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Hypertension and CAD

Energy Requirements

Mifflin-St. Jeor

(10 x 72.7 kg) + (6.25 x 167.6 cm) – (5 x 54 yrs) - 161 = 1344

1344 x 1.3 - 1.45 activity factor

= 1750 - 1950 kcal/day for weight maintenance

Reduce calorie intake by 250 kcal/day = 1/2 lb weight loss per week

= 1500 - 1700 kcal/day for gradual weight loss

Corey Anderson

Blood Pressure

Definition: The amount of pressure in the arteries when the muscle is contracting (the top and larger number) and also the measure of pressure in the arteries between heart contractions (the bottom and smaller number)

Additional Information

  • former smoker
  • lives with someone who also smokes

Nutrition Intervention

Reduce Saturated Fat and Cholesterol

How is it regulated?

  • Normally regulated through the barorecptors in the carotid and aortic bodies, along with the larger arteries of the neck and thorax.
  • Excitation of the baroreceptors by high pressure in the arteries reflexively causes arterial pressure to decrease.

2% Milk

Glazed Donut

Butter

Ranch Dressing

Ice Cream

1% or Skim Milk

Whole Wheat Bagel

Margarine

Vinaigrette

Fruit & Yogurt Smoothie

Non pharmacological Plan...

Patient History

Nutrition Intervention

Nutrition Intervention: DASH Diet

Hypertension

Reduce Sodium

- Decrease Na intake

- Walking 30 minutes 4-5 times per week

- Reduce intake of fat

Pharmacological Plan...

Additional Information cont...

  • Family history of
  • heart attack - mother
  • heart problems - mother
  • high blood pressure - mother

Gender: female

Age: 54

Profession: Housewife

Ethnicity: African American

DOB: 10/9

Campbell's Tomato Soup

Saltines

Table Salt

- 25 mg/d hydrochlorohiazide (diuretic)

Definition: abnormally high blood pressure due to an increase in the force of blood against your artery walls which leads to health problems, such as heart disease

Symptoms: do not arise until their pressure has reached a severe stage

dull headachces

dizzy spells

few more nosebleeds than normal

blood spots in the eyes for those with diabetes

Reduced Sodium Soups/Homemade

Unsalted or Lightly Salted Crackers

Season with Herbs and Spices

Monitoring & Evaluation

Alcohol in Moderation

Increase

  • Fruits and Vegetables
  • Low-fat Dairy
  • Nuts

Decrease

  • Sodium
  • Total Fat
  • Saturated Fat

Alcohol in Moderation

Kcal for Weight Management

Mrs. Anderson's conditions

Nutritional Assessment

Clinical Assessment

  • blood pressure - 160/100 mm Hg
  • heart rate - 80 bpm
  • eyes - no retinopathy
  • heart - normal heart sounds
  • skin - smooth, warm, dry, excellent turgor, no edema
  • abdomen - nontender, normal bowel sounds
  • chest/lungs - clear
  • genitalia - normal
  • nuerologic - alert and oriented
  • weight - 160 lbs
  • height - 5' 6"
  • BMI - 25.8

Blood Pressure <120/80

BMI 18.5 - 24.9

Total Cholesterol <200

LDL <100

HDL > 50

TG <150

Food Diary

Current intake:

2 regular beers per day

Recommended intake:

1 drink per day for women

2 drinks per day for men

*Switching to a light beer would reduce calories

- overweight

- hypertensive

- high blood glucose

- high LDL levels

- low HDL levels

Biochemicals

  • total cholesterol - 270
  • LDL - 210
  • HDL - 30
  • TG - 150

References

http://www.weightlossresources.co.uk/diet/atkins_diet/atkins.htm

http://www.nhlbi.nih.gov/health/health-topics/topics/ms/

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp

http://spectrum.diabetesjournals.org/content/19/1/32.full

http://www.webmd.com/hypertension-high-blood-pressure/guide/dash-diet

http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/symptoms/con-20019580

http://nutrition.highwire.org/content/129/12/2109.full

Academy of Nutrition and Dietetics. (2014). Evidence analysis library. Retrieved from http://andevidencelibrary.com/default.cfm.

Mahan, K. L., Escott-Stump, S., & Raymond, J. L. (2012). Krause’s food and the nutrition care process. St. Louis, MO: Elsevier Saunders.

Pronsky, Z. M., & Crowe, J.P. (2012). Food-medication interactions. Birchrunville, PA: Food-Medication Interactions.

Thank You!

ECG

62

bpm

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