University Assignment: Hypertension Fact Sheet and DASH Diet Analysis

This fact sheet, prepared for Nutrition Australia, addresses hypertension, a major chronic health condition contributing to high mortality rates. It provides an overview of hypertension, including its pathophysiology, highlighting increased cardiac output and vascular resistance. The report emphasizes the effectiveness of the DASH (Dietary Approaches to Stop Hypertension) diet in managing hypertension, supported by evidence of its impact on the renin-angiotensin-aldosterone system, triglycerides, and the cardiovascular system. It details the DASH diet's components, including grains, vegetables, fruits, and low-fat dairy, and offers recommendations for healthcare professionals, such as incorporating the DASH diet, avoiding alcohol, and maintaining a healthy weight, all aimed at controlling blood pressure and reducing complications. The fact sheet also acknowledges the limitations of the research and concludes with a summary of the DASH diet's benefits and recommendations for hypertension management.

Running head : FACT SHEET OF HYPERTENSION
Name of the Student
Name of the University
Author Note

DASH Diet as a management tool in the management of hypertension
With the global burden of the disease, hypertension is highlighted as one of the major chronic
health condition contributes to the high mortality rate (3). Even after the presence of different
guidelines and clinical management protocol, hypertension remains the leading cause of cardiac
and kidney disease. Estimated approximately close to six million individuals have hypertension
in Australia, highlighting 33. 7% of the adult Australians are suffering from hypertension in the
current situation (2). A considered number of the researchers highlighted that the prevalence of
hypertension is higher in Australian male approximately 35.3% or three million adults males
compared to the females in Australia highlighting 32.3% of the population which means 2.9
million females. Adults lived in remote or regional areas are experiencing a 27% higher rate of
hypertension compared to the individuals who lived in the metro areas (4).
As mentioned in a range of literature, along with physical activity, dietary intervention through
dietary modification is well established as a useful tool to manage hypertension (6). However, the
debate is going on regarding the most effective dietary interventions or management of
hypertension. Most recent evidence highlighted that DASH (dietary approach to stop
hypertension) is effective in managing hypertension and this factsheet is aimed to provide the
evidence and recommendations for the patient.
Pathophysiology of hypertension:
Hypertension is a chronic elevation of the blood pressure which has a
long term effect on a patient (9). The patient who is obese, living a sedentary
lifestyle, drinking alcohol, consuming high salt and potassium diet develop
hypertension (6). Hypertension is the products of both cardiac output and vascular
resistance. The patients with arterial hypertension have an increased cardiac output
because of the increased systemic vascular resistance and stiffness of vasculature (8).
Because of the increased α-adrenoceptor stimulation, the vascular tone may be
increased. In this case, the final pathway is an increase in cytosolic calcium in the
vascular smooth vasoconstriction and an increase in the blood pressure. The recent
evidence suggested that an increase in the vascular resistance and stiffness resulted
in imposing the load on the left ventricle which further induced left ventricular
diastolic dysfunction and hypertension (10). Renin-angiotensin-aldosterone is a
hormonal system which controls the blood pressure and fluid electrolyte balance in
the body. In hypertension, renin-angiotensin is highly regulated (11). Besides, in the
hypertensive patient both increased release of the norepinephrine was observed.
There is an abnormal relationship between blood pressure and sodium excretion
observed inpatient. In the patient with hypertension, the resetting in the natriuresis
where parallels shift to the high blood pressure observed.
Complication of hypertension:
Untreated hypertension has thousands of complications which
further contributed to the morbidity rate. The excessive pressure
on the artery walls caused by high blood pressure not only
damages the blood vessels but also affected other organs of the
body (6). The complications related to hypertension are the
following:
• Heart attack or stroke
• Heart failure
• Aneurysm
• Narrowed vessels in the kidney
• Metabolic syndrome
• Dementia
Figure 3: DASH diet reduces hypertension
Source: (13)
Management of hypertension:
The primary target of the physician is to manage the patients with the normal blood pressure
of 120/80 mm Hg which would reduce the complications of hypertension and further
minimize the probability of damaging organs (3).
Effective management aims to meet the following criteria:
• Blood pressure of 120/80 mm
• Healthy weight
• Healthy diet and physical activity

DASH diet in the management of hypertension:
As observed in the statistics, the DASH diet has been rated the best diet for overall health and wellness for the last five years to reduce hypertension (12). The 2010
Dietary Guidelines for Americans suggested that the best modification of diet to reduce hypertension is to the incorporation of the DASH diet in lifestyle (15). A
DASH diet sis most commonly described as the diet rich in grains, fruit, low-fat dairy along with a low sodium diet to control high blood pressure (13).
The evidence:
1.Effect on the renin-angiotensin-aldosterone system : The recent research on the DASH diet suggested that DASH diet reduces the increased blood pressure by
interacting with the renin-angiotensin-aldosterone (15). Renin-angiotensin-aldosterone is a hormonal system which controls three blood pressure and fluid electrolyte
balance in the body (12).
2. Effect on triglycerides: There was a mountain of evidence highlighted that the DASH diet is proved to be effective in the reduction of LDL. The researchers
suggested the DASH diet decrease the LDL in the patient by 20% along with the cholesterol level which further reduces the risk of coronary heart disease and stroke
and increases bone marrow turn ver.
3. The effect on the cardiovascular system: A recent study comparing meta-analysis and syntactic review suggested that to prevent cardiovascular disease, the DASH
diet has improved effect on the patient with cardio metabolic risk on the patient. The DASH diet appeared to reduce the cardio metabolic risk approximately 13% (1).
It is also effective in reducing the risk of gout.
4.Weight Loss: Weight loss is an integral part of hypertension management. As observed in the literature, since DASH diet mainly focuses on the vegetables, fruits,
low-fat diet and the moderate amount of whole grains, fish which are nutrient rich yet not the calorie-dense diet, it helps to maintain the healthy weight of a patient
with hypertension (13).
5. Reduction in the pharmacological interventions: As observe by researchers that DASH diet lower the sodium level in individuals to 2300 mg a day and reduction to
1500 mg of sodium lower the blood pressure even more which previously require to reduce by medications (13). Therefore, it would be effective in the reduction of
the health care sectors.
Limitation of the research:
The DASH diet has been established for approximately 5 years where it has established an effect on systolic blood pressure. Further study is required to evaluate the
effect of the DASH diet on the patient with other categories of hypertension.
Conclusion:
To conclude, Hypertension is highlighted as one of the major chronic health condition contributes to the high mortality rate. The pathophysiology is to increase in the
function of Renin-angiotensin-aldosterone. Therefore, for the last five years DASH diet is proved to reduce hypertension which mainly focuses on the high nutrient
rich and less calorie dense diet.
Recommendation of management of hypertension:
Incorporation of the DASH diet in the menu:
The DASH diet divided into five categories and recommended to consume food from each category to make it 2,000-calorie-a-day DASH diet. Grains include bread,
cereal pasta and pasta is recommended 6 to 8 servings a day (12). Vegetables such as Tomatoes, carrots, sweet potato, and broccoli are required to consume 4 to 5
times a day. Fruits containing fibers and antioxidants are required to consume 4 to 5 servings a day. Dairy products such as milk, yogurt is the major source of
calcium, protein and vitamin D and therefore, required to consume 2 to 3 times a day. Lean meat or poultry is required to consume at least once a day. Nuts and
seeds are required to consume 2 to 3 times a day (1).
1. Avoiding alcohol consumption: Since drinking too much hypertension, it is required to control the consumption of alcohol to maintain the effect of the DASH diet
(13).
2. Maintaining a healthy weight: DASH diet generally contains 2000 calorie a day. To maintain a healthy weight according to the height of the patient, it is
recommended to reduce the calorie consumption and increase exercise to the daily routine to be physically active (15).
3. Changes of variety: it is required to change the variety of the DASH diet to receive the faster result of hypertension. It is required to add adequate fruits in the
diet to reduce diarrhea or bloating inpatient (12).
References:
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Hypertension in Australia: A Life Table Modeling Study. Hypertension. 2019 Apr;73(4):777-84.3.Tooher J, Thornton C, Makris A, Ogle R, Korda A, Horvath J, Hennessy A. Hypertension in pregnancy and long-term cardiovascular mortality: a retrospective cohort study. American journal of obstetrics and gynecology. 2016 Jun 1;214(6):722-e1.)
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Y, Head GA. Transgenerational Inheritance of Obesity and Hypertension: Hypothalamic Regulation in Leptin mediated Sympathoexcitation. The FASEB Journal. 2017 Apr;31(1_supplement):1038-3.(7)Thakkar H, Anpalahan M. Masked Hypertension–A Systematic Review. Heart, Lung and Circulation. 2017 Jan 1;26:S59-60.(8)Majumder K, Wu
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Dechend, R. and LaMarca, B.D., 2019. Interleukin-4 supplementation improves the pathophysiology of hypertension in response to placental ischemia in RUPP rats. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.(10)Di Giosia P, Giorgini P, Stamerra CA, Petrarca M, Ferri C, Sahebkar A. Gender differences
in epidemiology, pathophysiology, and treatment of hypertension. Current atherosclerosis reports. 2018 Mar 1;20(3):13.( 11)Itoh H, Kurihara I, Miyashita K. Organ memory: a key principle for understanding the pathophysiology of hypertension and other non-communicable diseases. Hypertension Research. 2018 Aug 14:1.( 12)Hadtstein C,
Schaefer F. Hypertension in children with chronic kidney disease: pathophysiology and management. Pediatric Nephrology. 2008 Mar 1;23(3):363-71.( 13)Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. bmj.
2017 May 9;357:j1794.`(15)Soltani S, Shirani F, Chitsazi MJ, Salehi‐Abargouei A. The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta‐analysis of randomized controlled clinical trials. Obesity reviews. 2016 May;17(5):442-54.( 16)Juraschek SP, White K,
Tang O, Yeh HC, Cooper LA, Miller III ER. Effects of a Dietary Approach to Stop Hypertension (DASH) Diet Intervention on Serum Uric Acid in African Americans With Hypertension. Arthritis care & research. 2018 Oct;70(10):1509-16.