Dietary Counselling for Hypertension

About 45% of US adults have hypertension, and it is on the rise. Although hypertension is not the leading cause of death, it is a major risk factor for many other conditions, including stroke, heart attack, kidney disease, and some types of cancer. Hypertension management and reducing its complications and health care costs have been recognized as priorities by the US government and guidelines by professional organizations.

Hypertension was more common in men than women. The prevalence of obesity was positively associated with hypertension. Most hypertension was diagnosed on screening by physicians or screening from the health clinic. Screening for hypertension should be done as part of the routine medical evaluation for young people, and hypertension screening should be recommended to prevent hypertensive cardiovascular diseases.

Asymmetrical hypertensive pulse morphology may be associated with increased cerebrovascular risk. Given the lack of conclusive evidence, treatment of left ventricular dysfunction in hypertension remains a subject of clinical discussion.

More than half of those with hypertension may be treated by a combination of three or fewer different therapies to achieve a goal BP measurement or to improve their quality of life.

The standard method for establishing the diagnosis of hypertension is through non-invasive blood pressure measurements. As hypertension progresses, many patients will present with the classical symptoms of hypertension and an increase in blood pressure, including headache, palpitations, dizziness, abnormal sensations, chest pain or discomfort, and shortness of breath. If the patient has a history of hypertension, the doctor is motivated to confirm the diagnosis. There are other non-invasive blood pressure measurement methods such as pulse oximetry.\n\nIf the patient has non-insistent hypertension and a normal ankle-brachial index (ABI) then further examination through other methods such as echocardiogram are recommended.

Hypertension is the most common cardiovascular disease and the leading risk factor for death. The majority of hypertension cases are secondary to hypertension complications, such as stroke and myocardial infarction. In order to prevent and control hypertension, it is needed to maintain a healthy weight, smoke less, and have fewer meals in the course of a day.

There is a great deal of research on the association between hypertensive heart disease and hypertension and cardiac arrhythmias. The role of hypertension and hypertensive heart disease on outcomes in end-stage renal disease, the elderly, and the black patient is not clear and requires further study.

Patients are not able to manage their diabetes, HT or CKD by their own actions. Their dietary counsellors inform, advise, motivate and inform. Nutrition and diet counselling should be regarded as one of the core components of preventive medicine. Dietitians in primary care are able to intervene timely to prevent progression to atherosclerotic and renal diseases, but only when patients are motivated to behave in a healthy lifestyle as well as their dietary counsellors are able to inform and advise them.

A positive recommendation for dietetic advice is rarely given, regardless of the patient's lifestyle, medical condition or disease status. This may be because patients do not see themselves as needing dietary advice and this is not seen as part of the therapeutic process. A referral should always be made and patients should consult with their dietitian if they have a high blood pressure or Type 2 diabetes.

Findings from a recent study shows that dietary counselling alone is effective in improving BP lowering and lipid lowering. The counselling sessions need, however, to be carried out in such a way that it will be clearly evident for patients that the advice was heeded and that positive behaviour change occurred and this, in combination with lifestyle modifications, seems to enhance the patient's self-management. Further research is needed on the long-term impact of this intervention on BP control and other medical symptoms.

Physicians overestimate the urgency of ambulatory care and undertreat the seriousness of the disease. The need for more aggressive clinical management could potentially be decreased by greater awareness of the severity of the risks of untreated hypertension, and the likelihood of clinical or subclinical cardiac events with the use of antihypertensives for those with a low likelihood of immediate benefits.