Scribd Logo
Upload

Welcome to Scribd!

  • 47 views

    Nutrition and Hypertension Pa Tho Genesis

    Uploaded by

    La Ode Rinaldi
    This document discusses nutrition and hypertension. It covers the pathogenesis and epidemiology of hypertension, noting risk factors like stress, sedentary lifestyle, and consumption-based life. It examines the role of nutrients like sodium, potassium, calcium and their effects on blood pressure. Secondary causes of hypertension include renal, endocrine and neurological diseases, as well as drugs. The document also discusses hypertension classification and links affluence factors like obesity to increased cardiac output and stress responses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd

    Nutrition and Hypertension Pa Tho Genesis

    Uploaded by

    La Ode Rinaldi
    47 views32 pages
    This document discusses nutrition and hypertension. It covers the pathogenesis and epidemiology of hypertension, noting risk factors like stress, sedentary lifestyle, and consumption-based life. It examines the role of nutrients like sodium, potassium, calcium and their effects on blood pressure. Secondary causes of hypertension include renal, endocrine and neurological diseases, as well as drugs. The document also discusses hypertension classification and links affluence factors like obesity to increased cardiac output and stress responses.

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses nutrition and hypertension. It covers the pathogenesis and epidemiology of hypertension, noting risk factors like stress, sedentary lifestyle, and consumption-based life. It examines the role of nutrients like sodium, potassium, calcium and their effects on blood pressure. Secondary causes of hypertension include renal, endocrine and neurological diseases, as well as drugs. The document also discusses hypertension classification and links affluence factors like obesity to increased cardiac output and stress responses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    47 views32 pages

    Nutrition and Hypertension Pa Tho Genesis

    Uploaded by

    La Ode Rinaldi
    This document discusses nutrition and hypertension. It covers the pathogenesis and epidemiology of hypertension, noting risk factors like stress, sedentary lifestyle, and consumption-based life. It examines the role of nutrients like sodium, potassium, calcium and their effects on blood pressure. Secondary causes of hypertension include renal, endocrine and neurological diseases, as well as drugs. The document also discusses hypertension classification and links affluence factors like obesity to increased cardiac output and stress responses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 32

    Nutrition and Hypertension

    Pathogenesis
    Darmono SS
    Hypertension
    • WHO (2005), Joint National Committee on
    Prevention, detection evaluation and
    treatment of high blood pressure, dietary
    approaches to stop hypertension :
    • Chronic degenerative diseasee
    preventable
    Behavioral affluence
    Hectic,
    Hypertension
    • Neurohormonal disease, renin angiotension
    • Stress people
    • Consumptive life
    • Immobility
    • Less exercise
    • High cost in health care
    • Fatal cases
    Epidemiology
    • Research in more than 42 countries, 52 center.
    • Prevalence : 11-60 %
    • 90 % : essential of primary hypertension or primary
    hypertension
    • Indonesian Demographic & health survey since 1990, to
    1994, the diseases list number 15 increases to 9 and 7
    • Increase very dramatically. (SDKI 2004)
    • Commercial hospital care, most of BOR related to
    degenerative diseases (due to hypertension)
    Epidemiology
    • Riskesdas 2008 :
    • Prevalensi nasional hipertensi penduduk > 18
    tahun : 29,8 %
    • 10 propinsi mempunyai hipertensi di atas rata-
    rataa
    • Daerah pesisir lebih tinggi dibanding pedalaman
    • 10 kabupaten yang prevalensinya > 50 %
    • Silent killer, stroke, number one killer
    Pathophysiology
    • Stroke volume or cor : systole < 110 mmHg
    • Muscle relaxation of cor : diastole < 80 mmHg
    • Blood pressure : stroke volume X peripheri
    resistence.
    • Viscousity
    • Water load, electrolit inbalance
    • Blood volume (different position)
    Nutrient related to Blood Pressure
    • Dah’I hypotesis :
    • In animal & human experimental Na+, K+ ,
    • Sodium intake related to expanded blood
    volume, cardiovascular diseases
    • Health believe model : risk factor, diseases
    occurance and perceiving of life changes
    Pathogenesis hypertension
    Health impact
    • Increasing morbidities
    • Increasing mortalities
    • Decreasing quality of life
    • Less productivities
    • Complexes failure of target organ
    • Squealed
    • Cost of health care
    • Complication to target organ : brain (stroke), heart,
    renal, perifer blood vessels, ocular, cardiac-pulmonum
    Nutrition, metabolic risk factor
    • Ca,
    • Mg
    • Glucose
    • Refined ChO
    • Glycosylated Hb
    • Alcohol (energy)
    • Cholesterol total, fibre
    • Ratio lipid profile
    • Omega 6 (vegetable oil),
    • Omega 3 (eicosapentaenoic acid, marine) less potassium intake
    Nutrient related to blood pressure
    • Epidemiological research & hypertension
    • FDA : sodium intake
    • Sodium excretion & mean of blood pressure
    • Middle age man and women : average/gram of salt
    intake
    • 6,3 mmHg systolic
    • 2,2 mmHg diastolic per 10 % BW
    • Nutrition review 2005, high salt diet related to
    stroke
    Secondary causes 4-8 %
    Renal diseases
    • glomerulonephritis,
    • Chronic pyelonephritis
    • Polycystic disease
    • Renal vascular disease
    Secondary causes 4 – 8 % Endocrine Disease

    • Cushing’s syndrome
    • Conn’s syndrome
    • Phaeochromocytoma
    Secondary causes 4 – 8 % Drug Induced

    • Contraceptive pill
    • Liquorice containing compounds
    • Steroids ingestion in patients taking
    monoamine oxidase inhibitors
    Scundary causes 4 – 8 %
    • Coarctation of the aorta
    • Lead poisening, raised intracranial pressure
    • Attcks in porphyria
    Classification: Hypertension for > 18 years
    old
    Category Sistole BP (mmHg) Diastole BP (mmHg)
    Optimal < 120 And < 80
    Normal <130 And < 85
    Normal-(High) 130-139 Or 85-89
    Hypertension
    - Mild 1 140-159 Or 90-99
    - Moderate 2 169-179 Or 100-109
    - Severe 3 ≥180 Or ≥110
    Table : secondary causes of hypertension

    • Renal
    – Renal parenchymal disease (glomerulonephritis, polycystic
    disease, diabetic nephropathy)
    – Renovascular disease (renal artery stenosis. Fibromuscular
    dysplasia, vasculitis)
    • Endocrine
    – Hypo-or hyperthiroidism
    – Hyperparthyroidism
    – Adrenocorticoid excess (Cushing’s syndrome, primary
    aldosteronism)
    – Pheochromocytoma
    – Exogenous hormones (oral contraceptives, estrogen
    replacement)
    Table : secondary causes of hypertension

    • Neurologic Disorder
    – Brain tumors, sleep apnea, spinal cord injuries, lead
    poisoning, porphyria
    • Stress Induced
    – Pain, anxiety, hypoglycemia, alcohol withdrawal,
    postoperative
    • Toxic / Pharmacologic
    – Alcohol and drug use, NSAIDs, ephedrine, corticosteroids,
    monoamine oxidase inhibitors
    • Miscellaneous
    – Aortic Coarctation
    – Carcinoid Syndrome
    – pregnancy
    Sumber : Andreoli et al. Cecil Essentials of medicine 6th , 2004
    Sodium
    • Biochemical  vasometer
    • Inhibitor diuresis
    • Loading increase urinary excretion, serum
    parathyroid hormone, 1,25 dehydroxy vitamin D
    • Periphery resistance, increase volume
    • Osmoses pressure, extra cellular space
    • Mostly related to over calories consumption
    • Food preservative, food taste, soda bread,
    medicines (sedative, analgetic, antitusive etc)
    Patogenesis
    • Natrium : major kation in extra celluler
    • K : anion in intra celluler
    • NaCl  daily use (10 gram/day)
    • Na HCo3 : baking soda
    • Natrium benzoat : preservativeness
    • Mono sodium glutamat (tasty food)
    • Sodium diclofenac
    • Sodium medicine (cough, analgetic) etc
    Potassium
    • Natriuresis effect (WHO, should be natural
    basis. Cheap, long term effect). Potassium
    tablet not solve in gastric liquid.
    • Decreasing venticular ectopic
    • 75 % client diet satisfication
    • Decreasing Aldosteron, vasopresin, plasma
    angiotensin, plasma renin, prostaglandin.
    • Decreasing ectopic ventricular
    Calcium
    • Study in bio gerontology : CaCO3  decreasing
    hypertension
    • Hypertension : low calcium intake & level (100
    research of hypertension)
    • 1 gram Ca intake decreasing systolic 3 mmHg
    • Diastolic 2, 3 mmHg
    • Not for medicine intervention (pharmacology
    terminology)
    Nutrient related to blood pressure
    • Cicletanine (potential mechanism to block
    sympathetic nerve activity)  decreasing BP &
    plasma nor epinephrine concentration
    • Nor epinephrine release from : symphatic post
    ganglionic nerve terminal  modulated by
    dietary sodium
    • Intracellular sodium conc  modify
    epinephrine releases by affecting
    neurotransmitter re- uptake mechanism
    Nutrient related to blood pressure
    • Central nerves system & alpha adrenergic
    receptors
    • Renal control of renal function enhanced by
    sodium intake
    • Brain renin angiotensin system
    • Salt  induce enhancement
    • Hypothalamic nor ephinephrine concentration
    altered by sodium
    Nutrient related to blood pressure
    • Increasing NaCl,  decreasing
    norephinephrine concentration in anterior &
    posterior hypothalamus
    • Specific brain region  paraventricular &
    supra chiastic areas  BP regulation and
    neurotransmitter.
    • Beta adrenergic receptor (propanolol)  salt
    stress hypertension
    Affluence factors
    • Waist hip ratio women : > 0,85; men > 0,90 BMI
    overweight, obesity  increasing cardiac output
    • Cardiac pre & after loading  tension
    • Cardiac hyper therapy
    • Insuline ressistance  abnormal neuro endocrine
    • Stress response  increasing catecholamine,
    adrenaline response.
    • Medical treatment : affect to electrolyte, lipid
    profile
    Affluence factors
    • Neuronal discharge rate  maintaining
    homeostasis cardiovascular resting.
    • Renin angiotensin activity increasing beta
    adrenergic receptor.
    • Renin angiotensin aldosteron axis, sympatho
    adrenal like natri uretic factor, atrial natriuretic
    peptide, adenosin and vasopresin.
    Figure arteriogram of the distal aorta and its bifurcation into the common iliac arteries in a patient with left lower
    extremity claudication. There is mild atherosclerotic disease of the distal aorta before its bifurcation and normal.

    Sumber : Andreoli et al. Cecil Essentials of medicine 6th , 2004


    Hypertension case study in china (2007)

    • Life style
    • Food habits
    • Socio demographic
    • Body weight
    • Waist circumference
    • Fat free mass
    Hypertension

    You might also like