NUTRITION CASE STUDY

NUTRITION CASE STUDY

Introduction 

The patient in this is a black woman in her late sixties.  She is 47 years old and still active in her career.  I shall refer to the woman and Mrs. Y. Her family has a history of hypertension, with her father dying at the age of 72 years from hypertension that was related to complications in the heart.  Both her grandparents had the same condition for an extended period, which contributed to the demise. Mrs. Y is a cahier has worked in that position for almost two decades.

She was diagnosed with hypertension during her last pregnancy and had been living with the condition over the previous 8 years.  During this pregnancy, she visited the physician, and she complained that she had a general weakness and had severe headaches. She complained that at the time, she was too frail to perform her job duties effectively.  In she also narrated that she had problems with the eyesight and other cases, she experienced difficulties in breathing. It was during this time that she was diagnosed with hypertension and has been living with the condition for almost a decade now.  She also noted that hypertension might occur as a result of diabetes type two, which she has.  She was committed to medication, which she could not remember their names, but she says at the time she takes medicine irregularly because she forgets often. She feels that taking medicine is a bother for her since her blood pressures if high on most occasions.

Patient History

Mrs. y is a cashier, and this means that she spends most of her time sitting down. She I rarely involved in exercise or joint movement.  She attributes this as the cause of her diabetes.   This is because reduced physical activities mean that the body is not able to metabolize all the food taken, and hence there is a lot of accumulation of fats in the body. She noted that her diet is primarily made of fast foods because of the demands of her work. She also fond of meat, salted snacks, and whole milk products. She also enacts some fruits occasionally and breads with butter and margarine.  She is not a smoker, and she has not lived with an active smoker in the same house.  She has a BMI of 28 and recognizes that it was much higher, but she has significantly lost weight.

Pathophysiology

Hypertension refers to the raising of blood pressure.  In the long run, this condition results in the end organs of the body being destroyed by excessive blood pressure.  It often leads to increased morbidity and mortality rate.  Blood pressure involved the cardiac about put and the resistances that are differed by the systemic vascular (blood vessels) to the flow of the blood.  In younger people, there is more cardiac output, but in older people, there is increased resistance of the blood vessel resistance that results from increased stiffness that plays a critical role in the case. The increases in the adrenoceptor stimulation can increase the vascular tone, or it may also occur as a result of an increase in the release of products such as angiotensin or the endothelin (Yannoutsos et al., 2014). Angiotensin and endothelin are crucial in increasing the resistance of the vascular system or results in stiffness of the vascular system, which increases the load that is placed on the left ventricle (Foëx and Sear, 2004).  This often results in dysfunction of the left ventricle because of the increased loads that result from an increase in resistance of the systemic vascular.

In young people, there is a low pressure that is generated by the left ventricle. The waves are then reflected in the peripheral; vasculature, which is often felt after the end of the systole.   This results in high pressure during the early parts of the diastole, which leads to an increase in coronary perfusion.   In older people, the stiffening of the artery and inelasticity of the arteries leads to high pressure in the blood vessels (Yannoutsos et al., 2014). In this case, the reflected waves move from early diastole to late diastole.  This increases the load of the left ventricle, which results in left ventricular hypertrophy. This brings about breathing problems.

The automatic nervous system in the body plays a critical role in the control of the blood pressure in the body. In hypertensive patients, there is an increased peripheral sensitivities norepinephrine. Furthermore, there is also an enhanced sensitivity to stressful stimuli. This means that a person who has hypertension will be most likely more sensitive to highly stressful activities. There is a decrease in the sensitive of the baroreceptors, which means that there is reduced sensitivity to the changes in the pressure on the wall of the arteries (Foëx and Sear, 2004).  In some form of hypertension, there is the involvement of the rennin-angiotensin. This happens in the black, and the elderly patients are likely to have low renin hypertension more than the other groups of people. This means that the other groups are likely to have high renin hypertension, which increases their chances of developing a myocardial infarction (heart attack) when the blood stop [s to flow in a particular section of the heart (Beevers, Lip, & O’Brien, 2001).  These groups of people are also likely to develop other heart-related complications.

In essential and experimental types of hypertension, the relationship between the pressure of the blood and the excretion of sodium has been found to be abnormal.    Evidence has shown that rising natriuresis (sodium secretion) plays a critical role in the development of hypertension (Foëx and Sear, 2004).  The more enormous changes in the secretion of the sodium in the body have been observed to have a positive shifty to higher blood pressure or a condition of salt insensitive hypertension. Form the analysis. It seems that the patient fits in this profile of patients with this condition.

Disease and Its Relation to Nutrition

hypertension if related to nutrition in that with a poor diet, a person can get hypertension.  For example, if a person consumes a lot of sodium salt, they cause the blood to retain a lot of water or denies the kidney the ability to remove excess water from the blood.  This makes the volume of the blood increase leading to an increase in the pressure in the blood vessels.  Too much fats are not also good for the body since saturated fats have been known to increase the cholesterol levels in the body (Ruan et al., 2018).  this leads to weight gain.  Additionally, it leads to deposits in the blood vessels, which reduces the lumen of the blood vessels, increasing the pressure of the blood. Generally, foods that are full of fats or that that risk chances of diabetes such as fast foods are risks as they lead to hypertension.  While milk also contains very high levels of saturated fats, which have been known to increase the deposit of cholesterol along the lining of the blood vessels, which causes high blood pressure (Shin, Kim, & Kim, 2013).  Therefore, with the right diet, a person can be able to reduce the chances of hypertension.

Symptoms

In most cases, patients with hypertension may not show signs but those who do complaining of headaches, difficulties in breathing or in some times they may also complain of nose breeding.  It may also make a person fatigued, or they may have an irregular heartbeat.  In extreme cases, there is blood in the urine. However, most of these signs will not be visible until the patient is an acute or severe condition.

Risk Factors

Several risk factors may make a person gets high blood pressure.  One of them is having an intake of sodium in the diet.  This makes the blood to retain a lot of fluids.   In case the number of potassium ions in the body is little, it also means that the regulation of sodium in the body also becomes a problem.   Drinking too much alcohol and undertaking enough exercise is also a risk factor in causing hypertension.  Exercise is useful in making the body to metabolize and also release natural hormones such as cytokines that help in retaining the blood vessels.

Causes

There are serval causes of hypertension.  One of them being a heavy smoker and being overweight. It also caused by the consumption of excess alcohol in a day. It is caused by genetics.  Too much stress may also cause hypertension, and these factors will become severe is when they risk factors come into play.

There are several treatments for treating hypertension.  One of them is the use of Angiotensin-converting enzyme (ACE) inhibitor or the use of Angiotensin II receptor blockers (ARBs).   The patents can also be given diuretics, beta, and alpha-blockers for treatment.   They can also be given renin inhibitors or the calcium channel blockers.

Conclusion

Hypertension is the rising of blood pressure. From the pathophysiology, it is evident that Mrs. Y has hypertension, as shown by her difficulties in breathing, headaches, and fatigue because of improper circulation of nutrients in the body. One of the risk factors of hypertension is a poor diet that is full of saturated fats that deposit cholesterol along the lining of blood vessels, causing the pressure of the blood to increase. Additionally, a sedentary lifestyle is also a risk factor for hypertension. The disease is related to nutrition in that by observing the right diet, a person can be able to minimize the risk and manage hypertension.  There re several treatment options, some of which acts on hormones that cause the condition.

References

Beevers, G., Lip, G. Y., & O’Brien, E. (2001). The pathophysiology of hypertension. Bmj, 322(7291), 912-916. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120075/

Foëx, P., & Sear, J. W. (2004). Hypertension: pathophysiology and treatment. Continuing Education in Anaesthesia Critical Care & Pain, 4(3), 71-75.retrived from  https://academic.oup.com/bjaed/article/4/3/71/292146

Ruan, Y., Huang, Y., Zhang, Q., Qin, S., Du, X., & Sun, Y. (2018). Association between dietary patterns and hypertension among the Han and multi-ethnic population in Southwest China. BMC public health, 18(1), 1106. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-6003-7

Shin, J. Y., Kim, J. M., & Kim, Y. (2013). Associations between dietary patterns and hypertension among Korean adults: the Korean National Health and Nutrition Examination Survey (2008-2010). Nutrition research and practice, 7(3), 224-232. Retrieved from https://synapse.koreamed.org/search.php?where=aview&id=10.4162/nrp.2013.7.3.224&code=0161NRP&vmode=FULL

Yannoutsos, A., Levy, B. I., Safar, M. E., Slama, G., & Blacher, J. (2014). Pathophysiology of hypertension: interactions between macro and microvascular alterations through endothelial dysfunction. Journal of hypertension, 32(2), 216-224. doi: 10.1097/HJH.0000000000000021