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Slide 1 - Blood Pressure Management Liz Rhodes, RN ECU Student Nurse 1
Slide 2 - PROBLEM Uncontrolled blood pressures related to medications, poor diet, and decreased physical activity 2
Slide 3 - GOAL To motivate a change in behavior patterns and activities to control blood pressure for stroke prevention 3
Slide 4 - OBJECTIVES List four modifiable risk factors for strokes State the importance of controlling blood pressure. List different types of foods which are healthy and not healthy. Verbalize the importance of a healthy lifestyle to prevent a stroke Interpret BP results after participation in blood pressure screening and document results if follow-up required Complete the stroke risk factor form from using obtained knowledge of program  Be aware that there are others available for assistance Desire a more positive healthy life style Identify reasons for not taking medications   4
Slide 5 - BLOOD PRESSURE How can I tell if I have high blood pressure? High blood pressure usually has no symptoms. Many people have high blood pressure for years without knowing it. It's called the "silent killer." Hypertension is the medical term for high blood pressure. It doesn't refer to being tense, nervous or hyperactive. You can still have high blood pressure even if you are a calm, relaxed person.http://www.americanheart.org/presenter.jhtml?identifier=4473 5
Slide 6 - Why is Blood Pressure Management Important? There is a progressive increase in the risk of: stroke Elevated BP one of the most common reasons Elevated BP places unnecessary stress on blood vessels Coronary (heart) disease (Kaplan & Rose, 2008). 6
Slide 7 - Factors related to High Blood Pressure A family history of high blood pressure Age - The incidence of high blood pressure rises in men after age 35 and in women after age 45 Gender - Men are more likely to have high blood pressure than women Race - Approximately 33 percent of African-Americans have high blood pressure, compared to 25 percent of Caucasians 7
Slide 8 - Potential Reasons For Not Taking Medications Poor eye sight Impairs ability to read prescription and understand labeling on bottle Limited hearing Critical communication from health care provider is diminished Limited mobility Decreased mobility and dexterity can limit a person's ability to have prescriptions filled to open and close childproof containers Memory Loss Problem with recalling prescription instructions from healthcare provider 8
Slide 9 - Potential Reasons For Not Taking Medications Economic Condition Limited income Increase in prescription costs Depression Social and Health Beliefs beliefs can be based on: misconceptions faulty information cultural conditioning 9
Slide 10 - Blood Pressure Guidelines 10
Slide 11 - Why is Blood Pressure ManagementFor Stroke Prevention Important? Strokes Leading Cause of Disability in the U.S. 3rd Leading Cause of Death in the U.S. N.C. lies in the Stroke Belt The Stroke Belt has the highest morbidity and mortality from Stroke in the U.S. The Buckle of the Belt includes NC, SC and Georgia 11
Slide 12 - TYPES OF STROKES Hemorrhagic Stroke Blood vessels in the brain rupture Ischemic Stroke Blood clots or fatty deposits block vessels that supply the brain with blood. 12
Slide 13 - Modifiable Risk Factors of Strokes High cholesterol Hypertension (high blood pressure) Exercise Diet Tobacco Doubles stroke risk Increases blood pressure Obesity Alcohol 4 oz. wine or equivalent may be protective Diabetes Cardiac Disease Atrial Fibrillation TIA/Prior stroke 13
Slide 14 - PREVENTION Eating a well balanced diet Exercise Compliance with medications Management of: Diabetes HTN Heart disease 14
Slide 15 - STROKE RISK AWARENESS SURVEY Check all that applies to you. ***If you check two or more, please see a healthcare professional and determine what you can do to lower your risk. AGE ____ You are a man over 45 or a woman over 55 years old. FAMILY HISTORY ____ Your father or brother had a heart attack before age 55 or your mother or sister had one before age 65. MEDICAL HISTORY ____ You have coronary artery disease, or you have had a heart attack. ____You have had a stroke. ____You have an abnormal heartbeat. Tobacco SMOKE ____ You smoke, or live or work with people who smoke every day. Total CHOLESTEROL and HDL cholesterol ____ Your total cholesterol level is 240 mg/dL or higher. ____ Your HDL (“good”) cholesterol level is less than 40 mg/dL if you’re a man or less than 50 mg/dL if you’re a woman. ____ You don’t know your total cholesterol or HDL levels. 15
Slide 16 - Risk assess cont. BLOOD PRESSURE ____ Your blood pressure is 140/90 mm Hg or higher, or you’ve been told that your blood pressure is too high. ____ You don’t know what your blood pressure is. PHYSICAL INACTIVITY ____ You don’t accumulate at least 30 minutes of physical activity on most days of the week. Excess BODY WEIGHT ____You are 20 pounds or more overweight. DIABETES ____ You have diabetes or take medicine to control your blood sugar. American Heart Association. (2008). Personal risk assessment form. Accessed on September 12, 2008 at http://www.strokeassociation.org/presenter.jhtml?identifier=3034972 16
Slide 17 - Stroke is a Medical Emergency 17
Slide 18 - ABCs of Preventing Heart Disease, Stroke and Heart Attack 18
Slide 19 - http://www.strokeassociation.org/presenter.jhtml?identifier=3034972 19
Slide 20 - Heart-Healthy Cooking Tips Eat less cholesterol, salt and saturated and trans fats. Eating less saturated fat and trans fat helps to lower blood cholesterol levels. Eating fewer calories will help you lose weight, especially when you also enjoy regular physical activity. Eating less salt and more potassium helps control blood pressure in most people. Focusing your diet on foods such as fat-free and low-fat dairy fruits, vegetables and whole-grain, high-fiber foods is essential to good health. 20
Slide 21 - Here are some tips to help make your meals healthful: Frying Steam, stir-fry, broil, or bake foods in olive oil or canola instead of deep-frying in bacon grease or shortening. Salt Use lemon juice, vinegar, garlic, hot red pepper flakes, and onions or other low-salt spices instead of salt. Use little or no salt when you cook, spaghetti, noodles, hot cereal or rice.  Salad Dressing Use low-fat, low-calorie or fat-free salad dressings.   21
Slide 22 - TIPS continued Butter Use soft tub margarine instead of butter, or use other spreads that are lower in trans fat, cholesterol, and saturated fat such as a stick of margarine. Eggs Limit egg yolks to three or four per week, or eat egg whites instead.  Meat Buy fresh lean cuts of meat and trim the fat before cooking. Eat chicken, turkey, and very lean pork or beef. Remove the skin from poultry before cooking except when roasting a whole chicken. Roast, broil, or bake meats instead of frying them.   22
Slide 23 - TIPS continued Oils Use olive, canola, corn, or safflower oil in cooking. Use calorie-free, fat-free cooking spray to provide a non-stick surface for grills, bake ware, and wok-ware. Fat Limit saturated calories to less than 7 percent of your total calories and trans-fat calories to less than 1 percent of your total calories.   23
Slide 24 - AREA DIETICIANS Renee L Kemske MPH RD LDN Orange County Health Dept 2501 Homestead Rd Chapel Hill, NC 27514 Phone: (919) 968-2022 x309 Email: rkemske@co.orange.nc.us Areas of Practice: Individual Counseling, Group Counseling, Programs/Workshops, Cardiovascular/Hypertension, Diabetes, General Nutrition/Wellness, Gerontology, Weight Control 24
Slide 25 - AREA DIETICIANS Anne-Marie Scott UNC Wellness Center Health Education Dept 100 Sprunt St Chapel Hill, NC 27517 Phone: (919) 843-2163 Email: a_scott@uncg.edu Areas of Practice: Individual Counseling, Group Counseling, Programs/Workshops Cardiovascular/Hypertension, General Nutrition/Wellness, Gerontology, Weight Control 25
Slide 26 - AREA DIETICIANS Elizabeth A Watt RD LDN The Wellness Center at MeadowMont 100 Sprunt St Chapel Hill, NC 27517-7811 Phone: 919-843-2163 Email: ewatt@unch.unc.edu Areas of Practice: Individual Counseling, Group Counseling, Programs/Workshops, Cardiovascular/Hypertension, General Nutrition/Wellness, Weight Control 26
Slide 27 - AREA DIETICIANS Kara M Mitchell MS RD LD Duke Center for Living 1300 Morreene Rd Durham, NC 27710 Phone: (919) 660-6818 Email: mitch068@mc.duke.edu Areas of Practice: Individual Counseling, Group Counseling, Programs/Workshops Cardiovascular/Hypertension, Diabetes, General Nutrition/Wellness, Vegetarian, Weight Control 27
Slide 28 - FITNESS CENTERS Carolina Fitness 503-C West Main StCarrboro, NC 27510 phone (919) 960-9910 O2 Fitness View Website 300 Market Street, #110 (Southern Village),Chapel Hill, NC 27516 phone (919) 942-6002 28
Slide 29 - FITNESS CENTERS The Wellness Center at Meadowmont View Website 100 Sprunt StChapel Hill, NC 27517 phone (919) 966-5500   World-Renowned Residential Program-- Duke University Diet and Fitness Center 1-800-235-3853 http://www.dukehealth.org/Services/DietAndFitness/About/index/DFC%20Brochure%20Inside.pdf Check with your physician be for starting any physical fitness program 29
Slide 30 - Prescription Drugs WALMART/SAM'S CLUB $4 Prescription Drug Program Heart Health & Blood Pressure Medications Target $4 Prescription Drug Program UNC Hospital Program for free medications. An application needs to be filled out and submitted. It does go by income. **(Check with your physician for generic medication prescription for area programs) 30
Slide 31 - Things to Remember Help decrease your risk for a stroke or recurring stroke by: Maintaining a healthy diet Exercise Program Check with your physician before starting Control your blood pressure Monitoring/keep tract of results Medications Medical follow-up **If you think you are having a stroke, call 911 immediately! (See the following signs & symptoms) 31
Slide 32 - Signs & Symptoms of Strokes Sudden numbness or weakness Sudden confusion, trouble speaking or understanding Sudden trouble seeing Sudden trouble walking, dizziness, or loss of balance or coordination Sudden, severe headache 32
Slide 33 - Thank You 33
Slide 34 - Resources American Heart Association [AHA]. (2008). Diet and Nutrition. Site accessed on September 29, 2008 at http://americanheart.org/presenter.jhtml?identifier=1200010 American Heart Association. (2008). Personal risk assessment form. Accessed on September 12, 2008 at http://www.strokeassociation.org/presenter.jhtml?identifier=3034972  American Heart Association [AHA], (2008). Stroke risk factors. Site accessed on September 29, 2008 at http://www.americanheart.org/presenter.jhtml?identifier=9217   American Heart Association [AHA]/American Stroke Association [ASA]. (2007). Let’s talk about lifestyle changes to prevent stroke. Site accessed on September 29, 2008 at http://www.strokeassociation.org/downloadable/stroke/1219770019473Lifestyle%20Chgs%20to%20Prevent%20Stroke.pdf   American Stroke Association [ASA]. (2008). Converging risk factors. Site accessed on September 29, 2008 at http://www.strokeassociation.org/presenter.jhtml?identifier=3027394 American Stroke Association [ASA]. (nd). Stroke risk awareness survey. Site accessed on September 29, 2008 at http://www.strokeassociation.org/downloadable/stroke/1130509929967PTES%20Risk%20Assessment%20Card.pdf Dufresne, J. & Greene, V. (1990). Medication regimens: Causes of non-compliance. Department of Health and Human Services: Offices of Inspector General. Accessed on October 6, 2008 at http://www.oig.hhs.gov/oei/reports/oei-04-89-89121.pdf Every Day Health Network. (2008). Stroke center: Blood pressure guidelines Accessed on October 27, 2008 at http://www.everydayhealth.com/publicsite/index.aspx?puid=1c66ebdb-25c5-4042-bd9b-051cb3f9e623&xid=gslp&s_kwcid=blood%20pressure|2525548814&gclid=CMyQ8Z6rzZYCFQS7sgodBWgGzQ Kaplan, N. &Rose B. (2008). What is goal blood pressure in treatment of hypertension? Retrieved on October 19, 2008 from Up to date at UNC -Chapel Hill. Sebastian, J. G. in M. Stanhope & J. Lancaster (2008). The nurse leader in the community. Public health nursing: Population-centered health care in the community. (7th ed.). St. Louis, MO: Mosby. 34