BLOOD PRESSURE

Blood pressure is the force of the blood pushing against the walls of the arteries. Each time your heart beats, it pumps out blood into the arteries. The blood pressure is highest when the heart beats, pumping the blood. This is called systolic pressure. When the heart is at rest, between beats, the blood pressure falls. This is the diastolic pressure. It is measured in millimeters of mercury (mm Hg).

HIGH BLOOD PRESSURE (HYPERTENSION) High blood pressure (or hypertension) is defined in an adult as a blood pressure greater than or equal to 140 mm Hg systolic pressure or greater than or equal to 90 mm Hg diastolic pressure. 120/80 mm Hg or lower is normal blood pressure and 120 and 139 mm Hg systolic or between 80 and 89 mm Hg diastolic is prehypertension. Symptoms Early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal. Causes In 90 to 95 percent of high blood pressure cases, there's no identifiable cause. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years. The other 5 percent to 10 percent of high blood pressure cases are caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions can lead to secondary hypertension, including kidney abnormalities, tumours of the adrenal gland or certain congenital heart defects. Certain medications including birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs may cause secondary hypertension. Various illicit drugs, including cocaine and amphetamines can also increase blood pressure.

Complications

Excessive pressure on the artery walls can damage the vital organs. The higher the blood pressure and the longer it goes uncontrolled, the greater the damage. Uncontrolled high blood pressure can lead to:

1. Damage to arteries can result in hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack or other complications. An enlarged, bulging blood vessel (aneurysm) also is possible.
2. Heart failure to pump blood against the higher pressure in the vessels, the heart muscle thickens, which can lead to heart failure.
3. A blocked or ruptured blood vessel in the brain can lead to stroke.
4. Weakened and narrowed blood vessels in the kidneys - his can prevent these organs from functioning normally.
5. Thickened, narrowed or torn blood vessels in the eyes can result in vision loss.
6. Metabolic syndrome - this syndrome is a cluster of disorders of the body's metabolism including elevated waist circumference, high triglycerides, low high-density lipoprotein (HDL), or good, cholesterol, high blood pressure and high insulin levels. If you have high blood pressure, you're more likely to have other components of metabolic syndrome.
7. Cognitive impairment and dementia are more common in people who have high blood pressure

Dietary modifications

Objectives

• To maintain adequate nutrition.
• To reduce the sodium intake.
• To achieve a gradual weight loss in overweight individuals and maintain their weight slightly below normal weight.
• To restrict fat (if required) depending on the lipid (fat) profile.

Energy: Energy needs to be restricted in case of overweight individuals. Even normal weight individuals benefit with a slight reduction in energy. Therefore, the energy intake should be adjusted in such a way so as to bring about a weight loss and maintain slightly below the normal level.

Proteins: A normal protein intake is suggested. Excess amount of proteins should be avoided, as these foods are usually high in animal fat as well as sodium.

Fats: As low energy diets are essentially low fat diets, the quantity of fat should be reduced. Also, it is important to check the quality of fat. Fats should be of plant origin including soya oil, groundnut oil, sunflower oil and corn oil. Fats from animal origin such as ghee, butter etc. should be restricted.

Carbohydrates: Emphasis should be placed on including foods high in complex carbohydrates such as starches and dietary fibre rather than simple sugars.

Sodium: Sodium restriction along with weight reduction is effective in controlling mild to moderate hypertension. Therefore, use of salt for cooking and also for table purpose should be restricted.

Other minerals: Two other minerals, potassium and calcium, are important in relation to hypertension. An adequate potassium intake is an essential part of treatment. This can be done by including sufficient amounts of potassium rich foods such as milk, fruits and vegetables. Adequate amount of calcium intake is also beneficial in treating high blood pressure. Some of the calcium rich foods are milk, leafy vegetables etc.

Sodium restricted diets

Four levels of dietary sodium restriction are suggested:

• Sodium in normal diets (3 to 4 g)
• Mild sodium restriction (2 to 3 g)
• Moderate sodium restriction (1 g)
• Strict sodium restriction (500 mg)
• Severe sodium restriction (200 mg).
• The first three are most commonly used.

Cholesterol content of Foods