Non-Pharmacological Management of Hypertension Flashcards Preview

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Flashcards in Non-Pharmacological Management of Hypertension Deck (15)
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1
Q

What are the factors affecting development of essential and secondary hypertension?

A
  • Essential hypertension probably results from factors including:
    • Effects of ageing on renal function, peripheral resistance.
    • Genetic susceptibility.
    • Environment e.g. smoking, stress, diet and lifestyle.
  • Secondary hypertension results from:
    • Renal disease
    • Liver disease
    • Cardiac failure
    • Pre-eclampsia of pregnancy
2
Q

What are the modifiable risk factors for hypertension?

A
  • Excess dietary salt
  • Poor diet and obesity
  • Excess alcohol consumption
  • Lack of physical activity
  • Deprivation and socio-economic status
  • Mental health and stress
3
Q

What are the non-modifiable risk factors for hypertension?

A
  • Age
  • Ethnicity
  • Genetics
  • Gender
4
Q

What are the most significant diet and lifestyle influences on hypertension?

A
  • Overweight and obesity
  • Lack of physical activity
  • Excess alcohol intake
  • Excess salt intake
5
Q

Describe the ‘5As’ approach to behaviour change.

A
6
Q

What is te impact of screening and brief interventions for obesity in primary care?

A
  • n=1882 screened as obese.
  • Randomised to receive one of two 30 second interventions:
    • Advice only
    • Support (offer to refer to weight management group)
  • Both options found to be appropriate and helpful.
  • At 12 months, weight loss = 2.43kg (support) vs 1.04kg (advice only).
7
Q

What are the patient challenges when considering conservative management of hypertension?

A
  • Readiness to change
  • Motivation
  • Self-esteem and confidence
  • Appropriate time to attempt therapy?
  • Acceptance of the need for a lifestyle change
  • Any environmental, social and family factors (e.g. family Hx)
8
Q

What is the effect of regular aerobic exercise on hypertension?

A
  • Led to significant reductions in systolic and diostolic BP (-3.84mmHg and -2.58mmHg respectively) in analysis of 54 RCTs.
9
Q

What is the effect of endurance training on hypertension?

A
  • Led to reductions in BP in all study groups (hypertensive, prehypertensive and normotensive individuals), but significantly more pronounced in the hypertensive study groups in analysis of 72 trials.
10
Q

How would you assess the dietary intake of a hypertensive patient?

A
  • Food diary
  • Food frequency questionnaire
  • 24 hour recall
11
Q

What are the UK physical activity recommendations for adults?

A
  • To stay healthy, adults aged 19 to 64 should try to be active daily and should do:
    • at least 150 minutes of moderate aerobic activity such as cycling or brisk walking every week and
    • strength exercises on 2 or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms)
  • Or:
    • 75 minutes of vigorous aerobic activity such as running or a game of singles tennis every week and
    • strength exercises on 2 or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms)
  • Or:
    • a mix of moderate and vigorous aerobic activity every week – for example, 2 x 30-minute runs plus 30 minutes of brisk walking equates to 150 minutes of moderate aerobic activity and
    • strength exercises on 2 or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms)
12
Q

What is the effect of reduction in alcohol consumption of blood pressure?

A
13
Q

What are SMART goals?

A
  • Specific
  • Measurable
  • Acceptable
  • Realistic
  • Time - phased
14
Q

Describe the DASH diet?

(Dietary approaches to stop hypertension)

A
  • Diet rich in fruit and vegetables, low fat dairy products, wholegrains, fish, nuts and poultry.
  • DASH diet reduced SBP and DBP significantly more than a control diet (reduction of 5.5mmHg more and of 3.0mmHg moe respectively).
  • Similar to Mediterranean sytle diet and eatwell guide.
15
Q

What are the key recommendations for reducing BP?

A
  • Reduce salt intake to no more than 6g per day.
  • Moderate alcohol intake to within UK recommendations - no more than 14 units per week.
  • Reduce weight toward an ideal body weight.
  • Increase physical activity levels toward UK recommendations.
  • Increase fruit and vegetable intake to recommended levels.
  • The 5As approach to behaviour change is an effective tool for use in primary care to support individuals to make appropriate diet and lifestyle changes.