Weight loss;

• Standard component of Nutrition therapy for treatment of hypertension.

• An approximate 20-Ib weight loss will result in lowered  systolic BP، and even less than 10
• weight loss has a sustained effect on BP.

• Though waist circumference is related to body weight it is an independent predictor of hypertension risk.

• For those patients fall within normal or overweight BMI waist circumference should be measured.

• It is not necessary to measure waist circumference for those patients with the BMI >35

     Sodium;

• Urinary sodium  excretion has a significant and direct relationship with systolic blood pressure.

• It has been estimated that sodium modification may reduce incidence of hypertension by as much as 17 %.

• Individual responses sodium restriction can vary.

• Despite description of people as salt sensitive or salt resistance change in BP as result of sodium restriction are seen across all ages and all ethnicities.

• Effective reduction of sodium intake requires limited the intake of a highly processed foods avoiding those who that are cured using salt, and omitting salt during the cooking and preparation.

     Mechanism of sodium;

• Excessive sodium consumption ( defined by the world health organization as >5G sodium per day) has been shown to produce a significant increase in BP and has been linked with onset of hypertension and its cardiovascular complications.

• Excessive salt intake can lead to high blood pressure (hypertension) which Stiffen and narrows the blood vessels. Blood and oxygen flow to key organs decreases. so the heart tries harder to pump blood throughout the body, which further increase blood pressure.

• Increase salt consumption may provoke water retention, leading to condition of high flow in atrial vessels. The mechanism of pressure natriuresis has been proposed as a physiologic phenomenon where an increase in BP in the renal arteries causes increased salt and water excretion.

     Alcohol;

• Is alcohol intake increase about students per day for men ( and one drink they for women) are the risk of hypertension increase accordingly in a dose-dependent relationship.

• One drink is defined as
• 12 oz. of beer,
• 5 oz. of wine,
• 1.5 oz. of 80 proof distilled spirits
• 
  

    Potassium calcium and magnesium;

• Potassium ,calcium and magnesium have all been positively correlated with the reduction of BP and treatment of hypertension.

• All three minerals have an inverse relationship to hypertension.

• An increased potassium intake does not pose a health risk in healthy individuals.

• In those client who may have an impaired urinary excretion of potassium, however these recommendations may need to be modified.

• The DASH diet provide three cup of dairy products as their major source of calcium.

• These are the result of dietary pattern rich in these nutrient rather than mineral intake from supplements.

      Mechanism of calcium;

• Consumption of calcium rich diet play important role in the management of high blood pressure.

• The calcium ion plays a major role in excitation  contraction coupling in cardiac and smooth muscle cells.

• Calcium is involved in regulating blood pressure by controlling vascular smooth muscle cell contractility and thus modulating peripheral vascular resistance. IN addition, of extracellular ionized calcium in habits renin secretion by interacting with the calcium- sensing receptor.

     Mechanism of magnesium;

• Magnesium (MG )and essential element in the human body and may have beneficial health effects of the primary prevention of hypertension.

• Magnesium mein play a critical role in BP regulation, through 
• Directly stimulating prostacyclin and nitric oxide formation.
• Modulating endothelium- dependent and endothelium independent vasodilation,
• Producing vascular tone and reactivity
• Preventing vascular injury where is antioxidant and anti-inflammatory functions.

• Magnesium competes with sodium for binding sites on vascular smooth muscle cells, increase cross prostaglandins E, induce endothelial- dependent relation in hypertensive patients decrease in intracellular sodium and reduce BP.
• 
  
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    Mechanism of potassium;

• Potassium are important in managing high blood pressure (HBP or hypertension) because potassium Lessens the effect of sodium. The more potassium you eat, the more sodium you loss through urine.

• Potassium also helps to ease tension in your blood vessel was, which helps further lower blood pressure.

• Potassium are important for muscle function.  Potassium relaxes the walls of the blood vessels, lowering blood pressure and protecting against muscles cramping.

• Potassium in the body helps balance the overall amount of salt in body. Without potassium, salt is excessive in the body. The salt reduces the ability of kidneys to get out extra fluid. The remain in bloodstream and puts more stress on arteries and leads to higher blood pressure.

• Physical activity;

• Physical activity of 30 minutes per day does decrease blood pressure by 4-9 mm HG.

• Relative strain on the cardiovascular system will be reduced the BP response to the activity will be reduced as well.

• Increasing physical activity will facilitate weight management.

     Smoking cessation;

• Smoking cessation may be the most important change any individual can make to reduce the risk of hypertension.

• In order to achieve success, the smoker should also be able to identify his or her reason for quitting.

       What is the prefer diet therapy to prevent hypertension?

       What is the role of diet in hypertension?

        How effective is the dash diet in hypertension?

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