Lifestyle Management of Blood Pressure

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Lifestyle Management of Blood Pressure

• Salma Butt
• Dietitian

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• Almost Every one needs it,
• Asks for it, Give its,
• but almost No body takes it
• What is it?

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• ADVICE!

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National Standards

• The BHS BP gt 130/85 Lifestyle Advice
• NICE - Lifestyle modification management of
  hypertension in primary care
• NSF - Advice and treatment to maintain blood
  pressure below 140/85 - Focus on Exercise and
  Calorie intake

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Lifestyle contributions

• Being Overweight
• Drinking excess amounts of Alcohol
• Excess Salt Intake
• Smoking
• Environmental Stress

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DASH STUDY

• Dietary Approaches to Stop Hypertension (DASH)
• 459 subjects, 3 trails
• A control diet low in fruit, vegetable and dairy
  products and fat content typical of the American
  diet
• A diet rich in fruit and vegetables
• combination diet (DASH diet) rich in fruit/ veg
  and low fat dairy products with reduced saturated
  and total fat and reduced salt intake
• 
  (Appeal etal, N Eng J Med 1997)

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DASH STUDY
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Lifestyle factors that reduce Blood Pressure

• Salt - Clear association between dietary salt
  restriction and a fall in blood pressure
• Intersalt- A large epidemiological study
  involving
• 10, 000 across 52 populations
• ? in Na intake was associated with an in ?
  SBP
• (True in men/women, young /old, hypertensive/
  nonhypertensive
• Advice on Salt intake-
• Avoid adding salt to food / high salt content
  ready meal
• (Stanler J. Am J clin Nutr 1997)

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- FSA
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Fruit Vegetables

• The DASH study - Increase in fruit vegetable
  consumption significantly reduced blood pressure.
  
• Advice should be to consume a diet rich in
• fruit vegetable and low-fat dairy products,
  with reduced content of saturated and total fat
• Up to 7 portions per day (NSF, 2000)

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Alcohol

• High levels of alcohol intake are associated with
  an increase risk of developing hypertension
• Binge drinking should be discouraged as this is
  associated with rapid rises in blood pressure,
  and appears most closely linked to cardiovascular
  risk (InterSalt study)
• lt 21 units per week for men
• lt14 units per week for women (NSF, 2000)

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Factors affecting blood pressure

• Potassium- Evidence has shown that an increase in
  potassium intake helps reduce
• blood pressure
• (Whelton etal., 1997)
• Calcium- Dietary Calcium have shown a reduction
  in SBP DBP in hypertensive
• 
  (Griffith etal ., 1999)

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Dairy Peptides

• Dairy Peptides derived in milk potentially lower
  blood pressure (IPP/VPP)
• Inhibit the action of ACE enzymes involved in
  blood pressure regulation
• Found in blood pressure drinks-
• (Flora Proactive blood pressure drinks
• helps top control blood pressure)
• 
  
• 
  (Seiichi Mizuno, British J Nutr 2005)

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Weight Reduction

• Important strategy for the primary prevention of
  hypertension
• Weight reduction of 5kg (energy restriction
  increased physical activity) reduced SBP by
  4.44mmHg and DBP by 3.57 mmHg (Brand etal., 1991)
• Adults recommended 30min of moderate intensity
  activity, such as brisk walking. (NSF, 2000)

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Obesity Management

• Fit For Life- 12 week weight management session
• Brent heart group-On going screening and exercise
  programme
• Working in conjunction with community voluntary
  organisations

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Conclusions

• Diet and lifestyle modification have a
  significant role to play in managing blood
  pressure
• Lifestyle factors for blood pressure management,
  fruit and vegetables, salt, weight loss and
  physical activity, and the emerging lifestyle
  factors, such as dairy peptides

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• Healthcare professionals have a vital role to
  play in communicating the role of diet and
  lifestyle in managing blood pressure!