Hypertension Diet in Ramadan

Dehydration, volume depletion, and a tendency toward hypotension may occur with fasting during Ramadan, especially if the fast is prolonged and is associated with excessive perspiration. Hence, the dosage of anti hypertensive medications may need to be revised & can be adjusted to prevent hypotension. It is common practice that the intake of foods rich in carbohydrates and saturated fats is increased during Ramadan. Appropriate counseling should be given to avoid this practice, and agents that were previously prescribed for the management of elevated cholesterol and triglycerides should be continued. Based on the scarce available data, we would be more than happy to help you by offering the following recommendations which you can get personally with expert opinion. 1. Physician's advice and management should be individualized 2. Patient education should emphasize the need to maintain compliance with nonpharmacological and pharmacological measures 3. Diuretics are better avoided, especially in hot climates or to be administered in the early evening 4. Patients are encouraged to seek medical advice before fasting in order to adjust their medications if needed 5. A once daily dosage schedule with long acting preparations is recommended. 6. Patients with Hypertension should be advised to take a low salt, low fat diet 7. Patients with difficult to control Hypertension, should be advised not to fast until their BP is reasonably controlled 8. Patients with hypertensive emergencies should be treated appropriately regardless of fasting.

Blood Pressure ReadingsKnow Your Numbers. Systolic (mm) Diastolic (mm) Normal <120 and <80 Prehypertension 120 - 139 or 80 - 89 Hypertension Stage 1c 140 - 159 or 90 - 99 Stage 2d 160 or 100 Based on two readings taken 15 minutes apart with a confirmation reading in the contralateral arm. a mm HG How high the pressure of blood would raise a column of mercury. Prehypertension At risk for developing hypertension and cardiovascular disease. Stage 1 The most common level seen in adults, this group is most likely to have a heart attack or stroke. Stage 2 A serious form of hypertension that requires immediate treatment.

The DASH (Dietary Approaches to Stop Hypertension) Dietary Pattern. Daily Important Components for Lowering Blood Food Group Servings Pressure Whole grains and grain products 7-8 Carbohydrates and fiber Vegetables 4-5 Potassium, magnesium and fiber Fruits 4-5 Potassium, magnesium and fiber Low-fat or fat free milk or milk 2-3 Calcium, protein, potassium and magnesium products Lean meats, poultry and fish 2 or less Protein and magnesium Nuts, seeds and beans 4 - 5 a week Magnesium, potassium, protein and fiber Source: DASH Diet Eating Plan www.dashdiet.org.

Hypertension Diet Plan- Five Dietary Recommendations DASH dietary pattern (Dietary Approaches to Stop Hypertension) The healthy DASH diet plan was developed by the US National Institutes of Health to lower blood pressure without medication. Eating twice the average daily amount of fruits, vegetables, complex carbohydrates and low-fat dairy products. Its pattern is lower in fat, saturated fat, cholesterol, and sodium, and higher in potassium, magnesium, and calcium. The high levels of potassium, magnesium, and calcium in the DASH diet are thought to be at least partially responsible for its results. 1. Regulation of caloric intakeA reduction in daily caloric intake is associated with a significant decrease in systolic and diastolic blood pressure levels. 2. Low sodium dietA decrease in sodium (a major component of salt) is associated with a decrease in blood pressure. 4. Potassium, calcium, and magnesiumResearch shows that a high potassium-to-sodium ratio is associated with a greater likelihood that normal blood pressure will be maintained. Potassium rich foods such as leafy green vegetables, root vegetables like potatoes and carrots, and fruit, should be eaten everyday. An increased intake of calcium and magnesium may have blood pressure lowering benefits. General recommendations suggest meeting the Adequate Intake (AI) for calcium and the Recommended Dietary Allowance (RDA) for magnesium, through food sources instead of supplements. A good option is low fat Dairy Products. 3.Dietary fat decrease intake of saturated fat and trans fat as well as overall intake of dietary fat. This includes fruits and vegetables. For your guidance through a DASH diet Table 3: Follow the DASH dietary pattern. Choose a variety of foods that are low in sodium and dietary fat, and high in potassium and calcium. Food Group Levels (high or low) found in food groups Dietary Fat Sodium (Na) Potassium Calcium (Ca) (K) (> 50 mg (>200 mg considered considered a high source) a high source) Vegetables: Broccoli, Low Low (high High High (low carrots, corn, mushrooms, sources include sources include potatoes, and spinach. Most canned). mushrooms, raw vegetables are corn, potatoes, naturally low in fat and and tomato). sodium, and high in potassium and calcium. (recommended) Fruit: Apples, avocado, Low Low High Low (high bananas, strawberries, sources include oranges, peaches, and oranges). watermelon. All raw fruits

are naturally low in sodium, and contain high amounts of potassium. (recommended, especially oranges) Meat: Eggs, fish, red meat, High (low fat and poultry. These products options include vary widely in fat, sodium, skinless chicken, and mineral content. fish, eggs, and lean (Recommended) cuts of beef). Dairy: Cheese, milk, and High (low fat yogurt. Nearly all dairy options include noncontains high amounts of fat dairy product calcium and potassium. such as milk, cheese, This food group also and yogurt). contains high amounts of sodium and dietary fat. (recommended but non fat and low salt) Legumes and Nuts: High in healthy Almonds, black beans, mono and poly garbanzo beans, tofu, unsaturated fatty peanut butter, pistachios, acids (low fat foods and walnuts. This group in this group include contains high amounts of black beans, dietary fat in the form of garbanzo beans, and healthy mono and poly tofu). unsaturated fatty acids. Many foods in this group are also rich in potassium and calcium. ( recommended) Grain Products: WholeLow (high sources wheat bread, oatmeal, include premacaroni, and rice. Most packaged baked grains are low in dietary items). fat, potassium, and calcium. Some may contain high amounts of sodium, especially when more than one serving is consumed. (not recommended) Desserts: Pastries, cookies, High muffins, pie, and cake. Most baked goods are high in sodium and fat, and low in potassium and calcium.

Low (high sources include canned meats, and any saltcured meats). High

High (low Low (high sources sources include include eggs, salmon). and bacon). High (low High sources include some types of cheese).

Low (high sources include canned and salted).

High (low sources include tofu and peanut butter).

Low (high sources include almonds, black beans, and garbanzo beans).

Low (high sources include bread, and prepackaged baked items).

Low

Low

High

Low

Low

This group should be consumed in moderation. (not recommended) Condiments, Fats, and Oils: Ketchup, pickles, mayonnaise, barbeque sauce, butter, and salad dressing. This group is mostly high in fat and sodium, and nutrient poor. (not recommended)

Low (high sources High include mayonnaise, butter, margarine, and salad dressing).

Low (high sources include pickles).

Low

Summary
Hypertension has no symptoms therefore known as a silent killer, and over half of those with this condition are not currently treated. Untreated hypertension may lead to many health problems, including damage to blood vessels that may lead to heart failure. It is possible to control high blood pressure through a healthy diet and lifestyle that includes physical activity, avoiding tobacco, and limiting alcohol consumption. Additional recommendations include following a low sodium diet, regulating caloric intake, reducing dietary fat, increasing potassium, calcium, and magnesium through a diet rich in fruits and vegetables.

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