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controlled\tfeeding\tstudy\tshowed\tthat\ta\tdietary\tpattern\temphasizing\nfruits,\tvegetables,\tlow-fat\tdairy\tproducts,\twhole\tgrains,\tlean\tmeats,\n\tand\tnuts\tsignificantly\tdecreased\nSBP\tin\thypertensive\tand\tnormotensive\tadults.\tThe\tDASH\tdiet\t(see\t\nAppendix\t17\n)\twas\tfound\tto\tbe | [
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] |
Appendix\t17\n)\twas\tfound\tto\tbe\nmore\teffective\tthan\tjust\tadding\tfruits\tand\tvegetables\tto\ta\tlow-fat\tdietary\tpattern\tand\twas\tequally\neffective\tin\tmen\tand\twomen\tof\tdiverse\tracial\tand\tethnic\tbackgrounds\t(\nAppel\tet\tal,\t2006\n).\tThis\ndietary\tpattern\tserves\tas\tthe\tcore\tfor\tthe\tACC/AHA\tdietary\trecommendations\tfor\n\tlowering\tblood\npressure\t( | [
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lowering\tblood\npressure\t(\nWhelton\tet\tal,\t2018\n).\tAlthough\tthe\tDASH\tdiet\tis\tsafe\tand\tcurrently\tadvocated\tfor\npreventing\tand\ttreating\thypertension,\tthe\tdiet\tis\thigh\tin\tpotassium,\tphosphorus,\tand\tprotein,\ndepending\ton\thow\tit\tis\tplanned.\tFor\tthis\treason\tthe\tDASH\tdiet\tmay\tnot\tbe\tadvisable\tfor\tindividuals | [
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with\tend-stage\trenal\tdisease\twith\thigh-normal\tor\televated\tserum\tpotassium\tand\tphosphorus\tlevels\n(\nTyson\tet\tal,\t2012\n).\nSeveral\tversions\tof\tthe\tDASH\tdiet\thave\tbeen\texamined\tin\tregard\tto\tblood\tpressure–lowering\npotential.\tThe\tOmniHeart\ttrial\tcompared\tthe\toriginal\tDASH\tdiet\tto\ta\thigh-protein\tversion\tof\tthe | [
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resulted\tin\tgreater\tblood\tpressure\treductions,\tgreater\timprovements\tin\tvascular\tfunction,\n\tand\nreduction\tin\tleft\tventricular\tmass\tcompared\twith\tthe\tDASH\tdiet\talone\t(\nLee\tet\tal,\t2018\n).\nThe\tMeD\tdietary\tpattern\thas\tmany\tsimilarities\tto\tthe\tDASH\tdiet\tbut\tis\tgenerally\thigher\tin\tfat, | [
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primarily\tMUFA\tfrom\tolive\toil,\tnuts,\tand\tseeds.\tA\ttraditional\tMeD\tdiet\talso\tcontains\tfatty\tfish\trich\tin\nomega-3\tfatty\tacids.\tA\tsystematic\treview\tof\tthe\tMeD\tdiet\tand\tCVD\trisk\tfactors,\tfound\tthat\talthough\nlimited,\n\tevidence\tfrom\tRCTs\twas\tsuggestive\tof\ta\tblood\tpressure–lowering\teffect\tof\tthis\tstyle\tdietary\npattern\tin\tadults\twith\thypertension\t( | [
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pattern\tin\tadults\twith\thypertension\t(\nRees\tet\tal,\t2013\n).\tAccording\tto\tthe\tACC/AHA,\tmore\tstudies\ton\ndiverse\tpopulations\tare\twarranted\tbefore\trecommendations\tcan\tbe\tmade\trelated\tto\tthe\tMeD\tdiet\tfor\nuse\tin\tblood\tpressure\tmanagement\t(\nWhelton\tet\tal,\t2018\n).\nWeight\treduction\nThere\tis\ta\tstrong\tassociation\tbetween | [
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Benjamin\tet\tal,\t2018\n).\tWeight\tgain\tduring\tadult\tlife\tis\nresponsible\tfor\tmuch\tof\tthe\trise\tin\tblood\tpressure\tseen\twith\taging.\nSome\tof\tthe\tphysiologic\tchanges\tproposed\tto\texplain\tthe\trelationship\tbetween\texcess\n\tbody\tfat\tand\nblood\tpressure\tare\toveractivation\tof\tthe\tSNS\tand\tRAS\tand\tvascular\tinflammation\t(\nHall\tet\tal,\t2015\n). | [
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Hall\tet\tal,\t2015\n).\nVisceral\tfat\tin\tparticular\tpromotes\tvascular\tinflammation\tby\tinducing\tcytokine\trelease,\nproinflammatory\ttranscription\tfactors,\tand\tadhesion\tmolecules\t(\nHall\tet\tal,\t2015\n).\tLow-grade\ninflammation\toccurs\tin\tthe\tvasculature\tof\tindividuals\twith\televated\tblood\tpressure;\twhether\tit\nprecedes | [
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precedes\n\tthe\tonset\tof\thypertension\tis\tunclear.\tWeight\tloss,\texercise,\tand\ta\tMeD-style\tdiet\tare\nbeneficial\t(see\t\nAppendix\t23\n).\nVirtually\tall\tclinical\ttrials\ton\tweight\treduction\tand\tblood\tpressure\tsupport\tthe\tefficacy\tof\tweight\nloss\ton\tlowering\tblood\tpressure.\tReductions\tin\tblood\tpressure\tcan\toccur\twithout\tattainment\tof | [
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desirable\tbody\tweight\tin\tmost\tparticipants.\tLarger\tblood\tpressure\treductions\tare\tachieved\n\tin\nparticipants\twho\tlost\tmore\tweight\tand\twere\talso\ttaking\tantihypertensive\tmedications.\tThis\tlatter\nfinding\tsuggests\ta\tpossible\tsynergistic\teffect\tbetween\tweight\tloss\tand\tdrug\ttherapy.\tAlthough\tweight | [
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reduction\tand\tmaintenance\tof\ta\thealthy\tbody\tweight\tis\ta\tmajor\teffort,\tinterventions\tto\tprevent\nweight\tgain\tare\tneeded\tbefore\tmidlife.\tIn\taddition,\tBMI\tis\trecommended\tas\ta\tscreening\ttool\tin\nadolescence\n\tfor\tfuture\thealth\trisk\t(\nFlynn\tet\tal,\t2017\n).\nSodium\nEvidence\tfrom\ta\tvariety\tof\tstudies\tsupports\tlowering\tblood\tpressure\tand\tCVD\trisk\tby\treducing | [
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Cook\net\tal,\t2014\n).\tA\tmeta-analysis\tof\t37\tRCTs\tfurther\tsupports\tthe\tpositive\teffects\tof\tsodium\treduction\ton\nblood\tpressure\tand\tcardiovascular\toutcomes\tfor\n\tnormotensive\tand\thypertensive\tindividuals\t(\nAburto\net\tal,\t2013\n). | [
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achieved\tby\tthose\teating\tthe\t1500-mg\tsodium\n\tlevel\tin\tthe\tDASH\tdiet.\tIn\tthe\tDASH\tdiet\tand\tthe\ntypical\tAmerican\tdiet\tgroups,\tthe\tlower\tthe\tsodium,\tthe\tlower\tthe\tblood\tpressure.\tSuch\tdata\tprovide\nthe\tbasis\tfor\tthe\t2018\tACC/AHA\t(\nWhelton\tet\tal,\t2018\n)\tsodium\tguideline\tfor\tmost\tadults\tto\taim\tfor\tat | [
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Lennon\tet\tal,\t2017\n)\nand\tother\torganizations.\nThere\tis\tagreement\tthat\tsome\tpersons\twith\thypertension\tshow\ta\tgreater\tdecrease\tin\ttheir\tblood\npressures\tin\tresponse\tto\treduced\tsodium\n\tintake\tthan\tothers.\tThe\tterm\tsalt-sensitive\thypertension\nhas\tbeen\tused\tto\tidentify\tthese\tindividuals.\tSalt-resistant\thypertension\trefers\tto\tindividuals\twith | [
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to\tthe\teffects\tof\tsalt\tand\tsodium\ttend\tto\tbe\tindividuals\nwho\tare\tblack,\tobese,\tand\tmiddle-aged\tor\tolder,\tespecially\tif\tthey\thave\tdiabetes,\tchronic\tkidney\ndisease,\tor\thypertension.\tCurrently,\tthere\tare\tno\tclinical\ttests\tmethods\tfor\tidentifying\tthe\tsalt-\nsensitive\tindividual\tfrom\tthe\tsalt-resistant\tindividual.\nCalcium\tand\tvitamin\tD | [
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Calcium\tand\tvitamin\tD\nCalcium\tpotentiates\tvascular\tcontraction\tand\trelaxation\tthrough\n\tmodification\tof\t1,25-dihydroxy\nvitamin\tD\n3\n\tand\tparathyroid\thormone\tlevels\t(\nBrozovich\tet\tal,\t2016\n).\tPeptides\tderived\tfrom\tmilk\nproteins,\tespecially\tfermented\tmilk\tproducts,\tmay\talso\tfunction\tas\tACEs,\tthereby\tlowering\tblood\npressure\t(\nFekete\tet\tal,\t2016 | [
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pressure\t(\nFekete\tet\tal,\t2016\n).\tThe\tDASH\ttrial\tfound\tthat\t8-week\tconsumption\tof\ta\tdiet\thigh\tin\tfruits,\nvegetables,\tand\tfiber;\tthree\tservings\tof\tlow-fat\tdairy\tproducts/day;\tand\n\tlower\ttotal\tand\tsaturated\tfat\ncould\tlower\tSBP\tby\t5.5\tmm\tHg\tand\tDBP\tby\t3\tmm\tHg\tfurther\tthan\tthe\tcontrol\tdiet.\tThe\tfruit\tand | [
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Lennon\tet\tal,\t2017\n).\nThe\tDASH\tserving\trecommendation\tof\t2\tto\t3\tlow-fat\tdairy\tfoods\tper\tday\twould\tprovide\tthe\tminimum\ncalcium\tintake\t(∼\t800\tmg)\tnecessary\tto\tachieve\ta\tSBP\tlowering\tof\t4\tmm\tHg\tand\tDBP\tof\t2\tmm\tHg\tin\nadults\twith\thypertension\t(\nLennon\tet\tal,\t2017\n). | [
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adults\twith\thypertension\t(\nLennon\tet\tal,\t2017\n).\nCross-sectional\tstudies\tsuggest\tlower\t25-hydroxy\tvitamin\tD\t(25[OH]D)\tlevels\tare\tassociated\twith\nhigher\tblood\tpressure\tlevels\t(\nFraser\tet\tal,\t2010\n)\tand\thigher\n\trates\tof\tincident\thypertension\t(\nKunutsor\net\tal,\t2013 | [
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)\tand\thigher\n\trates\tof\tincident\thypertension\t(\nKunutsor\net\tal,\t2013\n).\tMechanistically,\tvitamin\tD\thas\tbeen\tshown\tto\timprove\tendothelial\tfunction,\treduce\tRAS\nactivity,\tand\tlower\tparathyroid\thormone\t(PTH)\tlevels.\tHowever,\trecent\tevidence\tsuggests\tthat\nsupplementation\twith\tvitamin\tD\tis\tnot\teffective\tas\ta\tblood\tpressure–lowering\tagent\ton\tits\town\tand | [
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] |
therefore\tis\tnot\trecommended\tas\tan\tantihypertension\tagent\t(\nQi,\t2017\n).\nMagnesium\nMagnesium\tis\ta\tpotent\tinhibitor\tof\tvascular\tsmooth-muscle\tcontraction\tand\tmay\tplay\ta\trole\tin\tblood\npressure\tregulation\tas\ta\tvasodilator.\tHigh\tdietary\tmagnesium\toften\tis\tcorrelated\twith\tlower\tblood\npressure\t(\nSchutten\tet\tal,\t2018 | [
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] |
pressure\t(\nSchutten\tet\tal,\t2018\n).\tTrials\tof\tmagnesium\tsupplementation\thave\tshown\tdecreases\tin\tSBP\nof\t3\tto\t4\tmm\tHg\tand\tDBP\tof\t2\tto\t3\tmm\tHg\twith\tgreater\tdose-dependent\teffects\tat\tsupplementation\nof\tat\tleast\t370\tmg/day\t(\nZhang\tet\tal,\t2016\n).\tThe\tDASH\tdietary\tpattern\temphasizes\tfoods\trich\tin | [
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] |
).\tThe\tDASH\tdietary\tpattern\temphasizes\tfoods\trich\tin\nmagnesium,\tincluding\tgreen\tleafy\tvegetables,\tnuts,\tand\twhole-grain\tbreads\tand\tcereals.\tOverall\tfood\nsources\tof\tmagnesium\trather\tthan\tsupplemental\tdoses\tof\tthe\tnutrient\tare\tencouraged\tto\tprevent\tor\ncontrol\thypertension\t(\nLennon\tet\tal,\t2017\n).\nPotassium | [
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] |
control\thypertension\t(\nLennon\tet\tal,\t2017\n).\nPotassium\nSupplemental\tdoses\tof\tpotassium\tin\tthe\trange\tof\n\t235\tto\t4700\tmg/day\tlower\tblood\tpressure\napproximately\t1\tto\t4\tmm\tHg\tDBP\tand\t3\tto\t6\tmm\tHg\tSBP\t(\nPoorolajal\tet\tal,\t2017\n).\tThe\teffects\tof\npotassium\tare\tgreater\tin\tthose\twith\thigher\tinitial\tblood\tpressure,\tin\tblacks\tcompared\twith\twhites, | [
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and\tin\tthose\twith\thigher\tintakes\tof\tsodium.\tHigher\tpotassium\tintake\talso\tis\tassociated\twith\ta\tlower\nrisk\tof\tstroke\t(\nAburto\tet\tal,\t2013\n).\tAlthough\tthe\tmechanism\tby\twhich\n\tpotassium\tlowers\tblood\npressure\tis\tuncertain,\tseveral\tpotential\texplanations\thave\tbeen\toffered,\tincluding\tdecreased\tvascular | [
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smooth\tmuscle\tcontraction\tby\taltering\tmembrane\tpotential\tor\trestoring\tendothelium-dependent\nvasodilation\t(\nBazzano\tet\tal,\t2013\n).\tFailure\tof\tthe\tkidney\tto\tadapt\tto\ta\tdiet\tlower\tin\tpotassium\thas\nbeen\tlinked\tto\tsodium-sensitive\thypertension.\nThe\tlarge\tnumber\tof\tfruits\tand\tvegetables\n\trecommended\tin\tthe\tDASH\tdiet\tmakes\tit\teasy\tto\tmeet | [
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recommended\tin\tthe\tDASH\tdiet\tmakes\tit\teasy\tto\tmeet\nthe\tdietary\tpotassium\trecommendations—approximately\t4.7\tg/day\t(\nLennon\tet\tal,\t2017\n).\tIn\nindividuals\twith\tmedical\tconditions\tthat\tcould\timpair\tpotassium\texcretion\t(e.g.,\tchronic\trenal\tfailure,\ndiabetes,\tand\tcongestive\tHF),\ta\tlower\tpotassium\tintake\t(less\tthan\t4.7\tg/day)\tis\tappropriate\tto | [
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prevent\thyperkalemia\t(see\t\nAppendix\t44\n).\nPhysical\tactivity\nLess\tactive\tpersons\tare\t30%\tto\t50%\tmore\tlikely\tto\tdevelop\thypertension\tthan\ttheir\tactive\ncounterparts.\tDespite\tthe\tbenefits\tof\tactivity\tand\texercise\tin\treducing\tdisease,\tmany\tAmericans\nremain\tinactive.\tThe\tprevalence\tof\tadults\tnot\tmeeting\tthe\tFederal\tPhysical\tActivity\tGuidelines\tfor | [
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Americans\t(2008)\tis\tas\tfollows:\tHispanics\t(54.3%\tmen,\t59%\twomen),\tblacks\t(49.7%\tmen,\t65%\nwomen),\tand\twhites\t(44.8%\n\tmen,\t49.1%\twomen)\tall\thave\ta\thigh\tprevalence\tof\tsedentary\tlifestyles\n(\nBenjamin\tet\tal,\t2018\n).\tExercise\tis\tbeneficial\tto\tblood\tpressure.\tIncreasing\tthe\tamount\tof\taerobic\tor | [
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of\tpharmacologic\tagents\tand\timprove\tother\tCVD\trisk\tfactors.\tManagement\tof\thypertension\trequires\na\tlifelong\tcommitment.\nFIG.\t32.9\nAlgorithm\tfor\ttreatment\tof\thypertension.\nACEI\n,\tAngiotensin-converting\tenzyme\tinhibitor;\t\nARB\n,\nangiotensin-receptor\tblocker;\t\nBB\n,\tbeta-blocker;\t\nCCB\n,\tcalcium\tchannel\tblocker;\t\nDBP\n,\tdiastolic\tblood\tpressure;\nSBP | [
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and\ttreatment\tof\thigh\tblood\tpressure,\tNIH\tPublication\tNo.\t04-5230,\tAugust\t2004.)\nPharmacologic\ttherapy\tis\tnecessary\tfor\tmany\tindividuals\twith\thypertension,\tespecially\tif\tblood\npressure\tremains\televated\tafter\t6\tto\t12\tmonths\tof\tlifestyle\tchanges.\tThe\tblood\tpressure\ttarget\tfor\ninitiating\tpharmacologic\ttreatment\tis\t130/80\tmm | [
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Thiazide-type\tdiuretics\tand\tCCBs\tare\trecommended\tin\tblack\tpopulations,\tincluding\tthose\twith\ndiabetes,\tbecause\tthey\thave\tbeen\tshown\tto\tbe\tmore\teffective\tin\timproving\tCVD\toutcomes\tcompared\nto\tother\tclasses\tof\tmedications\t(\nWhelton\tet\tal,\t2018\n).\tAll\tthese\tdrugs\tcan\taffect\tnutrition\tstatus\t(see\nAppendix\t13\n). | [
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).\tAll\tthese\tdrugs\tcan\taffect\tnutrition\tstatus\t(see\nAppendix\t13\n).\nDiuretics\tlower\tblood\tpressure\tin\tsome\tpatients\tby\tpromoting\tvolume\tdepletion\tand\tsodium\tloss.\nAt\thigh\tdoses\tother\twater-soluble\tnutrients\tare\talso\tlost\tand\tmay\thave\tto\tbe\tsupplemented.\tThiazide | [
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diuretic\n\tsuch\tas\tspironolactone\tor\ttriamterene,\tadditional\tpotassium\tusually\tis\trequired.\tGrapefruits\nand\tgrapefruit\tjuice\tcan\taffect\tthe\taction\tof\tmany\tCCBs\tand\tshould\tnot\tbe\tconsumed\twhile\ttaking\nthe\tmedication.\nA\tnumber\tof\tmedications\teither\traise\tblood\tpressure\tor\tinterfere\twith\tthe\teffectiveness\tof | [
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] |
antihypertensive\tdrugs.\tThese\tinclude\toral\tcontraceptives,\tsteroids,\tnonsteroidal\tantiinflammatory\ndrugs,\tnasal\tdecongestants\tand\tother\tcold\tremedies,\tappetite\tsuppressants,\tcyclosporine,\ttricyclic\nantidepressants,\tand\tmonoamine-oxidase\tinhibitors\t(see\t\nAppendix\t13\n). | [
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] |
Appendix\t13\n).\nIn\taddition\tto\tstandard,\tconventional\tmedical\tcare,\tmore\tthan\t½\tof\tAmericans\talso\tuse\ncomplementary\tapproaches\tand\tthis\tincludes\ttreatment\tof\thypertension\tand\tother\tcardiovascular\ndiseases.\t\nTable\t32.4\n\tlists\tsome\tthat\tare\tmost\tcommon. | [
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0.033599793910980225,
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0.0459672287106514,
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0.05813131481409073,
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0.03835587576031685,
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0.060819923877716064,
0.00936059094965458,
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0.03956148773431778,
0.016001243144273758,
0.05854715779423714,
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0.026995694264769554,
0.013730720616877079,
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0.008867098949849606,
0.07457523792982101,
0.05939184129238129,
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0.0746559202671051,
0.08427281677722931,
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0.05763516575098038,
0.004411958158016205,
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0.0866062268614769,
0.03746376559138298,
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0.04751130938529968,
0.08745650202035904,
0.046504560858011246,
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0.01689937338232994,
0.08403705060482025,
0.0864192396402359,
0.06873985379934311,
0.007026639301329851
] |
TABLE\t32.4\nComplementary\tand\tIntegrative\tApproaches\tfor\tCardiovascular\tHealth\nCommon\nName\nScientific\tName\nEffect\ton\tCardiac\tHealth\nSide\tEffects\tand\tRisks\nCoenzyme\tQ\n10\nUbiquinone\nDecreases\tSBP\tand\tDBP\tvia\ta\tdirect\neffect\ton\tthe\tvascular\tendothelium\nand\tsmooth\tmuscle.\tMay\tstrengthen\nthe\theart\tmuscle\tin\theart\tfailure.\nMay\tcause\ngastrointestinal | [
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0.037457987666130066,
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0.017107229679822922,
0.06887225806713104,
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0.0648026168346405,
0.08171521872282028,
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0.04335721582174301,
0.03336566314101219,
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0.02197442017495632,
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0.004248538985848427,
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0.08024417608976364,
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0.09702261537313461,
0.020649120211601257,
0.02287570759654045,
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0.04671376198530197,
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0.0385873056948185,
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0.011456944048404694,
0.092043437063694,
0.03391176834702492,
0.033440131694078445,
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0.03241630271077156,
0.04960204288363457,
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0.018594233319163322,
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2.6126287648826612e-33,
0.01223334576934576,
0.08339753746986389,
0.045726340264081955,
0.01921420358121395,
0.044188715517520905,
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0.007067241705954075,
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0.07061301916837692,
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0.021294770762324333,
0.03475511819124222,
0.08667461574077606,
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0.038770414888858795,
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0.13697318732738495,
0.028166403993964195,
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0.06307334452867508,
0.019878197461366653,
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0.0781683400273323,
0.02951814979314804,
0.0639386922121048,
0.03792594000697136,
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0.0033732112497091293,
0.020486047491431236,
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0.0220336951315403,
0.08222436904907227,
0.0016373051330447197,
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0.019029831513762474,
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0.04476908966898918,
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0.08026151359081268,
0.0016042074421420693,
0.035340163856744766,
0.024131234735250473,
0.0036032579373568296,
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0.04026411846280098,
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0.03748300299048424,
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0.021423133090138435,
0.04029867798089981,
0.11802050471305847,
0.03468243032693863,
0.053649358451366425,
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0.0008540324051864445,
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0.01919103041291237,
0.036740291863679886,
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0.03211222589015961,
0.06251290440559387,
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0.014309125952422619,
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0.058438740670681,
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0.09555493295192719,
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0.02760150469839573,
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0.03621238097548485,
0.007402220740914345,
0.07550108432769775,
0.01488781813532114,
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0.05549119412899017,
0.0773448571562767,
0.03611281141638756,
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0.048856157809495926,
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0.042513370513916016,
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0.010998201556503773,
0.03886933624744415,
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0.12481670826673508,
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0.03298583999276161,
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0.05748676881194115,
0.07006462663412094,
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0.06947039812803268,
0.005264136474579573,
0.01930413953959942,
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0.015462773852050304,
0.001002972829155624,
0.06466427445411682,
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0.0812322124838829,
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0.03359118849039078,
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0.09372622519731522,
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0.04464428126811981,
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0.03336361050605774,
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0.03386649489402771,
0.007893948815762997,
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0.02227010391652584,
0.034019310027360916,
0.0812617689371109,
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0.001529413159005344,
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0.04565559700131416,
0.12996424734592438,
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0.05115211009979248,
0.025199392810463905,
0.003146388800814748,
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0.0442533977329731,
0.044276490807533264,
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0.02736222930252552,
0.12508974969387054,
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0.0391082689166069,
0.00046671245945617557,
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0.07283887267112732,
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0.07423727214336395,
0.009562734514474869,
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0.03777886554598808,
0.0544997863471508,
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0.04031416028738022,
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0.11781969666481018,
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0.0641392320394516,
0.0580933541059494,
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0.10156144201755524,
0.01806950382888317,
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0.051913995295763016,
0.008634714409708977,
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0.046485599130392075,
0.078195720911026,
0.028989845886826515,
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0.0020389044657349586,
0.031118692830204964,
0.06838251650333405,
0.08369994908571243,
-0.02890678495168686
] |
the\theart\tmuscle\tin\theart\tfailure.\nMay\tcause\ngastrointestinal\ndiscomfort,\tnausea,\nflatulence,\tand\nheadaches\nVitamin\tC\tand\nvitamin\tE\ntaken\tin\ncombination\nas\nsupplement\nAscorbic\tacid\nα-tocopherol\nDecreases\tSBP\tand\tDBP,\tdecreases\narterial\tstiffness,\tand\timproves\nendothelial\tfunction\tby\timproving\nantioxidant\tstatus\nVitamin\tE\tmay\tincrease | [
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0.005027489271014929,
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antioxidant\tstatus\nVitamin\tE\tmay\tincrease\nbleeding\ttime\twith\nanticoagulants\tand\nreduce\tblood\tpressure.\nVitamin\tC\tmy\tcause\ndiarrhea\tat\thigh\tdoses.\nVitamin\tD\n1,25-dihydroxy\nvitamin\tD\n3\nDecreases\tSBP\tvia\tsuppression\tof\trenin\nexpression\tand\tvascular\tsmooth\nmuscle\tcell\tproliferation\nHypercalcemia\n\tmay\toccur\ndepending\ton\tlevel\tof\nsupplementation | [
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Hypercalcemia\n\tmay\toccur\ndepending\ton\tlevel\tof\nsupplementation\nFish\toil\nOmega-3\npolyunsaturated\nfatty\tacid\nTherapeutic\tdoses\t(2-3g\tEPA/DHA)\nlowers\ttriglycerides.\tLowers\tblood\npressure\tby\tincreasing\tendothelial\nvasodilatory\tresponse\tand\tmay\nincrease\tNO\nMay\tcause\ngastrointestinal\ndiscomfort,\tbelching,\nbad\tbreath,\tand\nincreased\tbleeding\ntime\tabove\t3g | [
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bad\tbreath,\tand\nincreased\tbleeding\ntime\tabove\t3g\nEPA/DHA\nGarlic\nAllium\tsativum\nReduces\tSBP\tand\tDBP\tin\tindividuals\nwith\thypertension\tvia\tvasodilation\nresulting\tfrom\tactivation\tof\npotassium\tchannels;\tmay\talso\tbe\tdue\nto\tactivation\tof\tNOS.\tSignificantly\nlowers\tserum\tcholesterol.\nMay\tcause\tbad\tbreath\nand\tbody\todor\tmay\nincrease\tbleeding\ttime | [
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] |
Lowers\tSBP\tin\tpre-\tand\tmildly\nhypertensive\tadults\tvia\tcalcium\nchannel\tactivation\nMay\thave\tan\tadditive\neffect\twhen\ttaken\twith\nantihypertensive\nmedication\nRed\tYeast\tRice\nMonascus\tpurpureus\nContains\n\ta\tcompound\tcalled\tMonakolin\nK\tthat\tis\tidentical\tto\tlovastatin.\nLowers\tcholesterol.\nBanned\tby\tthe\tFDA\tin\nstandardized\nquantities.\tMay\tcause\nmyalgias. | [
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] |
Banned\tby\tthe\tFDA\tin\nstandardized\nquantities.\tMay\tcause\nmyalgias.\nPlant\tsterols\nand\tstanols\nβ-sitosterol,\ncampesterol,\nsitostanol\tand\ncampestanol\nHave\tbeen\tshown\tto\tlower\tcholesterol\nnone\tknown\nDBP\n,\tdiastolic\tblood\tpressure;\t\nNO\n,\tnitric\toxide;\t\nNOS\n,\tnitric\toxide\tsynthase;\t\nSBP\n,\tsystolic\tblood\tpressure.\nData\n\tfrom\tFragakis\tAS,\tThomson\tC: | [
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SBP\n,\tsystolic\tblood\tpressure.\nData\n\tfrom\tFragakis\tAS,\tThomson\tC:\t\nThe\thealth\tprofessional’s\tguide\tto\tpopular\tdietary\tsupplements\n,\ted\t3,\tChicago,\t2007,\tAmerican\tDietetic\nAssociation.\t©\tAmerican\tDietetic\tAssociation.\tReprinted\twith\tpermission.\tNatural\tMedicines\t[database\ton\tthe\tInternet].\tSomerville\t(MA):\tTherapeutic | [
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Research\tCenter;\tpublication\tyear\t[December\t10,\t2019].\tAvailable\tfrom:\t\nhttps://naturalmedicines.therapeuticresearch.com\n.\nMedical\tnutrition\ttherapy\nThe\tappropriate\tcourse\tof\tnutrition\ttherapy\tfor\tmanaging\thypertension\tshould\tbe\tguided\tby\tdata\nfrom\ta\tdetailed\tnutrition\tassessment.\tWeight\thistory;\tleisure-time\tphysical\tactivity;\tand\tassessment | [
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blood\tpressure.\nEnergy\tintake\nFor\teach\tkilogram\tof\tweight\tlost,\treductions\tin\tSBP\tand\tDBP\tof\tapproximately\t1\tmm\tHg\tare\nexpected.\tHypertensive\tpatients\twho\tweigh\tmore\tthan\t115%\tof\tideal\tbody\tweight\tshould\tbe\tplaced\non\tan\tindividualized\tweight-reduction\tprogram\tthat\tfocuses\ton\thypocaloric\tdietary\tintake\tand\nexercise\t(see\t\nChapter\t20 | [
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] |
exercise\t(see\t\nChapter\t20\n).\tA\tmodest\tcaloric\treduction\tis\tassociated\twith\ta\tsignificant\n\tlowering\tof\nSBP\tand\tDBP,\tand\tLDL\tcholesterol\tlevels.\tHypocaloric\tdiets\tthat\tinclude\ta\tlow-sodium\tDASH\tdietary\npattern\thave\tproduced\tmore\tsignificant\tblood\tpressure\treductions\tthan\tlow-calorie\tdiets | [
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Slow\tchanges\tcan\treduce\tpotential\tshort-term\tgastrointestinal\ndisturbances\tassociated\twith\ta\thigh-fiber\tdiet,\tsuch\tas\tbloating\tand\tdiarrhea.\tThe\tDASH\tpattern\tis\nadvocated\tin\tthe\t2017\tACC/AHA\tnutrition\tguidelines\ton\tlifestyle\tmanagement\tto\treduce\tCVD\trisk\n(\nWhelton\tet\tal,\t2018\n).\tServings\tfor\tdifferent\tcalorie\tlevels\tare\tshown\tin\t\nAppendix\t17\n. | [
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).\tServings\tfor\tdifferent\tcalorie\tlevels\tare\tshown\tin\t\nAppendix\t17\n.\nSalt\trestriction\nThe\tDietary\tGuidelines\tfor\tAmericans\n\trecommend\tthat\tyoung\tadults\tconsume\tless\tthan\t2300\tmg\tof\nsodium\tper\tday.\tThis\tis\talso\trecommended\tfor\tolder\tpeople\twith\thypertension\t(\nWhelton\tet\tal,\t2018\n). | [
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Whelton\tet\tal,\t2018\n).\nAlthough\tfurther\tblood\tpressure\timprovements\tmay\tbe\tachieved\tby\treducing\tsodium\tto\t1500\tmg/day\n(\nAppel\tet\tal,\t2006\n),\tpatients\twith\tHF\tshould\tbe\tcautioned\tagainst\tuse\tof\tthis\tdietary\tapproach\nbecause\tadverse\thealth\teffects\tof\tvery-low-sodium\n\tdiets\tin\tthese\tpatients\thave\tbeen\treported\n(\nInstitute\tof\tMedicine\t[IOM],\t2013 | [
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(\nInstitute\tof\tMedicine\t[IOM],\t2013\n).\tAdherence\tto\tdiets\tcontaining\tless\tthan\t2\tg/day\tof\tsodium\tis\nvery\tdifficult\tto\tachieve.\nIn\taddition\tto\tadvice\ton\tselection\tof\tminimally\tprocessed\tfoods,\tdietary\tcounseling\tshould\tinclude\ninstruction\ton\treading\tfood\tlabels\tfor\tsodium\tcontent,\tavoidance\tof\tdiscretionary\tsalt\tin\tcooking\tor | [
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sodium\tin\tthe\tAmerican\tdiet\t(see\t\nFocus\tOn:\n\tSodium\tand\tthe\tFood\tIndustry\n).\n\t\nFOCUS\tON\nSodium\tand\tthe\tFood\tIndustry\nMost\tfoods\tsold\tin\tsupermarkets\n\tand\trestaurants\tare\thigh\tin\tsalt.\tThe\tdramatic\tdifferences\tin\nsodium\tfrom\tbrand\tto\tbrand\tsuggest\tthat\tmany\tcompanies\tcould\teasily\tachieve\tsignificant | [
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reductions\twithout\tsacrificing\ttaste.\tAccording\tto\tthe\tCenter\tfor\tScience\tin\tthe\tPublic\tInterest\n(\nLiebman,\t2014\n),\tprocessed\tfoods\tand\trestaurant\tfoods\tcontribute\tapproximately\t80%\tof\tthe\nsodium\tin\tAmericans’\tdiets:\t10%\tcomes\tfrom\tsalt\tadded\tduring\n\tcooking\tat\thome\tor\tat\tthe\ttable | [
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Potassium-calcium-magnesium\nConsuming\ta\tdiet\trich\tin\tpotassium\tmay\tlower\tblood\tpressure\tand\tblunt\tthe\teffects\tof\tsalt\ton\tblood\npressure\tin\tsome\tindividuals\t(\nAppel\tet\tal,\t2006\n).\tThe\trecommended\tintake\tof\tpotassium\tfor\tadults\tis\n4.7\tg/day\t(\nIOM,\t2004\n).\tPotassium-rich\n\tfruits\tand\tvegetables\tinclude\tleafy\tgreen\tvegetables,\tfruits, | [
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fruits\tand\tvegetables\tinclude\tleafy\tgreen\tvegetables,\tfruits,\nand\troot\tvegetables.\tExamples\tof\tsuch\tfoods\tinclude\toranges,\tbeet\tgreens,\twhite\tbeans,\tspinach,\nbananas,\tand\tsweet\tpotatoes.\tAlthough\tmeat,\tmilk,\tand\tcereal\tproducts\tcontain\tpotassium,\tthe\npotassium\tfrom\tthese\tsources\tis\tnot\tas\twell\tabsorbed\tas\tthat\tfrom\tfruits\tand\tvegetables\t(\nUSDA, | [
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blood\tpressure\tlowering\t(\nLennon\tet\tal,\t2017\n).\tThe\tguidelines\talso\trecommend\tconsideration\tof\ncalcium\tsupplementation\tof\tup\tto\t1500\tmg/day\tfor\tadults\n\twith\thypertension\twho\tare\tunable\tto\nachieve\tthe\tdietary\treference\tintake\t(DRI)\tof\tcalcium\twith\tdiet\tand\tfood\talone.\tThe\tDASH\tdiet\tplan | [
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encourages\tfoods\tthat\twould\tbe\tgood\tsources\tof\tcalcium\tand\tmagnesium,\tincluding\tlow-fat\tdairy\nproducts,\tdark\tgreen\tleafy\tvegetables,\tbeans,\tand\tnuts\t(see\t\nAppendix\t17\n).\nLipids\nCurrent\trecommendations\tfor\tlipid\tcomposition\tof\tthe\tdiet\tare\trecommended\tto\thelp\n\tcontrol\tweight | [
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control\tweight\nand\tdecrease\tthe\trisk\tof\tCVD.\tOmega-3\tfatty\tacids\tare\tnot\thighlighted\tin\tblood\tpressure\ttreatment\nguidelines\t(\nLennon\tet\tal,\t2017\n),\talthough\tintakes\tof\tfish\toils\texceeding\t2\tg/day\tmay\thave\tblood\npressure\tbenefits.\nAlcohol\nThe\tdiet\thistory\tshould\tcontain\tinformation\tabout\talcohol\tconsumption.\tAlcohol\tintake\tshould\tbe | [
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limited\tto\tno\tmore\tthan\ttwo\tdrinks\tdaily\tin\tmen,\twhich\tis\tequivalent\n\tto\t2\toz\tof\t80-proof\twhiskey,\t10\noz\tof\twine,\tor\t24\toz\tof\tbeer.\tWomen\tor\tlighter-weight\tmen\tshould\tconsume\thalf\tthis\tamount.\nExcessive\talcohol\tconsumption\tis\tassociated\twith\tleft\tventricular\tfunction.\nExercise | [
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] |
Exercise\nIncreasing\tthe\tamount\tof\taerobic\tor\tdynamic\tresistance\tphysical\tactivity\tto\ta\tminimum\tof\t90\tto\t150\nminutes\tper\tweek\tis\trecommended\tas\tan\tadjunct\ttherapy\tin\thypertension\tmanagement\t(\nWhelton\tet\nal,\t2018\n).\tBecause\texercise\tis\tassociated\tstrongly\twith\tsuccess\tin\tweight-reduction\tand\tweight- | [
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