35911 - Hypertension Hypertension 高高高 Dr Hildemar Dos Santos 高高高高高 Dr Assistant Professor Loma Linda University School of Public

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Unformatted text preview: Hypertension Hypertension 高高高 Dr. Hildemar Dos Santos 高高高高高 Dr. Assistant Professor Loma Linda University School of Public Health Public Former Director of the Former Lifestyle Management Centre 高高高高高高高高 Hong Kong Adventist Hospital 高高高高高高 Tsuen Wan Adventist Hospital 高高高高高高 高高高高高高 Stroke Stroke Types 高高高高高高高 高高高高高高高 • Western 80% ischemic, 20% hemorrhagic 高高 : 80% 高高高高高高 20% 高高高 80% 高高高 • China - 62.4% ischemic, 29.3% hemorragic, 8.3% China unknown - Lin-Feng Zhang et all, 2003 unknown 高高 - 62.4% 高高高高高高 29.3% 高高高 高高 62.4% 高高高高高高 29.3% • Hong Kong - 68.3% ischemic, 27.1% hemorrhagic, Hong 4.5% unknown - R. Kay et al, 1992 - Chinese University of Hong Kong University 香香 - 68.3% 高高高高高高 27.1% 高高高高 4.5% 高高 - 1992 高高高高高 高高高高高 香香 68.3% 高高高高高高 27.1% 高高高高 高 高高高高 高高高高 高高 高高高 高高高 高高高 高高高 高高高高高 高高高高高 Get to the hospital in less than 60 min! 高高高高高高 60 高高高高高高高 高高高高高 Fruits and Vegetables and Strokes Fruits 高高香高高高高高 • Danish Diet, Cancer and Health study Johnsen et all, 2003 Johnsen 高高高高高高高高高高高高高 高高高高 • Those who eat 673 g of fruits and Those vegetables have 30% less risk of ischemic stroke 高高高 673 高高高高高高高高高高高高高高高高高高高高高 30% 高高高 Whole Grain Consumption and Stroke Risk 高高高高高高高高高高 高高高高高高高高高高 • The Nurses’ Health Study - 12 years FU 高高高高高高 - 12 高高高 高高高高高高 12 • 75,521 women in the US 高高 75,521 高高高 高高 75,521 高高高 75,521 • 38-63 years 高高 38-63 高 38-63 38-63 • Whole grains: brown rice, oatmeal, whole wheat Whole bread and products bread 高高 : 高高香高高香高高高高高 高高 40% reduction of strokes among those regular 40% whole grain users 高高高高高高高高高高高高 40% whole • JAMA, September 27, 2000 - Vol 284, No. 12 Hypertension in Hong Kong 高高高高高高高高 • 17% of the population: +- 1,000,000 高高高高高高高 17 • Obese people have higher risk of hypertension 高高高高高高高高高高高高高 Healthy People 2010 Leading Health Indicator New Blood Pressure Norms 高高高高高高 Normal 香 香 Prehypertension 香 香 香 香 香 High blood pressure 香 香 香 < 120/80 120-139 / 80-89 140/90+ JNC 7 Report, JAMA May 21, 2003 © 2 003, P revMedix LLC 以以以以以以以以以以以以 Lifestyle Modifications to Lower Blood Pressure Maintain a healthy weight 以以以以以以以 BP drops 5-20 points with 10 kg wt loss 高高 10 高高高高高高高高高高 5-20 高 JNC 7 Report, JAMA May 21, 2003 © 2003, P revMedix LLC DASH Dietary Approaches to Stop Hypertension 以以以以以以以以以以以以 Lifestyle Modifications to Lower Blood Pressure 跟 跟 DASH跟 跟 Follow the DASH diet eating plan - 跟 跟 跟 跟 跟 跟 -跟 跟 8跟 10跟 E at an abundance of fruits and vegetables - 8 to10 servings per day -跟 跟 跟 , 跟 跟 , 跟 跟 跟 跟 跟 -跟 跟 跟 跟 跟 跟 跟 (跟 跟 跟 跟 , 跟 跟 ) Include whole grains, nuts, and legumes - Limit foods high in saturated fat (e.g. meats, butter) -跟 跟 跟 8-14跟 B P drops 8-14 points on the DASH diet JNC 7 Report, JAMA May 21, 2003 © 2003, PrevMedix LLC 以以以以以以以以以以以以 Lifestyle Modifications to Lower Blood Pressure Reduce sodium intake 減 減 減 減 減 減 減 -跟 跟 跟 跟 跟 跟 跟 跟 E at less salt and salty foods -減 減 減 減 減 減 減 減 減 減 2-8減 Limiting sodium reduces BP by 2-8 points • • < 2.3 g rams of sodium (1 teaspoon) 高 高 2.3 高 高 (高 高 高 ) JNC 7 Report, JAMA May 21, 2003 © 2003, PrevMedix LLC 減減減減減減減減減減減減 Lifestyle Modifications to Lower Blood Pressure 減減減減減減減減減減減 Engage in regular aerobic physical activity -跟 跟 跟 跟 30 跟 跟 At least 30 minutes per day - -跟 跟 跟 4-9跟 BP drops 4-9 points with increased activity Limit alcohol intake, if used at all Limit 香香香香香 , 香香香香香香 香香香香香 香香香香香香 BP drops 2-4 points by limiting alcohol - 香香香香香香香香 2-4 香 JNC 7 Report, JAMA May 21, 2003 © 2 003, PrevMedix LLC Hypertension and Anger 高高高高高高 • Dr. Dick Tibbits Tibbits 高高 • Results: Learn how to forgive can lower blood pressure on patients with high levels of anger. • 高高 : 高高高高高高高高高高高高高高高高高高 Blood pressure and anger 高高高高高 Patient # 高高 # 高高 1 2 3 4 5 Anger Score 高高高高 高高高高 (Red 高高 ) 高高 34 28 26 26 19 Initial Initial Blood Pressure Blood 高高高高 Final Blood Pressure Blood 高高高高 144/97 154/98 151/99 157/107 153/87 130/81 124/76 132/86 123/84 124/80 Tibbits, 2004 Soy and Hypertension Soy 高高高高高高 • • • • Shanghai Women’s Health Study 高高高高高高 Shanghai 高高高高高高 45,694 participants - 2 - 3 years follow up 45,694 高高高 - 高高高高高高 高高高 高高高高高高 Compared women who ate 25 g soy protein/day with those Compared who took less than 2.5 g soy protein/day 高高高高 25 高高高高高高高高高高高高高高高 高高高高 高 25 高高高高高高高 Women 25g/soy/day Systolic (mmHg) Diastolic (mmHg) ??? All women ??? -1.9 -0.9 ???? 60 years and older 60? ? ? ? -4.9 -2.2 American Journal of Clinical Nutrition 2005; 81:10121017 Soy protein contents 高高高高高高高高 • 1 cup cooked soybeans = 28.6 g 1 高高高高高 = 28.6 高 高高高高高 • 1/2 cup tofu raw = 10g 高高高高高 = 10 高 1/2 • 1/2 cup tofu firm = 19g 高高高高高 = 10 高 1/2 • 1 cup soybean milk = 6.6 g 1 高高高 = 6.6 高 高高高 6.6 • 1/2 cup green soybeans = 11g 1/2 高高高高高 = 11 高 11 Garlic and Hypertension 高高高高高高 • Garlic can drop 8-11 mm Hg for the systolic and 5 - 8 mm Hg for the diastolic 高高高高高高高高 8-11 mm Hg 高高高高 5 - 8 mm Hg • Garlic Daily Dose 高高高高高高高高 : • 4,000 mcg of Allicin 4,000 mcg 高高 • 4 g of fresh garlic 4 高高高高高 • 1 - 4 garlic cloves 1-4 高高高 Encyclopedia of Natural Medicine page 527 Framinghan Heart Study Framinghan 高高高高 (Franco et all, 2004) • Chocolate - 100 g day reduces systolic blood pressure by 5.1 mm Hg, and diastolic by 1.8 mm Hg • 高高高 - 高高 100 高高高高高高高 5.1 mm Hg 高高高高 1.8 mm Hg • 400 g of fruit and vegetables/day - similar results as chocolate 高高高 400 高高高高高高高高高高高高高 CoQ10 and Hypertension (Lowers Peripheral Resistance?) 高高高 Q10 高高高高 ( 高高高高高高高 ?) • 39% of hypertension patients are deficient 高高高高高高高 35 高高高高高 • Some small studies have found a lower effect of CoQ10 Some on hypertension 高高高高高 C0Q10 高高高高高高高 高高高高高 • Ten patients with high blood pressure 高高高高高高高高高 Ten 高高高高高高高高高 » 100 mg CoQ10/ day - 10 weeks 高高 100 mg - 10 高高 » Systolic from 161 to 142 mmHg 高高高高 161 高高 142 » Diastolic from 98.5 to 83 mmHg 高高高高 98.5 高高 83 Encyclopedia of Natural Medicine page 527 Vitamin C and Hypertension Vitamin 高高高 C 高高高高 高高高高 • • • Study 2g loading dose 高高 - 高高高高 Study 高高高高 500 mg/daily - 30 days 高高 500 高高 - 30 高 高高 高高 30 Decrease systolic pressure by 13 mm Hg 高高高高高 13 mm Hg • No effect on diastolic 高高高高高高 No 高高高高高高 • Increased Nitric Oxide 高高高高高 Increased 高高高高高 • Lancet, 1999;354:2048-2049 高高高高 Lancet Lancet, 高高高高 ...
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This note was uploaded on 02/26/2012 for the course PHARM 210 taught by Professor Staff during the Fall '10 term at Rutgers.

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