Oct 9, 2020 in Medicine

Nutritional support for patients with Hypertension

Hypertension is a heart condition that is associated with increased blood pressure against vessel walls. The magnitude of this force depends on the blood vessels and the cardiac output. Hypertension occurs when the diastolic reading is over 90 millimeters of mercury (90mmhg) and a systolic reading of over 140 millimeters of mercury (140mmhg). Hypertension affects almost 50 million persons in the United States and exposes them to the increased risk of developing cardiovascular diseases (O'Keefe, 2015). The risk is high when blood pressure rises, and patients with hypertension are always put on nutritional and medical therapy as well as advised on other effective ways of maintaining their blood pressure within normal ranges. The paper explains nutritional support for patients with hypertension and more so, the elderly.

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Hypertension among Elderly Patients

Hypertension is a common health condition among the elderly and an important risk factor for various vascular diseases. Blood pressure is often an indication of the health of the circulatory system. A patient with high blood pressure is at increased risk for chronic kidney disease, damage to the arteries, stroke, and heart failure. The condition is the same for the patients in their senior years (O'Keefe, 2015). Blood pressure often increases with the age of the patient. Patients having a healthy blood pressure at the age of 50 have a greater risk (90%) of developing hypertension later in life. Thus, O'Keefe (2015) reveals that rising blood pressure is common among the elderly even though the risk factors are often similar to the other population as a whole. Seniors at risk of hypertension are those with chronic kidney disease, diabetes, and obesity. Therefore, a dietary approach can help maintain a blood pressure of the elderly within normal range and reduce the chances of hypertensive patients developing chronic vascular diseases.

Reduced salt intake among the elderly is a crucial step towards reducing blood pressure since salt raises blood volume that in turn raises the blood pressure. Furthermore, blood pressure is affected by multiple dietary factors. Well established nutritional support that lowers blood pressure is the moderation in alcohol consumption, weight loss, and reduced salt intake. Over the past 10 years, the use of dietary patterns and increased potassium intake based on diet has emerged as one of the effective methods of lowering blood pressure in the elderly hypertensive patients (Choose foods low in sodium, 2013). It is understood that older people who are at risk of hypertension can make and sustain dietary modifications essential to their health. Given the current epidemic of increased prevalence of hypertension and blood pressure related diseases, the efforts to lower blood pressure among hypertensive and nonhypertensive individuals are warranted. Thus, hypertensive patients should be advised to moderate alcohol consumption, reduce weight as well as cholesterol and salt intake as a way of reducing the chances of developing other heart conditions that are caused by high blood pressure.

Elderly Hypertensive Nutritional Requirements

As advised by Mayo Clinic Staff (2016), the notional requirement for the elderly is the same to that of the public in general. However, some seniors need proper nutrient regarding protein, folic acid, energy, vitamin C, vitamin D, iron, calcium, dietary fiber, fluid, and therapeutic diets. Older people require weight reducing and diabetic diets, adequate fluid intake, adequate amount of dietary fiber, the consumption of foods high in calcium, iron, vitamin C, and vitamin D as well as sufficient amounts of protein, folic acid-carbohydrate, and reduced salt. Hypertension is a significant health concern among elderly patients around the world. Its attendant mortality and morbidity complications have great results on the patient's quality of life and survival. Optimizing control of blood pressure is considered one of the most efficient ways of dealing with high blood pressure. Numerous dietary components such as calcium, potassium, sodium, and magnesium are also an important factor in maintaining normal blood pressure (O'Keefe, 2015). It is important for health care providers to discuss dietary modification with the elderly patients as part of preventing hypertension. Nevertheless, attempt to provide the elderly with adequate nutrition face numerous challenges. Their nutritional requirements are not well defined since both basal metabolic rate and lean body mass decline with age.

Many diseases that affect older people are often related to dietary factors. Dietary modification seems to affect the level of risk factors throughout out life, and its implications among the elderly are high. A relatively modest reduction in salt intake and saturated fat would reduce cholesterol level, and blood pressure, hence decreasing the risk for cardiovascular diseases. At the same time, increasing vegetables and fruit consumption by two servings a day could lower cardiovascular risk by 30% (O'Keefe, 2015). Therefore, senior citizens should consume less salt, drink more water, avoid alcohol, and take adequate amount of food rich in vitamins and minerals as well as limit their intake of food containing saturated fat and high cholesterol levels.

Physiology of the Elderly and how It Relates to Hypertension

Pietinen and Aro (1990) reveal that the significance of hypotension as a risk factor for cardiovascular diseases tends to increase progressively with the patient's age. Diastolic pressure often plateaus at the age of 50, resulting in a rise in pulse pressure among the elderly. A widened pulse pressure and the isolated systolic hypertension is the most common form of hypertension seen in individuals older than 65 years of age. Pulse pressure is the most common form of blood pressure measurement that is used to predict cardiovascular diseases. With aging, both functional and structural changes take place, which results in a less compliant vessel and aorta.

Mayo Clinic Staff (2016) reveals that the researchers, who use augmentation index and pulse wave velocity as a measure of the stiffness of blood vessels, have repeatedly indicated that arterial stiffness increases with age. The primary mechanism that may account for the decline in diastolic and the rise in systolic pressure associated with arterial stiffness is related to the earlier return of the reflected pulse wave to the aorta during systole. Some of the factors that can help decrease arterial stiffness entail reducing sodium and cholesterol intake (O'Keefe, 2015). The risk of stroke, artery disease, chronic kidney insufficiency, congestive heart disease, and dementia has continued to rise among the elderly patients with high blood pressure. Therefore, it is important for practitioners and specialists to design an appropriate dietary remedy that will help reduce the stiffness of arteries to lower blood pressure. Patients should be aware that reduction of cholesterol intake and sodium could help reduce arterial stiffness that leads to increased blood pressure.

Factors that Affect Nutrition in the Elderly

Seniors may not receive all the sustenance and nutrients they need due to a variety of situational, psychological, and physical factors. Several factors affect nutrition among the elderly individuals such as decreased taste, loss of appetite, nutrient absorption, lack of mobility and financial issues as well as depression and isolation, heart disease risk and menopause problems. Older people have the reduced number of taste buds, which leads to decreased taste sensation. Loss of consciousness makes food less enjoyable and tasty, making it difficult to control the amount of salt added to food. Senior citizens have reduced appetite and they eat less amount of food, making it challenging to take adequate amount of nutrients such as calcium and iron that are vital to the body.

At the same time, lack of mobility and financial challenges make it difficult for the elderly to access nutritious food (Mayo Clinic Staff, 2016). Vitamin B12 deficiency is common among the elderly due to the inability of their digestive tract to absorb sufficient amount of this nutrient. Menopause increases the risk of developing osteoporosis as the result of a loss of bone mass; therefore, elderly women need to take adequate amount of calcium. Seniors should reduce the intake of food with high amount of salt and saturated fat and replace it with almonds, walnut, olive, avocado, banana and low-fat milk. Depression and isolation, which are common among seniors, should be avoided as they lower appetite and reduce the intake of food.

Recommendation

I recommend that hypertensive patients, especially the elderly, should consume foods that have low amounts of cholesterol and saturated fats. They should also take fruits, low-fat dairy products and vegetables as well as small amount of sugar containing beverages, sweets, and red meat to lower the risk of developing cardiovascular diseases. It is important to understand that a diet, or proper nutrition, plays a crucial role in controlling blood pressure among patients of all ages. Blood pressure is sometimes considered a disease of the elderly since it affects many seniors as compared to the young. I believe nutrition affects blood pressure since weight reduction is known to reduce blood pressure, and weight gain causes hypertension. At the same time, certain foods are known to decrease blood pressure, and finally some foods increase cases of high blood pressure. Medical practitioners should advise hypertensive patients to take low-fat dairy products, fruits, vegetables, fish, nuts, poultry, whole grains, and those that contain reduced amount of sweet, red meat, and sugar (Choose foods low in sodium, 2013). Additionally, they should take food containing less salt as well as that with decreased amounts of cholesterol and saturated fat to lower blood pressure in individuals with hypertension and those within normal ranges of blood pressure.

Conclusion

Nutritional support among patients with hypertension should not be underrated. Dietary modification should serve as an initial therapy before drug treatment is begun. In patients already on medication, lifestyle changes such as reducing the intake of salt can further decrease blood pressure. Health care providers, government officials, the public, and researchers should develop and implement effective public and clinical strategies that will lead to sustainable dietary modification among the elderly individuals with high blood pressure.
 
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