|
D. Cardiovascular
System
D.2 Hypertension
Content
Areas
- Insulin
resistance syndrome
- Sodium
- Potassium
- Calcium
- Magnesium
- Alcohol
- Prevention
and lifestyle modification
- Physical
activity
- Dietary
Approaches to Stop Hypertension (DASH) Diet
- Medical
nutrition therapy
| After
training, the learner will be able to: |
| Knowledge
Objectives: Medical Students |
- Explain
the effects of abdominal obesity, insulin resistance, lack
of physical activity, high sodium intake, and high alcohol
consumption on blood pressure control in both hypertensive
and non-hypertensive individuals; explain possible mechanisms
for each effect.
- Summarize
the recommendations of the DASH-sodium diet.
- Describe
the metabolic and pathophysiologic consequences of hypertension
including cardiovascular, cerebrovascular, and peripheral
vascular disease. Identify those forms of hypertension
that are responsive to nutritional management.
- Explain
how high intake of sodium and low intake of calcium, potassium,
and magnesium affect the control of blood pressure in normal
and hypertensive individuals.
- List
at least five common foods that contain large amounts of
each of the following: sodium, calcium, potassium, and
magnesium.
|
| Knowledge
Objectives: Residents |
- Summarize
the scientific evidence evaluating the effectiveness of
the DASH-sodium diet, and describe when it should be prescribed.
- Compare
and contrast the DASH-sodium diet with the National Cholesterol
Education Program (NCEP) Therapeutic Lifestyle Changes (TLC)
Diet.
|
| Practice
Behavior Skills: Medical Students |
- Take
an appropriate medical history that includes family history
of hypertension; duration of hypertension; recent weight
change; sequelae of co-morbid conditions including cardiovascular,
cerebrovascular, and renal diseases; and use of prescribed
and over-the-counter medications and nutritional supplements.
- Based
on the current Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure (JNC 6),
differentiate between patients who, in addition to lifestyle
modification, require medication and/or dietary modification
for the control of blood pressure.
- Take
an appropriate social and dietary history, including an
assessment of the patient’s diet, exercise patterns,
and weekly alcohol consumption, and identify areas of concern.
|
| Practice
Behavior Skills: Residents |
- Provide
effective individualized dietary counseling for hypertensive
patients, focusing on body weight, energy balance, and dietary
intake of fruits, vegetables, sodium, potassium, calcium,
magnesium, and total and saturated fat.
- Consult
with a registered dietitian as appropriate to prioritize
dietary guidelines and lifestyle changes for hypertensive
patients with or without other common chronic diseases.
- Clearly
explain to a patient what the DASH-sodium diet is and how
it works; effectively support the patient who adopts the
DASH-sodium diet.
|
| Attitudes
Objectives: All Learners |
- Recognize
the value of a healthy diet and lifestyle in the prevention
and treatment of patients with hypertension.
- Demonstrate
a commitment to utilize a multi-disciplinary team approach
in medical care, seeking consultation with and referring
patients to registered dietitians and other credentialed
healthcare professionals as appropriate.
|
|
|
