5 things you can do today to be heart healthy

1. Blood Pressure Control
William Abide, M.D.

2. 
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Normal: < 120/<80
Pre-Hypertension: 120-139/80-89
Stage I Hypertension: 140-159/90-99
Stage II Hypertension: >160/>100

4. 
Genetics
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If parents have it, 2x more likely
Increase sodium intake
Obesity
Physical inactivity
Race
High cholesterol

5. 
Secondary Causes:
Kidney disease
 Drug induced (NSAIDS)
 Renovascular Disease
 Endocrine disorders (hypo/hyperthyroidism)
 Sleep Apnea


6. 
High Blood Pressure increases risk of:
Kidney disease
 Stroke
 Heart failure
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Mortality benefit with decreased BP starting at
115 mm Hg

9. 
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< 140/<90
? With diabetes
? With CAD
? With CKD
ACCORD Trial-5 years of follow up
BP in treatment group 119 mmHg vs 134 mm Hg
 No difference in outcomes (MI, non-fatal stroke,
death)
 More adverse events (3.3% vs 1.3%)

 Hypotension, syncope, bradycardia, angioedema, renal
failure

10. 
Persistently above 140/90
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medications
> 160/100
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medications

11. 
Weight Loss
0.5-2 mmHg for every 1 Kg weight loss
 Very effective with low sodium diet
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12. 
Aerobic Exercise
Can lower BP as much as 5-15 mmHg
 Usually SBP decrease of 4-6 mmHg and diastolic
decrease of 3 mmHg
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Resistance Training
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BP decrease of 4/4
Recommendations:

30 min of activity most days of the week

14. 
Moderate salt restriction

15. 
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Diet of fruits, vegetables, low fat dairy
products
DASH Trial:
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One of 3 diets:
 Control diet: LOW in fruits, vegetables, and legumes
and HIGH in snacks, sweets, meats and saturated fat
 Trial diet: HIGH in fruits, vegetables, and legumes and
LOW in snacks and sweets
 Combination diet: HIGH in fruits, vegetables, legumes,
and low fat dairy products and LOW in snacks, sweets,
meats, and saturated fat

16. 
Trial diet:
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Combination diet:
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Decrease in BP by 5.5/3 mmHg
If dx of HTN, even more benefit
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Decrease in BP by 2.8/1.1 mmHg
11.4/5.5 mmHg
BP decrease was max at end of week 2 and
continued until end of trial (week 8)

17. 
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Regardless of sodium, DASH diet lowered BP
Low sodium in either diet lowered BP
Biggest benefit between high sodium control
diet and low sodium dash diet
11.5
mmHg

18. 
Alcohol use
Women with 2 or more drinks daily and men with 3
or more drinks daily have higher chance of HTN
 Dose related effect
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Is some alcohol good for me??
LOW to MODERATE amount may be
 1 drink/day for women
 1-2 drinks/day in men
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