HIGH CHOLESTEROL & HYPERTENSION CMT Training The Center for
Life Enrichment
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Section 1 High Cholesterol
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What is it? Cholesterol is necessary for proper digestion,
hormone balance, and healthy cell membranes When the blood
cholesterol is too high, it forms deposits or plaque inside the
walls of arteries When the deposits are large enough to decrease
blood flow, heart disease, stroke, or peripheral vascular disease
develops
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Why does it occur? Cholesterol is made by the liver In some
people, the liver makes too much cholesterol Cholesterol is also
contained in food rich in animal fats Cholesterol circulates in the
blood stream bound to proteins of various densities called
lipoproteins
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LDL vs. HDL Low Density Lipoproteins (LDL) in excess increase
the risk of plaque formation Commonly called Bad Cholesterol LDL
Cholesterol: Less than 100 mg/dl High Density Lipoproteins (HDL)
are cardio-protective Commonly called Good Cholesterol HDL
Cholesterol: 40 mg/dl or higher for men; 50 mg/dl or higher for
women LDLHDL
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What the person might complain about/What to look for? There
are no specific symptoms of high cholesterol; that is why it is
recommended that everyone have a blood cholesterol test The
desirable amount of total cholesterol in the blood is less than 200
mg/dl. This level, if normal, should be rechecked every five years
If the cholesterol level is greater than 200 mg/dl, the doctor may
recommend dietary interventions and/or cholesterol lowering
medications
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Other Risk Factors for Heart Disease: High Blood Pressure
Smoking Family History of Heart Disease Diabetes Elevated LDL or
Decreased HDL Cholesterol Elevated Triglycerides (A type of fat
found in your blood) Obesity Sedentary Lifestyle
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What medications are used? There are numerous medications on
the market to lower cholesterol What to look for while the person
is taking medication to lower cholesterol: Muscle cramping
Rash/Hives Constipation/Diarrhea Flushing Stomach Upset/Pain
Headache Labs will be routinely followed to monitor liver and
kidney function
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Your Responsibility The individual/caregiver must know: Some of
these medications may interact with other medications the person
may take- Make sure the Healthcare Professional (HCP) is aware of
all medications being taken The person should exercise regularly
Follow a diet low in cholesterol, saturated fats (including
hydrogenated fats) and transfatty acids
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Specific Foods to Avoid Fried Foods: If not avoided, consider
using olive or sunflower oil when frying A recent study published
in the science journal BMJ found that in Spain, where olive and
sunflower oils are used for frying, eating fried food is not
associated with increased rates of heart disease as it is in
Western countries, where saturated fats, like lard and butter, are
used Hydrogenated Oil: Found in packaged foods, such as cookies,
pastries, mayonnaise, crackers, microwave popcorn, frozen dinners,
etc. Hydrogenated oil is used to increase a products shelf life
Check food labels and ingredients carefully- if you see the word
hydrogenated, avoid it! Meat: Avoid meat with visible fat Try to
reduce the amount of meat in your diet When preparing/eating meat,
trim off any visible fat on steaks and chops, always remove the
skin off turkey and chicken, and choose the leanest ground meat
possible Full-Fat Dairy Products: Instead, choose dairy products
that are fat-free, made with 2% milk, or part skim
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Foods that Lower Cholesterol Monounsaturated and
polyunsaturated fats: Can help decrease LDL cholesterol Eat fish
high in omega-3 fatty acids, such as salmon, tuna, trout, herring,
or king mackerel, at least twice a week Other good sources of
unsaturated fats include avocados, almonds, walnuts, and olive oil
Soy Foods: Good sources of soy protein include tofu, soy milk, and
edamame High-Fiber Foods: High-fiber foods that lower cholesterol
include whole grains, such as 100 percent whole-wheat bread, oats,
and barley; beans; dark, leafy green vegetables; and fruits with a
tough skin Spices: Not only do spices help flavor foods, but some
in particular are also a good part of a cholesterol-lowering diet,
such as turmeric, red cayenne pepper, thyme oil, and ginger
What is it? Hypertension or high blood pressure usually has no
symptoms and, because of this, is called the silent killer Normal
blood pressure is generally below 120/80 120 represents the
systolic measurement 80 represents the diastolic measurement
Desirable blood pressure is: Systolic - from 90 to 119 Diastolic -
from 60 to 79 Pre-hypertension: When the reading is between 120/80
and 139/89 Hypertension: When the reading is at least 140/90 The
persistent elevated pressure in the vascular system can damage the
heart, brain, kidney, and eyes. Therefore, untreated high blood
pressure can lead to heart disease, stroke, kidney disease, and
blindness!
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Taking a blood pressure measurement The procedure is
straightforward and provides the HCP with vital data regarding the
condition of the individuals blood vessels and heart Two blood
pressure readings are measured: The Systolic Pressure: the maximum
pressure in an artery. It occurs when the heart contracts; when it
is beating, and blood is being pumped through The Diastolic
Pressure: the minimum pressure in an artery. It occurs just before
the heart contracts; in between heartbeats. It occurs when the
heart is resting Both readings are important. If either the
systolic or diastolic pressure is too high, the individual has
hypertension Blood pressure readings may be taken while the
individual is sitting or standing Several different readings (on
different days) are usually taken before the diagnosis of high
blood pressure, or hypertension, is made
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Why does it occur? In 90% of individuals, there is no known
cause for high blood pressure or hypertension However, many factors
may contribute to hypertension including: Obesity High Salt Intake
Alcohol Use Sedentary Lifestyle Use of Certain Medications (which
may cause a rise in blood pressure) A Family History of High Blood
Pressure Excessive Stress In 10% of people with high blood
pressure, there is a known cause for high blood pressure. Known
causes include: kidney disease, diabetes mellitus, adrenal tumors,
or diseases of the blood vessels
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What the individual might complain about/What to look for? High
blood pressure is generally without symptoms Having blood pressure
checked routinely is the best method for detecting the problem In
some people with high blood pressure, signs and symptoms may be
present. If the following signs or symptoms are noted, report them
to the RN CM/DN or HCP: Change in vision Chest pain Confusion
Dizziness (blackout) Nausea and vomiting Nosebleeds Shortness of
breath
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What medications are used? There are many different types of
medications that can be used to treat high blood pressure Some
medications are a combination of two or more medications It often
takes more than one medication to manage hypertension
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How to determine if the medication is working? The individuals
blood pressure should be checked regularly in order to tell if the
blood pressure is within the target range identified by the HCP The
following side effects are common to many medications used to treat
high blood pressure. They often disappear after a few weeks of
treatment. If they continue to be a problem, contact your RN CM/DN
and the HCP. It may be necessary for the HCP to reduce the dose or
change the medication: Dizziness Persistent coughing Mood changes
Change in bowel habits Loss of energy Sexual impotence Fatigue
Muscle Weakness
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Your Responsibility It is important for the
individual/caregiver to understand the following: Individuals who
are on a diuretic need to have their blood tested to be certain
that their potassium, sodium, and other important electrolytes
remain normal. Individuals should not buy/take potassium
supplements on their own Many individuals who receive a diuretic
are also on digoxin. If this is true, more careful monitoring of
side effects is necessary It is very important for individuals to
drink plenty of fluids and limit salt intake, unless told otherwise
by the HCP The individual should move from a sitting to standing
position or from a lying to standing position slowly to avoid
becoming dizzy Be sure to tell the HCP if the individual has gout
or diabetes. Diuretics may interfere with the treatment of both of
these diseases
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Your Responsibilities Continued Report any side effects to the
RN CM/DN or HCP. The HCP may decide to change the medication or
reduce the dose If the individuals blood pressure is being
monitored, have the equipment checked each year to be certain it is
working correctly The individual should not stop taking any
medication suddenly as this could be life-threatening! If the
individual wants to discontinue a blood pressure medication, it
must be discussed with the HCP Be certain that you know exactly how
to operate the blood pressure measuring equipment
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Blood Pressure Monitors Digital Blood Pressure Monitors are
available at TCLE and our off-sight locations to measure blood
pressure On occasion, CMTs may need to use a Blood Pressure Monitor
to measure a participants blood pressure; please contact the agency
nurse with any questions or concerns (301-373-8100)