11d. CV Health - Hypertension

Question 1

What does blood pressure reflect?

Answer 1

The force of circulating blood against artery walls

Question 2

How is blood pressure expressed?

Answer 2

Systolic
Diastolic

Question 3

What is systolic BP?

Answer 3

The pressure blood exerts on arterial walls when the heart contracts

Question 4

What is diastolic BP?

Answer 4

Blood pressure when the heart relaxes

Question 5

What measurement is considered as hypertension?

Answer 5

140/90 mmHg or higher

Question 6

Signs and symptoms of hypertension

Answer 6

Fatigue
Headache
Dizziness
Visual disturbance

Question 7

What is essential hypertension?

Answer 7

No specific underlying medical cause

Question 8

What are the drivers of essential hypertension?

Answer 8

Vascular resistance
Obesity
Stress
Anxiety
Smoking
High salt intake

Question 9

What is secondary hypertension?

Answer 9

Due to diseases of kidneys, adrenals, thyroid, diabetes

Question 10

What is malignant hypertension?

Answer 10

Pressure above 180/120
Risks damaging organs

Question 11

Causes and risk factors for hypertension

Answer 11

Genetic
Obesity
Excess alcohol
Stress
Nutritional deficiencies
High table salt
Inactivity
Smoking
Drugs
Raised uric acid

Question 12

Why is obesity a risk factor for hypertension?

Answer 12

Activates RAAS causing vasoconstriction and water restriction

Question 13

Why is excess alcohol a risk factor for hypertension?

Answer 13

Reduces the baroreceptor reflex (ability to respond to BP changes)
Increases sympathetic outflow
Increases HR and BP
Stimulates the endothelium to release vasoconstrictors
Activates the RAAS

Question 14

Why is stress a risk factor for hypertension?

Answer 14

Increases SNS activity causing vasoconstriction
High cortisol increases the potent vasoconstrictor ET-1
Activates the RAAS

Question 15

What nutritional deficiencies are risk factors for hypertension?

Answer 15

Mg (vasodilator)
K (increases urinary excretion of Na; reduces blood volume)

Question 16

Why is inactivity a risk factor for hypertension?

Answer 16

Associated with higher HR
Increased cardiac contractility
Greater force on arteries

Question 17

Why is smoking a risk factor for hypertension?

Answer 17

Damages endothelium
Nicotine constricts blood vessels
Nicotine increases HR

Question 18

Which drugs are risk factors for hypertension?

Answer 18

NSAIDs
Corticosteroids
Decongestants
(can increase BP)

Question 19

Why is raised uric acid a risk factor for hypertension?

Answer 19

Stimulates the RAGE pathway
Increasing NF-kB
Disrupts eNOS activity - lowers NO
Exacerbates endothelial insulin resistance

Question 20

Natural approach to hypertension

Answer 20

Increase K/Na ratio >3:1
Lower uric acid levels
DASH diet
ACE inhibitory peptides
Optimise sleep
Optimise weight
Stress management

Question 21

Why is K important in supporting hypertension?

Answer 21

Increases natriuresis
Encourages vasodilation
Reduces sensitivity to angiotensin II
Lowers SNS activity
Lowers NADPH oxidase

Question 22

How much should salt be restricted to in hypertension?

Answer 22

1.5g/day

Question 23

What does the DASH diet consist of?

Answer 23

Fresh fruit/veg
Legumes
Nuts
Seeds
Wholegrains
Fish
Lean meat
Low fat dairy
Restricted Na

Question 24

What do ACE inhibitory peptides do?

Answer 24

Encourage ACE to react with the peptides
Reduces vasoconstriction via angiotensin II

Question 25

Food sources of ACE inhibitory peptides

Answer 25

Spirulina Mushrooms Spinach Hemp seeds Walnuts

Question 26

Why should sleep be optimised to support hypertension?

Answer 26

Melatonin is associated with anti-hypertensive effects through GABA stimulation Angiotensin II Increases NO

Question 27

Why is stress management important in supporting hypertension?

Answer 27

Diaphragmatic breathing - shown to decrease systolic and diastolic BP, HR and anxiety Promotes sense of relaxation Earthing - walking barefoot on grass or sand Improves HR variability, lowers night-time cortisol and promotes a parasympathetic state

Question 28

Nutrients to support hypertension

Answer 28

C, D Mg L-arginine B6 CoQ10 Hawthorn

Question 29

Why is vit D important in supporting hypertension?

Answer 29

Deficiency leads to overexpression renin, activating RAAS Increases vasoconstriction and retention of Na and water Reduced proinflammatory cytokines Increases NO Increases endothelial function Reduces hsCRP

Question 30

Why is Mg important in supporting hypertension?

Answer 30

Effects cardiac and vascular tone and reactivity

Question 31

Why is L-arginine important in supporting hypertension?

Answer 31

Substrate for vascular NO synthesis Inhibits ACE activity

Question 32

Dosage of L-arginine in supporting hypertension

Answer 32

1000-2000mg/day x3

Question 33

Why is B6 important in supporting hypertension?

Answer 33

Deficiency is associated with hypertension Increases cysteine synthesis, glutathione Blocks Ca channels Reduces SNS tone

Question 34

Herbs to support hypertension

Answer 34

Hawthorn Yarrow Lime flower Dandelion leaf

Question 35

Actions of hawthorn in supporting hypertension

Answer 35

Cardiotonic Hypotensive

Question 36

Actions of yarrow in supporting hypertension

Answer 36

Diuretic Hypotensive

Question 37

Actions of lime flower in supporting hypertension

Answer 37

Nervine relaxant Diuretic Anti-hyperlipidaemic

Question 38

Actions of dandelion leaf in supporting hypertension

Answer 38

Diuretic Rich in K (3-4 fresh leaves/day)