Question

Bill is a 56-year-old, overweight truck driver. Due to the nature of his job, Bill is quite sedentary and eats from fast food chains for 80% of his meals. Although Bill has not been diagnosed with hypertension, he is conscious of the fact that his parents and siblings have hypertension. Bill smokes ½ pack of cigarettes per day and drinks 3 beers daily.

What risk factors does Bill have for hypertension?

Do you think Bill is likely to have hypertension?

Would Bill be more likely to have primary or secondary hypertension?

What lifestyle changes would you recommend for Bill?

Why would weight management and sodium restriction be beneficial for Bill?

Would the DASH diet be appropriate for Bill to follow? If so, indicate your recommendations.

Answer 1

Hypertension:

It is a disease  condition characterised by abnormally high blood pressure.

1. Risk factors of Hypertension:

Bill have the risk factors for hypertension such as :

* Age and gender: The risk of hypertension increases with Age. Hypertension is more seen in men untill the age 64. Bill is 56 years old , who is at risk for developing Hypertension.

* Family history: Hypertension is a hereditary disorder. Hypertension in first degree relatives possess a high risk of the disease in the individual.

* Obesity or overweight: It is an another risk factor for developing Hypertension. As the Bill is overweight he is at risk for developing the hypertension.

* Using tobacco and the habit of drinking alcohol: Bill have both the risk factors ; chemicals in tobacco can damage the lining of arteries and the heavy drinking can damage the heart.

* physical inactivity: As Bill is truck driver, he is physically inactive and physical inactivity is a major risk factor for hypertension.  

* Regular consumption of fast food: More salt and too little Potassium in the diet possess the risk for hypertension. Fast food contains more Sodium.

2. As Bill is having most of the risk factors present , such as family history, overweight, physical inactivity, fast food and Alcohol consumption, smoking etc. I think Bill is more likely to have Hypertension.  

3. Primary Hypertension , also known as Essential hypertension . 90 to 95 % of hypertensive people are suffering with Primary Hypertension. Secondary Hypertension occurs due to an identifiable secondary cause like Kidney problems, thyroid problems, use of illegal drugs or congenital disorders of heart or blood vessels.

Bill may have Primary Hypertension as no secondary disorders for Bill mentioned in the case study.

4. Life style changes:

* Maintain a healthy body weight and loss the extra weight

* Regular physical exercise

* Eat a heart healthy diet with low fat , low sodium diet. Include more vegetables , fruits, whole grains to diet. Avoid fried items and Red meat.  

* Avoid smoking and alcoholism , otherwise it may lesds severe damage to heart and blood vessels.  

5. Weight management and Sodium restrictions:

As more weight a person have , the more blood and nutrients should be supplied to the tissues and it may results increased blood volume passes through the blood vessels, automatically Blood pressure increases. Lossing extra weight and maintaining healthy body weight helps to control BP.

Sodium increases water retention and there by increases the Blood pressure. Sodium restrictions can decrease water retention and can decrease the Blood pressure.  

So weight management and Sodium restrictions can be helpful for Bill.

6. DASH Diet

'Dietary Approaches to Stop Hypertension ' is recommended for the patients with Hypertension or people who are in more risk for developing Hypertension. DASH approach is appropriate for Bill and he can reduce his Blood pressure or the risk by following it .

Recommendations:

* Eat more vegetables and fruits with low fat diet. Avoid fried items and foods contain saturated or trans fat.

* Use low fat dairy products.

* Limit salt, sodium, redmeet, sugary drinks, artificial sweeteners etc.

*Include whole grains , nuts , fish and Poultry in the diet.

* Have a controlled diet , cut down extra calories.