Improving Cardiovascular Health In African Americans

Purpose of Presentation: Increasing awareness of genetic and behavioral risk factors in African AmericansBy Nathan Banda, RN

Healthy People 2020 Goal in relation to Cardiovascular Health in African Americans

To reduce hypertension prevalence to 26.9 % and raise treatment to 69.5 %

In this presentation the hypertension will be abbreviated as HTN, blood pressure as BP, systolic blood pressure as SBP, diastolic blood pressure as DBP and Body Mass Index as BMI

Hypertension is one of the biggest challenges in cardiovascular health of African Americans

Pre-Test on knowledge on Hypertension in African Americans

What do you know about hypertension? List the two leading causes of death in USA. What are the risk factors of HTN in the general population vs in African

Americans? What is the impact of fast foods on HTN? List any 3 foods which are not healthy choices for a HTN patient. Is there are association between weight vs HTN? What do you know about BMI?

Objectives of Presentation

Increase understanding of HTN Results of uncontrolled or under-controlled HTN Show the prevalence of HTN in African Americans Identify dietary impact on HTN a) high fat diet b) Low fiber c) high sodium Review overweight and obesity in relation to HTN Stress, alcohol and tobacco on HTN Identify physical activity and exercise regimen impact on cardiovascular health

Lecture Notes

Definition Hypertension is defined as a systolic blood pressure greater than 140mm Hg and a diastolic blood pressure greater than 90 mm Hg based on the average of two or more correct blood pressure measurements taken during two or more contacts with a health care provider. (Smeltzer & Bare, 2004, p.855).

Ideal blood pressures is a systolic of 120 and diastolic 80.

What Causes Hypertension

Genetic factors Blacks have a predisposition to HTN Stress levels which are uncontrolled from increased sympathetic nervous system

activity or dysfunction of the automatic nervous system Drug-induced or related causes Increased renal reabsorption of sodium, chloride, and water related to genetic

variation in kidney functioning Decreased vasodilation of the arterioles related to dysfunction of the vascular

endothelium Resistance to insulin action

Taken from Smeltzer & Bare, 2004

Risk factors of HTN

Age – Risk of HTN increases as one ages. Age greater than 45 in men and 65 in women Race – More common in blacks, then Hispanics. In other words African Americans are at a high risk

for HTN than their Caucasian counter parts. Family History- HTN runs in families Being overweight or obese Using tobacco. Even second hand smoking is a risk factor for HTN Not being physically active or leading a sedentary life style Too much salt in diet Stress Too much alcohol Chronic conditions like kidney failure

Taken from www.mayoclinic.org

Prevalence of HTN in African Americans

Hypertension is called a silent killer because an individual can be symptom free yet hypertensive

HTN in African men is 39% and 43% in African women. This implies that at least 4 in every 10 African Americans has HTN Life span in African American men is 70 years compared to 79 years in their

white American counterparts. Rates of stroke and heart attacks are higher in African Americans than any

other race in the United States of America See the graph showing the prevalence of HTN in relation to other races

Prevalence of Hypertension in African Americans

Dietary Impact on Hypertension in African Americans

• There are many fast food across the nation rendering easy access for meals to busy individuals in their hectic schedules.

• So many drive-throughs• What about their nutritive content and

value?

Dietary Impact on HTN in African American

Fast foods are high in fat and low in fibre. They are also high in sodium content.

Research shows a tendency for African Americans for fast foods and high fat and low fibre diets

The result is high overweight and obesity levels which are rampant in the nation and most communities with low socioeconomic status

Although fast foods and high fat foods are less expensive and thus attractive, they are not good for cardiovascular health

Health diets for better cardiovascular health and overall health

Below is the food pyramid depicting healthy food choices and their servings

Right food choices and portions

It is important that we make right choices in the food and snacks we eat as these have a direct impact on cardiac health

Foods high in fat and low in fiber should be avoided as much as possible Red meats where feasible should be kept to a minimum Drinks high in soda and sugar should be avoided Water is actually the best drink Food high in fibre and low in fat content is best for cardiac health Highly processed food are not good for cardiovascular health as they contain high

levels of sodium and salts Food diet high in fruits are best in cardiac health. Not only is the quality of what we eat important but the quantity, small frequent

portions are better that large infrequent portions.

Weight vs HTN

Body mass index (BMI) is used to define overweight and obesity in individuals

BMI is calculated by Weight (in kilograms)/Height(in meters squared) OR Weight (in pounds)/Height (in inches squared) x 703 (Stanhope& Lancaster, 2014,p.684)

Maintaining normal weight is equal to cardiovascular health Any decrease in weight results in decrease in your blood pressure Better weight control results in increases self esteem and increased

confidence level as it betters your personal outlook and physical health. Weight control decreases the risk of other heart diseases like diabetes

Overweight and Obesity

• The graph on this slide shows obesity among adults in the United States by ethnicity

• Blacks have the highest numbers of overweight and obese adults

• Non Hispanic whites trail in obesity and overweight

Taken from www.anthropology.msu.edu

BMI charts

Are you in good shape weight-wise?Check your weight against your height and find out where you stand.

BMI Made Simple

Normal body weight = BMI from 18.5 to 24.9 Overweight = BMI of 25.0-29.9 Obesity = BMI 30.0-39.9 Extreme Obesity = BMI greater than 40

Taken from Stanhope&Lancaster (2014, p. 684).

Stress, alcohol and tobacco on HTN

Stress increases HTN. Engaging in exercise regimen or being involved in community activities is an effective way of managing stress levels.

Too much consumption of alcohol is one of the risk factors of HTN. Consuming alcohol in moderation or quitting altogether is good for cardiovascular health

Smoking is bad for heart health. It leads to difficulties with breathing by constricting airways and increasing cardiac work during breathing. Second hand smoking is also a risk factor in hypertension. Engaging in smoking cessation programs will better cardiac health of a smoker.

Questions and Answers post session on hypertension Questions from the class Comments from the class What are the risk factors for hypertension and causes Recall the relationship between overweight and obesity against

controlled weights State what an ideal weight is. Are there any behavioral changes you intend to initiate when they go

back home List at least 3 foods in a balanced meal constituting a health diet List exercise regimen for cardiovascular health

Evaluation Survey on Teaching Session: Improving Cardiovascular HealthOn a scale of 0 to 5, 0 meaning I strongly disagree and 5 meaning I strongly agree, Respond to the following;

1. The information was provided in a clear manner.2. The length of the session was just right.3. I am now able to define hypertension.4. I know what foods puts an individual at risk for hypertension5. I am planning to engage in regular exercise regimen6. This session was just a waste of time7. I would recommend that the session be provided to other members of

the public in future.8. I need to learn more about hypertension

References Bastable, S. (2014). Nurse as Educators: Principles of Teaching and Learning for Nursing Practice. (4th ed.). Burlington, MA: Jones & Bartlett LearningBMI Chart. Retrieved from http://www.bing.com/images/search?q=BMI&FORM=HDRSC2#view=detail&id=0554671395709FF9998D4F4720A8C596675572135&selected index=3CDC/NCHS, National Health and Nutrition Examination Surveys 1999-2006Covelli, M.(2007). Prevalence of Behavior and Physiological Risk Factors of HTN in African American Adolescents. Pediatric Nursing. Retrieved from http://eds.b.ebscohost.com.vlib.excelsior.edu/eds/pdfJarvis, C. (2008). Physical Examination & Health Assessment. (5th ed.). St Louis, MO: ElsevierHealthy diet. Retrieved from waynejoseph.wordpress.comHigh Blood Pressure. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-condition/high-blood-pressure/basics/risk-factors/con-20019580Obesity among African Americans. Retrieved from Athropology.msu.eduSmeltzer. S, & Bare, B. (2004). Brunner & Suddarth’s Textbook of Medical Surgical Nursing. (10th ed.). Philadelphia, PA: Lippincott Williams & WilkinsStanhope, M. & Lancaster, J. (2014). Public Health Nursing: Population-Centered Health Care in the Community. (8th ed.). Maryland Heights, MO: ElsevierPurnell, L. (2013). Transcultural Health Care: A culturally Competent Approach. (4th ed.)). Philadelphia, PA: F.A. Davis Company