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Clinical Nutrition 1 > Hypertension 2 > Flashcards

Hypertension 2 Flashcards

(61 cards)

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1
Q

How much PA to reduce BP in HTN?

A
  • moderate PA of 30-60 min/d (4-7days/week)

- in addition to daily activities

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2
Q

Would you promote high intensity activities to reduce BP?

A

No

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3
Q

Tips for a patient to increase PA

A
  • needs to be a GRADUAL increase to 30-60 min/d
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4
Q

For stage 1 HTN, how does resistant training impact BP?

A

Does not impact negatively

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5
Q

Nutrition Assessment HTN

A
  • identify dietary factors and patterns (contributing to increase BP)
  • evaluate need for weight control
  • prioritise methods to meet DASH dietary goals
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6
Q

Nutrition Diagnosis HTN

A
  • excessive energy intake
  • excessive/inappropriate intake of fats
  • excessive sodium intake
  • inadequate calcium, fiber, potassium, or magnesium intake
  • overweight/obesity
  • food & nutrition knowledge deficit
  • physical inactivity
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7
Q

Nutrition Intervention HTN

A

Comprehensive approach that addresses multiple lifestyle factors:

  • DASH
  • Weight loss
  • Low Sodium
  • Alcohol in moderation
  • Potassium, calcium, magnesium
  • Physical activity
  • Smoking cessation
  • Stress management
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8
Q

DASH diet rich in

A

F and V, legumes, low-fat dairy, high K, Mg, Ca, fibre; poor T fat, SDA and dietary cholesterol

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9
Q

Benefits of DASH diet according to studies

A
  • average reduction of 5.5mmHg SBP and 3.0mmHg DBP

- further decrease in HTN subjects of 11.4mmHg/5.5mmHg

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10
Q

DASH stands for

A

Dietary
Approach to
STOP
Hypertension

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11
Q 
For a 2,100 kcal diet, how much 
- sodium
- potassium
- calcium
- magnesium
- fiber 
in a DASH diet
A
  • 2300 mg sodium
  • 4700mg potassium
  • 1250 mg calcium
  • 500mg magnesium
  • 30g fiber
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12
Q

What % of Total fat, saturated fat, protein, carb in a DASH diet

A
  • Total fat = 27% (includes 6% sat fat)
  • Protein = 18%
  • Carbohydrate = 55%
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13
Q

Which diet is most beneficial:

HTN or Mediterranean

A

DASH

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14
Q

When would you recommend 1500mg Na to HTN patient?

A

If he has refractory HTN (= BP not controlled)

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15
Q

How much NA do you recommend to a HTN patient?

A

3000mg

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16
Q

DASH diet improves

A

BP
LDL
VLDL
TG

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17
Q

DASH diet implies increasing what? and reducing what?

A

Increasing: potassium, magnesium, calcium, fiber

Reducing saturated FA and sodium

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18
Q

A patient has a blood pressure of 130 (SBP) what is his risk?

A

HTN high risk

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19
Q

Antihypertensive drugs examples

A
  • thiazide diuretics
  • distal tubular diuretics
  • angiotensin converting enzyme inhibitors
  • ANG2 receptor blockers
  • calcium channel blockers
  • beta blockers
  • single pill combination
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20
Q

First drug to treat HTN in adult without complications

A

Thiazide/ thiazide-like diuretic

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21
Q

SBP and DBP goal in most HTN pt without diabetes?

A

SBP < 140 mmHg

DBP < 90 mmHg

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22
Q

SBP and DBP goal in HTN pt with diabetes?

A

SBP < 130 mmHg

DBP < 80 mmHg

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23
Q

SBP and DBP in high-risk HTN pt

A

SBP < 120 mmHg

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24
Q

Drug treatment considerations

A
  • Location and drug metabolism and excretion
  • Drug/nutrient interactions
  • Drug/ drug interaction
  • Nutritional status
  • Physiological status
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25
Drug/nutrient interaction example
natural liquorice (glycyrrhinic acid)
26
Drug tx for patient with : | - diabetes (+complications)
ACEi or ARB
27
Drug tx for patient with : | - diabetes (+ no complications)
ACEi or ARB or CCB or diuretics
28
Drug tx for patient with : | - coronary artery disease
ACEi or ARB
29
Drug tx for patient with : | - heart failure
ACEi or ARB + beta blockers
30
Drug tx for patient with : | - coronary artery disease (+ stable angina)
beta blockers or CCB
31
Loop diuretics generic name
furosemide (Lasix)
32
Thiazides generic name
hydrochlorothiazide (Apo-Hydro)
33
Potassium sparing generic name
spironolactone (Aldactone), triamterene, amiloride
34
ACE inhibitors generic name
ramipril (Altace)
35
ANG2 receptor blockers (ARB) generic name
Valsartan (Diovan) | Losartan (Cozaar)
36
Calcium channel blockers generic name
Amlodipine (Norvasc)
37
Beta-blockers generic name
Propanolol (Inderal), atenolol, metoprolol
38
Low albumin affects drug effect how?
Increases drug effect because of more free drug in the blood
39
2 types of diuretics
- loop and thiazides | - K-sparing
40
Loop and thiazides mechanism
- decreased reabsorption of Na and K - production of osmotic diuresis - increased excretion of Na and K (and H+)
41
K-sparing mechanism
inhibit action of aldosterone
42
Loop and thiazides provided with
- potassium rich food | - potassium supplements (side effects)
43
WIth potassium sparing diuretics avoid
excess dietary potassium and supplements, avoid salt substitues, excess water consumption, natural liquorice
44
Side effects of loop diuretics
``` hypokalemia hyperglycemia anorexia nausea/vomiting constipation ```
45
SIde effects of thiazides
``` hypokalemia hyperglycemia anorexia malaise muscle weakness ```
46
Side effects of potassium supplements
irritates mucosal lining, increased risk for ulceration, nausea/vomiting/diarrhea
47
Mechanism of ACE inhibitors
- inhibit conversion of ANG1 to ANG2 | - decrease vasoconstriction, vasopressin, inhibit aldosterone release
48
Side effects of ACE inhibitors
hypotension (older patients) dry cough may worsen renal function
49
With ACE inhibitors avoid
salt substitutes | natural licorice
50
Side effects of ACE inhibitors are increased in
African Americans
51
When are ANG2 receptor blockers used
when ACEi are not tolerated
52
Mechanism of ANG2 receptor blockers
Block ANG2 receptor and decrease its activity --> vasodilation, reduced vasopressin and aldosterone
53
Side effects ANG2 receptor blockers
hyperkalemia, nausea, dizziness
54
With ANG2 receptor blockers avoid
salt substitutes natural licorice grapefruit
55
Mechanism of calcium channel blockers
affect movement of Ca through Ca channels causing blood vessel relaxation
56
Side effects calcium channel blockers
edema, náuseas, heartburn
57
With calcium channel blockers avoid:
natural liquorice caffeine alcohol grapefruit
58
Contraindication of calcium channel blockers with
heart failure
59
Beta-blockers mechanism
block adrenergic beta-receptors in heart --> decrease rate and cardiac output
60
Side effects beta-blockers
nausea/vomiting, constipation/diarrhea, bloating, masks symptoms of hypoglycaemia, dizziness, fatigue, CHF, hallucination, insomnia
61
Beta-blockers not recommended if
- diabetes mellitus | - initial therapy if >60y

Clinical Nutrition 1 (13 decks)

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