tal,\t2018
|
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] |
(\nWhelton\tet\tal,\t2018\n).\tAdults\twith\tdiabetes\thave\tCVD\tdeath\trates\ttwo\tto\tfour\ttimes\thigher\tthan\nadults\n\twithout\tdiabetes\t(\nBenjamin\tet\tal,\t2018\n).\tConsequently,\tnational\thealth\torganizations,\nincluding\tthe\tACC/AHA,\thave\tset\tthe\ttarget\tblood\tpressure\tgoal\tfor\tantihypertensive\ttherapy\tfor
|
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individuals\twith\tdiabetes\tlower\tthan\tthat\trecommended\tfor\tthe\tgeneral\tpopulation,\twhich\tis\t140/90\nmm\tHg\t(\nWhelton\tet\tal,\t2018\n).\tIn\tadults\twith\tdiabetes\tand\thypertension,\tthe\tACC/AHA\trecommends\nantihypertensive\tdrug\n\ttreatment\tto\tbe\tinitiated\tat\ta\tblood\tpressure\tof\t130/80\tmm\tHg\tor\thigher\twith
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a\ttreatment\tgoal\tof\tless\tthan\t130/80\tmm\tHg.\tBlood\tpressure\tcontrol\tis\toften\tmore\tdifficult\tto\tachieve\nin\tpatients\twith\tdiabetes\tthan\tin\tthose\twithout\tdiabetes,\tnecessitating\tuse\tof\ta\tcombination\tof\tblood\npressure–lowering\tmedications\tin\tthe\tmajority\tof\tpatients\t(\nWhelton\tet\tal,\t2018\n).\nAlthough\thypertensive\tpatients\tare
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] |
Whelton\tet\tal,\t2018\n).\nAlthough\thypertensive\tpatients\tare\n\toften\tasymptomatic,\thypertension\tis\tnot\ta\tbenign\tdisease.\nCardiac,\tcerebrovascular,\tand\trenal\tsystems\tare\taffected\tby\tchronically\televated\tblood\tpressure\n(\nTable\t32.2\n).\tHigh\tblood\tpressure\twas\tthe\tprimary\tor\ta\tcontributory\tcause\tin\t427,631\tof\tthe\t2.7\nmillion\tU.S.\tdeaths\tin\t2009\t(
|
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] |
million\tU.S.\tdeaths\tin\t2009\t(\nBenjamin\tet\tal,\t2018\n).\tBetween\t2005\tand\t2015\tthe\tage-adjusted\tdeath\nrate\tfrom\thypertension\tincreased\tby\t10.5%;\toverall\n\tdeaths\tfrom\thypertension\tincreased\tby\t37.5%.\nDeath\trates\tfrom\thypertension\tare\tapproximately\tthree\ttimes\thigher\tin\tblacks\tthan\tin\twhites\n(\nBenjamin\tet\tal,\t2018
|
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0.010970629751682281
] |
(\nBenjamin\tet\tal,\t2018\n).\tHypertension\tis\ta\tmajor\tcontributing\tfactor\tto\tatherosclerosis,\tstroke,\trenal\nfailure,\tand\tMI.\tFactors\tassociated\twith\ta\tpoor\tprognosis\tin\thypertension\tare\tshown\tin\t\nBox\t32.6\n.\nTABLE\t32.2\nManifestations\tof\tTarget\tOrgan\tDisease\tfrom\tHypertension\nOrgan\tSystem\nManifestations\nCardiac
|
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] |
Organ\tSystem\nManifestations\nCardiac\nClinical,\telectrocardiographic,\tor\tradiologic\tevidence\tof\tarterial\twall\tthickening\tleft\nventricular\thypertrophy;\tleft\tventricular\tmalfunction\tor\tcardiac\tfailure\nCerebrovascular\nTransient\tischemic\tattack\tor\tstroke\nPeripheral\nAbsence\tof\tone\tor\tmore\tpulses\tin\textremities\t(except\tfor\tdorsalis\tpedis)\tAnkle-Brachial
|
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0.0940159410238266,
0.04210042953491211,
-0.05765252560377121,
-0.01686839386820793,
0.07413221895694733,
-0.006537931505590677,
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-0.045723188668489456,
0.054118916392326355,
0.0936884731054306,
0.057728562504053116,
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0.023023955523967743,
0.06020157411694527,
0.08218502253293991,
0.0657668262720108,
-0.01934794709086418
] |
Index\t<0.9\nRenal\nSerum\tcreatinine\televated:\n\tmen\t1.3-1.5\tmg/dL,\twomen\t1.2-1.4\tmg/dL\nCalculated\tGFR\t<60\tmL/min/1.73\tm\n2\nElevated\talbumin\texcretion\nRetinopathy\nHemorrhages\tor\texudates,\twith\tor\twithout\tpapilledema\nGFR\n,\tGlomerular\tfiltration\trate.\nAdapted\tfrom\tSchmieder\tR:\tEnd\torgan\tdamage\tin\thypertension,\t\nDtsch\tArztebl\n\t107:866,\t2010.\nBOX\t32.6
|
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0.019917896017432213
] |
Dtsch\tArztebl\n\t107:866,\t2010.\nBOX\t32.6\nRisk\tFactors\tand\tAdverse\tPrognosis\tin\tHypertension\nRisk\tfactors\nBlack\trace\nYouth\nMale\tgender\nPersistent\tdiastolic\tpressure\t>115\tmm\tHg\nSmoking\nDiabetes\tmellitus\nHypercholesterolemia\nObesity\nExcessive\talcohol\tintake\nEvidence\tof\tend\torgan\tdamage\nCardiac\nCardiac\tenlargement
|
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] |
Evidence\tof\tend\torgan\tdamage\nCardiac\nCardiac\tenlargement\nElectrocardiographic\tsigns\tof\tischemia\tor\tleft\tventricular\tstrain\nMyocardial\tinfarction\nHeart\tfailure\nEyes\nRetinal\texudates\tand\themorrhages\nPapilledema\nRenal\nImpaired\trenal\tfunction
|
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] |
Nervous\tsystem\nCerebrovascular\taccident\nFrom\tFisher\tND,\tWilliams\tGH:\tHypertensive\tvascular\tdisease.\tIn\tKasper\tDL,\tet\tal,\teditors:\t\nHarrison’s\nprinciples\tof\tinternal\tmedicine,\n\ted\t16,\tNew\tYork,\t2005,\tMcGraw-Hill.\nPathophysiology\nBlood\tpressure\n\tis\ta\tfunction\tof\tcardiac\toutput\tmultiplied\tby\tperipheral\tresistance\t(the\tresistance\tin
|
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] |
the\tblood\tvessels\tto\tthe\tflow\tof\tblood).\tThus\n\tthe\tdiameter\tof\tthe\tblood\tvessel\tmarkedly\taffects\tblood\nflow.\tWhen\tthe\tdiameter\tis\tdecreased\t(as\tin\tatherosclerosis)\tresistance\tand\tblood\tpressure\tincrease.\nConversely,\twhen\tthe\tdiameter\tis\tincreased\t(as\twith\tvasodilator\tdrug\ttherapy),\tresistance\tdecreases\nand\tblood\tpressure\tis\tlowered.
|
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] |
and\tblood\tpressure\tis\tlowered.\nMany\tsystems\tmaintain\thomeostatic\tcontrol\tof\tblood\tpressure.\tThe\tmajor\tregulators\tare\tthe\tSNS\nfor\tshort-term\n\tcontrol\tand\tthe\tkidney\tfor\tlong-term\tcontrol.\tIn\tresponse\tto\ta\tfall\tin\tblood\tpressure,\nthe\tSNS\tsecretes\tnorepinephrine,\ta\tvasoconstrictor,\twhich\tacts\ton\tsmall\tarteries\tand\tarterioles\tto
|
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] |
increase\tperipheral\tresistance\tand\traise\tblood\tpressure.\tConditions\tthat\tresult\tin\toverstimulation\tof\nthe\tSNS\t(i.e.,\tcertain\tadrenal\tdisorders\tor\tsleep\tapnea)\tresult\tin\tincreased\tblood\tpressure.\tThe\nkidney\tregulates\n\tblood\tpressure\tby\tcontrolling\tthe\textracellular\tfluid\tvolume\tand\tsecreting\trenin,\nwhich\tactivates\tthe
|
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] |
which\tactivates\tthe\t\nrenin-angiotensin\tsystem\t(RAS)\n\t(\nFig.\t32.8\n).\tAbnormal\tblood\tpressure\tis\nusually\tmultifactorial.\tIn\tmost\tcases\tof\thypertension,\tperipheral\tresistance\tincreases.\tThis\tresistance\nforces\tthe\tleft\tventricle\tof\tthe\theart\tto\tincrease\tits\teffort\tin\tpumping\tblood\tthrough\tthe\tsystem.\tWith\ntime,\tLVH\tand\teventually\n\tHF\tcan\tdevelop.
|
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] |
time,\tLVH\tand\teventually\n\tHF\tcan\tdevelop.\nFIG.\t32.8\nRenin-angiotensin\tcascade.\nACE,\n\tAngiotensin-converting\tenzyme.\n\tSource:\t(Reprinted\twith\tpermission\tfrom\nFox\tSI:\t\nHuman\tphysiology\n,\ted\t6,\tNew\tYork,\t1999,\tMcGraw-Hill.)\nCommon\tgenetic\tvariants\tof\tthe\tRAS\tgene,\tincluding\tangiotensin-converting\tenzyme\t(ACE)\tand
|
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] |
angiotensinogen,\thave\tshown\trelationships\twith\thypertension\t(\nHeidari\tet\tal,\t2017\n).\tAn\tincreased\nproduction\tof\tthese\tproteins\tmay\n\tincrease\tproduction\tof\tangiotensin\tII,\tthe\tprimary\tmediator\tof\tthe\nRAS,\tthus\tincreasing\tblood\tpressure.\tAngiotensin\tII\tmay\talso\ttrigger\tlow-grade\tinflammation\twithin
|
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] |
the\tblood\tvessel\twall,\ta\tcondition\tthat\tpredisposes\tto\thypertension\t(\nMcMaster\tet\tal,\t2015\n).\nHypertension\toften\toccurs\twith\tother\trisk\tfactors\tfor\tCVD,\tincluding\tvisceral\t(intraabdominal)\nobesity,\tinsulin\tresistance,\thigh\ttriglycerides,\n\tand\tlow\tHDL\tcholesterol\tlevels.\tThe\tcoexistence\tof
|
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] |
and\tlow\tHDL\tcholesterol\tlevels.\tThe\tcoexistence\tof\nthree\tor\tmore\tof\tthese\trisk\tfactors\tleads\tto\tmetabolic\tsyndrome.\tIt\tis\tunclear\twhether\tone\tor\tmore\tof\nthese\trisk\tfactors\tprecede\tthe\tothers\tor\twhether\tthey\toccur\tsimultaneously.\tAccumulation\tof\tvisceral
|
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fat\tsynthesizes\tincreased\tamounts\tof\tangiotensinogen,\twhich\tactivates\tthe\tRAS\tand\tincreases\tblood\npressure\t(\nZhou\tet\tal,\t2012\n).\tAlso,\tangiotensin\n\tII,\tthe\tprimary\tmediator\tof\tthe\tRAS,\tpromotes\tthe\ndevelopment\tof\tlarge\tdysfunctional\tadipocytes,\twhich\tproduce\tincreased\tamounts\tof\tleptin\tand
|
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] |
reduced\tquantities\tof\tadiponectin.\tHigher\tlevels\tof\tleptin\tand\tlower\tamounts\tof\tcirculating\nadiponectin\tactivate\tthe\tSNS,\ta\tkey\tcomponent\tof\tthe\thypertensive\tresponse\t(\nDeMarco\tet\tal,\t2014\n).
|
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] |
Primary\tprevention\nPositive\tchanges\tin\thypertension\tawareness,\n\ttreatment,\tand\tcontrol\thave\toccurred\tduring\tthe\tlast\nseveral\tyears.\tBased\ton\tanalysis\tof\tNational\tHealth\tand\tNutrition\tExamination\tSurvey\t(NHANES)\ndata\tfrom\t2011\tto\t2014,\t84.1%\tof\tpeople\twith\thypertension\tare\taware\tthat\tthey\thave\tit\t(\nBenjamin\tet\nal,\t2018
|
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] |
Benjamin\tet\nal,\t2018\n),\tup\tfrom\t81%\tin\t2007\tto\t2010.\tAlthough\tcurrent\thypertension\ttreatment\tand\tcontrol\trates\nhave\tincreased\tfrom\t48.4%\tto\t53.3%,\tduring\tthis\tsame\n\ttime\tperiod,\tadditional\tefforts\tare\tneeded\tto\nmeet\tthe\t\nHealthy\tPeople\t2020\n\tobjective\tof\t61.2%.\tIn\t2015\twomen,\tyounger\tadults\t(aged\t18\tto\t39
|
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] |
objective\tof\t61.2%.\tIn\t2015\twomen,\tyounger\tadults\t(aged\t18\tto\t39\nyears),\tand\tHispanic\tindividuals\thad\tlower\trates\tof\tblood\tpressure\tcontrol\tcompared\twith\tmen,\nyounger\tindividuals,\tand\tnon-Hispanic\twhites.\tImproving\thypertension\ttreatment\tthrough\ttargeted\nintervention\tprograms\tshould\thave\ta\tpositive\teffect\ton\tCVD\toutcomes.
|
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] |
intervention\tprograms\tshould\thave\ta\tpositive\teffect\ton\tCVD\toutcomes.\n\tBlood\tpressure\ttreatment\nguidelines\thighlight\tthe\timportance\tof\tevaluating\tpatients\tfor\tthe\tpresence\tof\tmultiple\tCVD\trisk\nfactors\tand\tindividualizing\tlifestyle\tmodification\tand\tdrug\ttherapies\taccordingly.
|
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Changing\tlifestyle\tfactors\thave\tdocumented\tefficacy\tin\tthe\tprimary\tprevention\tand\tcontrol\tof\nhypertension.\tThese\tfactors\twere\tsystematically\treviewed\tand\tcategorized\tby\tthe\tAcademy\tof\nNutrition\n\tand\tDietetics\t(AND)\tin\t2015\t(\nLennon\tet\tal,\t2017\n)\tand\tmore\trecently\tby\tthe\tACC\tand\tAHA\nin\t2018\t(\nWhelton\tet\tal,\t2018
|
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] |
)\tand\tmore\trecently\tby\tthe\tACC\tand\tAHA\nin\t2018\t(\nWhelton\tet\tal,\t2018\n).\tThese\tguidelines\tmade\ta\tstrong\trecommendation\t(i.e.,\thigh\nbenefit/risk\tratio\twith\tsupporting\tevidence)\tfor\treducing\tintake\tof\tdietary\tsodium\tin\tadults\twith\nelevated\tblood\tpressure\tand\thypertension\tand\tfor\tweight\tloss\tin\tadults\twith\televated\tblood\tpressure
|
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recommended\tas\tthe\tmost\tefficacious\tapproach\tto\tsubstantially\tlowering\tblood\tpressure\tin\tadults\tat\nhigh\tCVD\trisk.\tAdditional\tstrong\trecommendations\n\tfrom\tboth\tthe\tACC/AHA\tand\tthe\tAND\twere\tmade\nfor\tincreasing\tphysical\tactivity\twith\ta\tstructured\texercise\tprogram\tand\tfor\tmoderating\talcohol
|
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consumption,\tparticularly\tamong\theavy\tdrinkers.\tThe\tACC/AHA\talso\tincluded\ta\tstrong\nrecommendation\tfor\tsupplementation\twith\tpotassium\tto\tlower\tblood\tpressure.\tIncreased\tpotassium\nintake\tshould\tpreferably\tbe\tin\tthe\tform\tof\tdiet\tmodification\tand\tmay\tbe\tcontraindicated\n\tfor\tsome
|
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] |
for\tsome\npatients\twith\tCKD.\tA\tsummary\tof\trecommendations\tand\tratings\tfrom\tthe\tACC/AHA\tand\tthe\tAND\tcan\nbe\tfound\tin\t\nTable\t32.3\n.\nTABLE\t32.3\nRecommendations\ton\tBlood\tPressure\tin\tHypertensive\tAdults\tfrom\tEvidence\tAnalysis\tLibrary\t(2015)\tand\nAmerican\tCollege\tof\tCardiology/American\tHeart\tAssociation\t(2018)\nFood\tor\nNutrient\nEAL\tRecommendation\nRating
|
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-0.041898101568222046,
-0.05037643387913704,
0.1041768416762352,
0.06449774652719498,
-0.0584595762193203,
-0.09047244489192963,
0.059217024594545364,
-0.0036209227982908487,
-0.04899466410279274,
0.005054353270679712,
0.024553745985031128,
0.014569711871445179,
-0.016524964943528175,
-0.04038608446717262,
0.06367569416761398,
0.1102522611618042,
-0.017789602279663086,
0.015578658320009708,
-0.0017279349267482758,
0.07990576326847076,
0.003848173888400197,
0.053687285631895065,
0.019796816632151604
] |
Food\tor\nNutrient\nEAL\tRecommendation\nRating\nACC/AHA\tRecommendation\nRating\nSodium\nThe\tRDN\tshould\tcounsel\non\treducing\tsodium\nintake\tfor\tblood\npressure\treduction\tin\nadults\twith\tHTN.\nLowering\n\tdietary\nsodium\tintake\tto\n1500-2000\tmg/day\nreduced\tSBP\tand\tDBP\nup\tto\t12\tand\t6\tmm\nHg,\trespectively.\nStrong\nLower\tsodium\tintake\nConsume\tno\tmore\tthan\t2400
|
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] |
Strong\nLower\tsodium\tintake\nConsume\tno\tmore\tthan\t2400\nmg\tof\tsodium/day;\tfurther\nreduction\tof\tsodium\tto\t1500\nmg/day\tis\tdesirable\tbecause\nit\tis\tassociated\twith\teven\ngreater\treduction\tin\tblood\npressure;\treduce\tintake\tby\tat\nleast\t1000\tmg/day\tbecause\nthat\twill\tlower\tblood\npressure,\teven\tif\tthe\tdesired\ndaily\n\tsodium\tintake\tis\tnot\nachieved.\nStrong
|
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] |
daily\n\tsodium\tintake\tis\tnot\nachieved.\nStrong\nModerate\nDietary\npatterns\nemphasizing\nfruits\tand\nvegetables\nThe\tRDN\tshould\tcounsel\non\ta\tDASH\tdietary\npattern\tplus\treduced\nsodium\tintake\tfor\nblood\tpressure\nreduction.\nConsensus\nConsume\ta\tdietary\tpattern\tthat\nemphasizes\tintake\tof\tvegetables,\nfruits,\tand\twhole\tgrains;\nincludes\tlow-fat\tdairy\tproducts,
|
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] |
fruits,\tand\twhole\tgrains;\nincludes\tlow-fat\tdairy\tproducts,\npoultry,\tfish,\tlegumes,\nnontropical\tvegetable\toils\tand\nnuts;\tand\tlimits\tintake\tof\tsweets,\nsugar-sweetened\tbeverages,\tand\nred\tmeat;\tadapt\tthe\tpattern\tto\nappropriate\tcalorie\nrequirements;\tachieve\tthis\npattern\tby\tfollowing\tplans\tsuch\nas\tDASH,\tUSDA\tfood\tpattern,\tor\nthe\tAHA\tDiet;\tcombine\tthe
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as\tDASH,\tUSDA\tfood\tpattern,\tor\nthe\tAHA\tDiet;\tcombine\tthe\nDASH\tdietary\tpattern\twith\tlower\nsodium\tintake.\nStrong\nFruits\tand\nvegetables\nFruits\tand\tvegetables\nshould\tbe\nrecommended\tat\ta\nlevel\tof\t5\tto\t10\nservings\tper\tday\tfor\nsignificant\tblood\npressure\treduction.\nStrong\nNot\nevaluated\nWeight\nmanagement\nOptimal\tbody\tweight\nshould\tbe\tachieved\nStrong
|
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] |
Weight\nmanagement\nOptimal\tbody\tweight\nshould\tbe\tachieved\nStrong\nCounsel\toverweight\tand\tobese\nadults\twith\thigh\tblood\tpressure\nStrong
|
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] |
and\tmaintained\t(BMI\n18.5-24.9)\tto\treduce\nblood\tpressure.\nthat\tlifestyle\tchanges\tthat\nproduce\teven\tmodest,\tsustained\nweight\tloss\tof\t3%\tto\t5%\tproduce\nclinically\tmeaningful\tbenefits\n(e.g.,\treduce\tTG,\tblood\tsugar,\n\tHb\nA1C);\t>5%\twill\treduce\tblood\npressure\tand\treduce\tthe\tneed\nfor\tmedications\tto\tcontrol\tblood\npressure.\n*\nPhysical\nactivity
|
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for\tmedications\tto\tcontrol\tblood\npressure.\n*\nPhysical\nactivity\nIndividuals\tshould\tbe\nencouraged\tto\tengage\nin\taerobic\tphysical\nactivity\tfor\tat\tleast\t30\nminutes\tper\tday\ton\nmost\tdays\tof\tthe\nweek,\tbecause\tit\nreduces\tSBP.\nConsensus\nAdvise\tadults\tto\tengage\tin\taerobic\nphysical\tactivity\tto\tlower\tblood\npressure:\tthree\tto\tfour\tsessions
|
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0.06447768211364746,
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0.012236581183969975,
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0.14488551020622253,
0.0067280493676662445,
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0.003682393115013838,
0.10557009279727936,
0.06394809484481812,
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0.08188598603010178,
0.048375215381383896,
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0.03536583110690117,
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0.09974246472120285,
0.049287889152765274,
0.033970173448324203,
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0.018790967762470245,
0.07806365191936493,
0.07507377862930298,
0.03383234143257141,
-0.048811156302690506
] |
physical\tactivity\tto\tlower\tblood\npressure:\tthree\tto\tfour\tsessions\na\tweek,\tlasting\ton\taverage\t40\nminutes\tper\tsession,\tand\ninvolving\tmoderate-to-vigorous-\nintensity\tphysical\tactivity.\nModerate\nAlcohol\nFor\tindividuals\twho\tcan\nsafely\tconsume\nalcohol,\tconsumption\nshould\tbe\tlimited\tto\nno\tmore\tthan\ttwo\ndrinks\t(24\toz\tbeer,\t10\noz\twine,\tor\t3\toz\tof\t80-
|
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0.01901201903820038,
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0.010014128871262074,
0.05679714307188988,
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0.01253077108412981,
0.10035374015569687,
0.0074984049424529076,
0.0524003691971302,
0.05249273404479027,
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0.004603537265211344,
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0.045162640511989594,
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0.09012595564126968,
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0.04891691356897354,
0.054027482867240906,
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0.07433205842971802,
0.018433373421430588,
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0.06508517265319824,
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0.024703461676836014,
0.07086073607206345,
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0.004171967972069979,
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0.016122886911034584,
0.07081297785043716,
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0.008962619118392467,
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0.056495800614356995,
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0.10964837670326233,
0.015309484675526619,
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0.07599977403879166,
0.09289784729480743,
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0.053532447665929794,
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0.09958913177251816,
0.014519644901156425,
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0.06862025707960129,
0.019336793571710587,
0.03353869169950485,
0.003932570107281208,
0.009880557656288147,
0.11118894815444946,
0.061111271381378174,
0.046226341277360916,
-0.023806754499673843
] |
no\tmore\tthan\ttwo\ndrinks\t(24\toz\tbeer,\t10\noz\twine,\tor\t3\toz\tof\t80-\nproof\tliquor)\tper\tday\nin\tmost\tmen\tand\tto\tno\nmore\tthan\tone\tdrink\nper\tday\tin\twomen.\nConsensus\nNot\nevaluated\nPotassium\nStudies\tsupport\ta\nmodest\trelationship\nbetween\tincreasing\nintake\tof\tpotassium\nand\ta\tlower\tsodium-\npotassium\tratio\twith\nlowered\tblood\npressure.\nFair\nInsufficient\tevidence
|
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lowered\tblood\npressure.\nFair\nInsufficient\tevidence\nLow\nCalcium\nThe\teffect\tof\tincreasing\ncalcium\tintake\twith\nlowered\tblood\npressure\tis\tunclear;\nalthough\tsome\nresearch\tindicates\nminimal\tbenefit.\nFair\nNot\nevaluated\nMagnesium\nThe\teffect\tof\tincreasing\nmagnesium\tintake\nwith\tlowered\n\tblood\npressure\tis\tunknown;\nalthough\tsome\nresearch\tindicates
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blood\npressure\tis\tunknown;\nalthough\tsome\nresearch\tindicates\nminimal\tbenefit.\nFair\nNot\nevaluated\nOmega-3\tfatty\nacids\nStudies\tinvestigating\nincreased\nconsumption\tof\nomega-3\tfatty\tacids\nhave\tnot\ndemonstrated\ta\nbeneficial\teffect\ton\nblood\tpressure.\nFair\nNot\nevaluated\nACC\n,\tAmerican\tCollege\tof\tCardiology;\t\nAHA\n,\tAmerican\tHeart\tAssociation;\t\nBMI
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AHA\n,\tAmerican\tHeart\tAssociation;\t\nBMI\n,\tbody\tmass\tindex;\t\nDASH\n,\tDietary\tApproaches\tto\tStop\n\tHypertension;\nDBP\n,\tdiastolic\tblood\tpressure;\t\nHb\tA1C\n,\themoglobin\tA1C;\t\nHTN\n,\thypertension;\t\nRDN\n,\tregistered\tdietitian\tnutritionist;\t\nSBP\n,\tsystolic\tblood\tpressure;\nTG\n,\ttriglyceride;\t\nUSDA\n,\tU.S.\tDepartment\tof\tAgriculture.
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] |
TG\n,\ttriglyceride;\t\nUSDA\n,\tU.S.\tDepartment\tof\tAgriculture.\nRecommendations\tlisted\tare\tfor\tthose\trated\tby\tthe\tAcademy\tof\tNutrition\tand\tDietetics\tand\tthe\tAmerican\tAcademy\tof\tCardiology\t(ACC)/American\nHeart\tAssociation\t(AHA)\tas\tstrong,\tfair/moderate,\n\tand\tconsensus;\tfor\tthose\twith\tweak\tratings\tconsult\tthe\tAmerican\tDietetic\tAssociation\tEvidence
|
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] |
Analysis\tLibrary\tfor\tHypertension\t(2009)\t\nhttp://www.adaevidencelibrary.com/topic.cfm?cat=3259\n\tor\tthe\tACC/AHA\tdata\tsupplement\tat\nhttp://circ.ahajournals.org/lookup/suppl/doi:10.1161/01.cir.0000437740.48606.d1/-DC1\n*\nWeight\tmanagement\tguidelines\tare\tfrom\tJensen\tMD,\tet\tal:\t2013\tAHA/ACC/TOS\tguideline\tfor
|
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-0.07368047535419464,
-0.043357208371162415,
0.08655995875597,
0.013112637214362621,
-0.017109127715229988,
0.10384593904018402,
-0.056603457778692245,
-0.08034097403287888,
0.027598470449447632,
0.054461508989334106,
-0.007391844876110554,
0.018226366490125656,
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0.04085935279726982,
-0.04743005335330963,
0.07724224030971527,
0.0009043673635460436,
0.021294761449098587,
0.06324607878923416,
-0.04180730879306793,
-0.029348639771342278,
-0.02325385808944702,
0.015125597827136517,
0.07306090742349625,
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0.00740562891587615,
0.16850093007087708,
0.022295448929071426,
-0.014203573577105999,
0.0028461909387260675,
0.13242024183273315,
0.0941561758518219,
-0.06286893039941788,
-0.023115018382668495,
0.10515058040618896,
0.011927441693842411,
-0.0640420988202095,
-0.011560333892703056,
0.06265266239643097,
-0.03529762849211693,
-0.001584207871928811,
-0.04842984676361084,
0.04364258795976639,
0.09487208724021912,
0.07850459218025208,
-0.02003921940922737,
0.025404302403330803,
0.10536520183086395,
0.053187981247901917,
0.06358551979064941,
-0.005504915490746498
] |
with\tanother\thave\tgenerally\tshown\tno\tor\tonly\ta\tsmall\teffect\ton\tblood\n\tpressure\t(\nAl-Khudairy\tet\tal,\n2015\n;\t\nMaki\tet\tal,\t2018\n).\tSupplementation\twith\tn-3\tPUFAs\t(EPA\t+\tDHA)\tin\tdoses\thigher\tthan\t2\tg/day\nshowed\tmodest\treductions\tin\tSBP\tand\tDBP,\tespecially\tin\tuntreated\thypertensive\tadults\t(\nMiller\tet\tal,\n2014\n).
|
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0.04569492116570473,
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0.06484352797269821,
0.03175762668251991,
0.04770922660827637,
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] |
Protein\nEvidence\tfrom\tobservational\tstudies\tand\tRCTs\tsuggests\treplacement\tof\tprotein\tfor\tfat\tor\ncarbohydrate\tin\tan\tisocaloric\tdiet\tresults\tin\tlowered\tblood\tpressure\n\t(\nBazzano\tet\tal,\t2013\n).\tProtein\nsupplementation\tin\tdoses\tof\t60\tg/day\treduced\tSBP\tby\t4.9\tmm\tHg\tand\tDBP\tby\t2.7\tmm\tHg\tcompared
|
[
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] |
with\t60\tg/day\tof\tcarbohydrate\tin\toverweight\tindividuals\twith\televated\tblood\tpressure\tand\tuntreated\nstage\t1\thypertension\t(\nTeunissen-Beekman\tand\tvan\tBaak,\t2013\n).\nDietary\tpatterns\temphasizing\tfruits\tand\tvegetables\nSeveral\tdietary\tpatterns\thave\tbeen\tshown\tto\tlower\tblood\tpressure.\n\tPlant-based\tdietary\tpatterns\thave
|
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] |
Plant-based\tdietary\tpatterns\thave\nbeen\tassociated\twith\tlower\tSBP\tin\tobservational\tstudies\tand\tclinical\ttrials\t(\nAlexander\tet\tal,\t2017\n).\nAverage\tSBP\treductions\tof\t5\tto\t6\tmm\tHg\thave\tbeen\treported.\tSpecifically,\tthe\t\nDietary\tApproaches\nto\tStop\tHypertension\t(DASH)\n\tcontrolled\tfeeding\tstudy\tshowed\tthat\ta\tdietary\tpattern\temphasizing
|
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] |
controlled\tfeeding\tstudy\tshowed\tthat\ta\tdietary\tpattern\temphasizing\nfruits,\tvegetables,\tlow-fat\tdairy\tproducts,\twhole\tgrains,\tlean\tmeats,\n\tand\tnuts\tsignificantly\tdecreased\nSBP\tin\thypertensive\tand\tnormotensive\tadults.\tThe\tDASH\tdiet\t(see\t\nAppendix\t17\n)\twas\tfound\tto\tbe
|
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] |
Appendix\t17\n)\twas\tfound\tto\tbe\nmore\teffective\tthan\tjust\tadding\tfruits\tand\tvegetables\tto\ta\tlow-fat\tdietary\tpattern\tand\twas\tequally\neffective\tin\tmen\tand\twomen\tof\tdiverse\tracial\tand\tethnic\tbackgrounds\t(\nAppel\tet\tal,\t2006\n).\tThis\ndietary\tpattern\tserves\tas\tthe\tcore\tfor\tthe\tACC/AHA\tdietary\trecommendations\tfor\n\tlowering\tblood\npressure\t(
|
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] |
lowering\tblood\npressure\t(\nWhelton\tet\tal,\t2018\n).\tAlthough\tthe\tDASH\tdiet\tis\tsafe\tand\tcurrently\tadvocated\tfor\npreventing\tand\ttreating\thypertension,\tthe\tdiet\tis\thigh\tin\tpotassium,\tphosphorus,\tand\tprotein,\ndepending\ton\thow\tit\tis\tplanned.\tFor\tthis\treason\tthe\tDASH\tdiet\tmay\tnot\tbe\tadvisable\tfor\tindividuals
|
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with\tend-stage\trenal\tdisease\twith\thigh-normal\tor\televated\tserum\tpotassium\tand\tphosphorus\tlevels\n(\nTyson\tet\tal,\t2012\n).\nSeveral\tversions\tof\tthe\tDASH\tdiet\thave\tbeen\texamined\tin\tregard\tto\tblood\tpressure–lowering\npotential.\tThe\tOmniHeart\ttrial\tcompared\tthe\toriginal\tDASH\tdiet\tto\ta\thigh-protein\tversion\tof\tthe
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] |
DASH\tdiet\t(25%\tof\tenergy\tfrom\tprotein,\tapproximately\thalf\tfrom\tplant\tsources),\tand\ta\tDASH\tdiet\nhigh\tin\tunsaturated\tfat\t(31%\tof\tcalories\tfrom\tunsaturated\tfat,\tmostly\tmonounsaturated).\tAlthough\neach\tdiet\tlowered\n\tSBP,\tsubstituting\tsome\tof\tthe\tcarbohydrate\t(approximately\t10%\tof\ttotal\tcalories)
|
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] |
in\tthe\tDASH\tdiet\twith\teither\tprotein\tor\tmonounsaturated\tfat\tachieved\tthe\tbest\treduction\tin\tblood\npressure\tand\tblood\tcholesterol\t(\nMiller\tet\tal,\t2006\n).\tThis\tcould\tbe\tachieved\tby\tsubstituting\tnuts\tfor\nsome\tof\tthe\tfruit,\tbread,\tor\tcereal\tservings.\nBecause\tmany\thypertensive\tpatients\tare\toverweight,\thypocaloric\tversions\n\tof\tthe\tDASH\tdiet\talso
|
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] |
of\tthe\tDASH\tdiet\talso\nhave\tbeen\ttested\tfor\tefficacy\tin\tpromoting\tweight\tloss\tand\tblood\tpressure\treduction.\tA\thypocaloric\nDASH\tdiet\tversus\ta\tlow-calorie,\tlow-fat\tdiet\tproduced\ta\tgreater\treduction\tin\tSBP\tand\tDBP.\tMore\nrecently,\tthe\tENCORE\tstudy\tshowed\tthat\tthe\taddition\tof\texercise\tand\tweight\tloss\tto\tthe\tDASH\tdiet
|
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] |
resulted\tin\tgreater\tblood\tpressure\treductions,\tgreater\timprovements\tin\tvascular\tfunction,\n\tand\nreduction\tin\tleft\tventricular\tmass\tcompared\twith\tthe\tDASH\tdiet\talone\t(\nLee\tet\tal,\t2018\n).\nThe\tMeD\tdietary\tpattern\thas\tmany\tsimilarities\tto\tthe\tDASH\tdiet\tbut\tis\tgenerally\thigher\tin\tfat,
|
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primarily\tMUFA\tfrom\tolive\toil,\tnuts,\tand\tseeds.\tA\ttraditional\tMeD\tdiet\talso\tcontains\tfatty\tfish\trich\tin\nomega-3\tfatty\tacids.\tA\tsystematic\treview\tof\tthe\tMeD\tdiet\tand\tCVD\trisk\tfactors,\tfound\tthat\talthough\nlimited,\n\tevidence\tfrom\tRCTs\twas\tsuggestive\tof\ta\tblood\tpressure–lowering\teffect\tof\tthis\tstyle\tdietary\npattern\tin\tadults\twith\thypertension\t(
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pattern\tin\tadults\twith\thypertension\t(\nRees\tet\tal,\t2013\n).\tAccording\tto\tthe\tACC/AHA,\tmore\tstudies\ton\ndiverse\tpopulations\tare\twarranted\tbefore\trecommendations\tcan\tbe\tmade\trelated\tto\tthe\tMeD\tdiet\tfor\nuse\tin\tblood\tpressure\tmanagement\t(\nWhelton\tet\tal,\t2018\n).\nWeight\treduction\nThere\tis\ta\tstrong\tassociation\tbetween
|
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] |
).\nWeight\treduction\nThere\tis\ta\tstrong\tassociation\tbetween\n\tBMI\tand\thypertension\tamong\tmen\tand\twomen\tin\tall\trace\tor\nethnic\tgroups\tand\tin\tmost\tage\tgroups.\tIt\tis\testimated\tthat\tat\tleast\t75%\tof\tthe\tincidence\tof\nhypertension\tis\trelated\tdirectly\tto\tobesity\t(\nBenjamin\tet\tal,\t2018\n).\tWeight\tgain\tduring\tadult\tlife\tis
|
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] |
Benjamin\tet\tal,\t2018\n).\tWeight\tgain\tduring\tadult\tlife\tis\nresponsible\tfor\tmuch\tof\tthe\trise\tin\tblood\tpressure\tseen\twith\taging.\nSome\tof\tthe\tphysiologic\tchanges\tproposed\tto\texplain\tthe\trelationship\tbetween\texcess\n\tbody\tfat\tand\nblood\tpressure\tare\toveractivation\tof\tthe\tSNS\tand\tRAS\tand\tvascular\tinflammation\t(\nHall\tet\tal,\t2015\n).
|
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] |
Hall\tet\tal,\t2015\n).\nVisceral\tfat\tin\tparticular\tpromotes\tvascular\tinflammation\tby\tinducing\tcytokine\trelease,\nproinflammatory\ttranscription\tfactors,\tand\tadhesion\tmolecules\t(\nHall\tet\tal,\t2015\n).\tLow-grade\ninflammation\toccurs\tin\tthe\tvasculature\tof\tindividuals\twith\televated\tblood\tpressure;\twhether\tit\nprecedes
|
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] |
precedes\n\tthe\tonset\tof\thypertension\tis\tunclear.\tWeight\tloss,\texercise,\tand\ta\tMeD-style\tdiet\tare\nbeneficial\t(see\t\nAppendix\t23\n).\nVirtually\tall\tclinical\ttrials\ton\tweight\treduction\tand\tblood\tpressure\tsupport\tthe\tefficacy\tof\tweight\nloss\ton\tlowering\tblood\tpressure.\tReductions\tin\tblood\tpressure\tcan\toccur\twithout\tattainment\tof
|
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desirable\tbody\tweight\tin\tmost\tparticipants.\tLarger\tblood\tpressure\treductions\tare\tachieved\n\tin\nparticipants\twho\tlost\tmore\tweight\tand\twere\talso\ttaking\tantihypertensive\tmedications.\tThis\tlatter\nfinding\tsuggests\ta\tpossible\tsynergistic\teffect\tbetween\tweight\tloss\tand\tdrug\ttherapy.\tAlthough\tweight
|
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reduction\tand\tmaintenance\tof\ta\thealthy\tbody\tweight\tis\ta\tmajor\teffort,\tinterventions\tto\tprevent\nweight\tgain\tare\tneeded\tbefore\tmidlife.\tIn\taddition,\tBMI\tis\trecommended\tas\ta\tscreening\ttool\tin\nadolescence\n\tfor\tfuture\thealth\trisk\t(\nFlynn\tet\tal,\t2017\n).\nSodium\nEvidence\tfrom\ta\tvariety\tof\tstudies\tsupports\tlowering\tblood\tpressure\tand\tCVD\trisk\tby\treducing
|
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] |
dietary\tsodium.\tFor\texample,\tin\tthe\tTrials\tof\tHypertension\tPrevention\tmore\tthan\t2400\tindividuals\nwith\tmoderately\televated\tblood\tpressure\twere\tassigned\trandomly\tto\teither\tcut\ttheir\tsodium\tby\t750\nto\t1000\tmg\tper\tday\tor\tto\tfollow\tgeneral\tguidelines\tfor\n\thealthy\teating\tfor\t18\tmonths\tto\t4\tyears.\tIn\t10
|
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healthy\teating\tfor\t18\tmonths\tto\t4\tyears.\tIn\t10\nto\t15\tyears\tafter\tthe\tstudies\tended,\tindividuals\twho\tcut\ttheir\tsodium\texperienced\ta\t32%\tlower\trisk\nof\theart\tattacks,\tstrokes,\tor\tother\tcardiovascular\tevents\tcompared\twith\tthe\tgroup\tthat\tdid\tnot\t(\nCook\net\tal,\t2014
|
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] |
Cook\net\tal,\t2014\n).\tA\tmeta-analysis\tof\t37\tRCTs\tfurther\tsupports\tthe\tpositive\teffects\tof\tsodium\treduction\ton\nblood\tpressure\tand\tcardiovascular\toutcomes\tfor\n\tnormotensive\tand\thypertensive\tindividuals\t(\nAburto\net\tal,\t2013\n).
|
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The\tDASH\tsodium\ttrials\ttested\tthe\teffects\tof\tthree\tdifferent\tlevels\tof\tsodium\tintake\t(1500\tmg,\n2400\tmg,\tand\t3300\tmg/day)\tcombined\twith\teither\ta\ttypical\tU.S.\tdiet\tor\tthe\tDASH\tdiet\tin\tpersons\nwith\tprehypertension\tor\tstage\t1\thypertension\t(\nAppel\tet\tal,\t2006\n).\tThe\tlowest\tblood\tpressures\twere\nachieved\tby\tthose\teating\tthe\t1500-mg\tsodium
|
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0.06510161608457565,
0.0649099051952362,
0.052763376384973526,
0.012163777835667133
] |
achieved\tby\tthose\teating\tthe\t1500-mg\tsodium\n\tlevel\tin\tthe\tDASH\tdiet.\tIn\tthe\tDASH\tdiet\tand\tthe\ntypical\tAmerican\tdiet\tgroups,\tthe\tlower\tthe\tsodium,\tthe\tlower\tthe\tblood\tpressure.\tSuch\tdata\tprovide\nthe\tbasis\tfor\tthe\t2018\tACC/AHA\t(\nWhelton\tet\tal,\t2018\n)\tsodium\tguideline\tfor\tmost\tadults\tto\taim\tfor\tat
|
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] |
Whelton\tet\tal,\t2018\n)\tsodium\tguideline\tfor\tmost\tadults\tto\taim\tfor\tat\nleast\t1000\tmg/day\treduction\tin\tsodium\tand\tfor\tadults\twith\televated\tblood\tpressure\tto\treduce\tsodium\nto\tan\toptimal\tgoal\tof\t<1500\tmg/day.\tFor\tthose\twith\n\tnormal\tblood\tpressure,\tthe\tDietary\tGuidelines
|
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] |
normal\tblood\tpressure,\tthe\tDietary\tGuidelines\nfor\tAmericans\trecommend\tan\tintake\tof\tless\tthan\t2300\tmg\tof\tsodium,\tthe\tequivalent\tof\t6\tg\tof\tsalt,\neach\tday\t(\nUSDA,\t2015\n).\tThis\tgoal\tis\tsupported\tby\tthe\tAND\tPractice\tGuidelines\t(\nLennon\tet\tal,\t2017\n)\nand\tother\torganizations.
|
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0.03085755929350853,
0.05650707334280014,
-0.009265465661883354
] |
Lennon\tet\tal,\t2017\n)\nand\tother\torganizations.\nThere\tis\tagreement\tthat\tsome\tpersons\twith\thypertension\tshow\ta\tgreater\tdecrease\tin\ttheir\tblood\npressures\tin\tresponse\tto\treduced\tsodium\n\tintake\tthan\tothers.\tThe\tterm\tsalt-sensitive\thypertension\nhas\tbeen\tused\tto\tidentify\tthese\tindividuals.\tSalt-resistant\thypertension\trefers\tto\tindividuals\twith
|
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] |
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