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Hypertension and Cardiovascular Disease  Instructions: Answer the questions below. You may print your answers or e-mail them to your instructor.  1. Define arterial blood pressure (BP) and explain how it is measured.  2. Discuss briefly the mechanisms that regulate arterial blood pressure including the sympathetic nervous system, the renin-angiotensin-aldosterone system (RAAS), and renal function?  3. What causes essential hypertension? What is the etiology?  4. What are the common symptoms of essential hypertension?  5. Using the JNC 8 guidelines, how is the diagnosis of hypertension made? What blood pressure readings are used to identify normal BP, stage 1 hypertension, and stage 2 hypertension?  6. List the risk factors for developing hypertension. What risk factors does Mrs. Moore currently have? Discuss the contribution of ethnicity to hypertension, especially for African Americans  7. What are the four major modes of treatment for hypertension?  8. Dr. Evans indicated in his note that he will “rule out metabolic syndrome.” What is metabolic syndrome?  9. What factors found in the medical and social history are pertinent for determining Mrs. Moore’s coronary heart disease (CHD) risk category?  10. How is hypertension related to other cardiovascular disorders? What are the possible complications of uncontrolled or untreated hypertension?  11. Briefly describe the DASH eating plan and discuss the major nutrients that are components of this nutrition therapy.  12. Using the 2015 Dietary Guidelines, describe why decreased sodium intake is targeted as a focus to improve the health of Americans.  13. What do the current literature and the Evidence Analysis Library (EAL) indicate regarding the role of sodium intake in the control of hypertension? Is there a significant correlation between sodium intake and cardiovascular risk?  14. What is the Mediterranean diet? How might this dietary approach be appropriate for Mrs. Moore? Would this be culturally appropriate for her?  15. Lifestyle modifications reduce blood pressure, enhance the efficacy of antihypertensive medications, and decrease cardiovascular risk. List lifestyle modifications that have been shown to lower blood pressure.  16. What are the health implications of Mrs. Moore’s body mass index (BMI)?  17. Calculate Mrs. Moore’s energy and protein requirements.  18. Identify the major sources of sodium and saturated fat in Mrs. Moore’s diet. Compare her typical diet to the components of the DASH diet.  19. What dietary assessment tools that target nutrients known to be associated with hypertension and CVD risk might be useful in assessing Mrs. Moore’s diet?  20. Go to http://cvdrisk.nhlbi.nih.gov/. Using this online calculator, determine Mrs. Moore’s risk of CVD based on her lipid profile. Are there other factors that contribute to her CVD risk?  21. When you talk with Mrs. Moore on 3/15, you ask how much weight she would like to lose. She tells you she would like to weigh 125, which is what she weighed most of her adult life. Is this reasonable? What would you suggest as a goal for weight loss for Mrs. Moore? How quickly should Mrs. Moore lose this weight?   22. List your major recommendations for dietary substitutions and/or other changes that would help Mrs. Moore reach her medical nutrition therapy goals, to be consistent with the DASH diet and sodium intake guidelines.  23. Phillipians 4:6-7 relates to one of the risk factors of hypertension. What is this risk factor? How does this verse apply?   Write your understanding of nutritional genomics and the prospective benefits discussed in the reading. 24. Be sure to define and examine nutrigenetics, nutrigenomics, genome, and genotype.  25. Find two articles pertaining to ethics, morals or integrity regarding this topic. Use AMA style to cite both articles.  26. Discuss how God’s word applies to this newly emerging field. Support your assertions with the text, articles and the Bible. Clearly state your opinions and back up your perspective using biblical citations.

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