Hypertension

In the adult, hypertension (high blood pressure) is defined as a pressure greater than, or equal to, 140 mmHg systolic, or greater than or equal to, 90 mmHg diastolic pressure (9). In 90 to 95% of the cases of high blood pressure, the specific cause may be unknown (10). Hypertension is a risk factor for both coronary heart disease and stroke. Although it can occur in children and adolescents, it is more prevalent in the middle-aged and elderly, especially African

Table 4. Selected Recommendations from the First

Federal Obesity Guidelines Panel

• Engage in moderate physical activity (30 min or more) on most/all days of the week.

• Reduce dietary fat and calories. Cutting back on dietary fat can help reduce calories and is heart-healthy.

• The initial goal of treatment should be to reduce body weight by about 10% from baseline, an amount that reduces obesity-related risk factors. With success, and if warranted, further weight loss can be attempted.

• A reasonable time line for a 10% reduction in body weight is six months of treatment (weight loss of 1 to 2 lb per week).

• Weight maintenance should be a priority after the first 6 months of weight-loss therapy.

• Overweight and obese patients who do not wish to lose weight, or are otherwise not candidates for weight-loss treatment, should be counseled on strategies to avoid further weight gain.

• Age alone should not preclude weight-loss treatment in older adults. A careful evaluation of potential risks and benefits in the individual patient should guide management.

Americans and the obese. Heavy drinkers and women who are taking oral contraceptives (11) are also at increased risk. Individuals with diabetes mellitus, gout, or kidney disease also have a higher frequency of hypertension. Salt consumption can increase blood pressure for some. High blood pressure is related to obesity and to increases in body weight over time (9,12). Factors increasing the risk of developing high blood pressure are listed in Table 5.

Weight loss, an active lifestyle, reduction in sodium intake, and moderation of alcohol consumption are recommended for prevention and management (9). For many, however, medical intervention with antihypertensive drugs is required to maintain acceptable blood pressure.

Table 5. Risk Factors for Hypertension (High Blood Pressure)

• Sodium or salt sensitivity

• Heavy alcohol consumption

• Sedentary and inactive lifestyle

• Race (African Americans are at greater risk)

• Obesity and overweight

• Use of oral contraceptives and some other medications Source: Ref. 11.

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