dieta e pressione arteriosa
TRANSCRIPT
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www.carlomaggio.itwww.salusproject.itwww.facebook.com/carlo.maggio
Un naturale approccio terapeutico
con dieta e attività fisica
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Mappa mentale Xmind
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INTERHEART
1.Fumo2.Diabete3. Ipertensione4.Obesità viscerale5.Psicosociale6.ApoB/ApoA1
1.Frutta e verdura2.Attività fisica3.Alcool moderato
Yusuf. Lancet. 2004; 364: 937-952
15152/14820 caso/controllo
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Ipertensione = rischio
Ipertensione
Insufficienza renale
Scompenso cardiaco
Ictus
Infarto cardiacoFibrillazione atriale
Demenza
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Riduzione PA e mortalità
Stamler. Hypertension. 1991; 17(suppl I): I16-I20
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Meglio una parola…
Meglio una parola prima, che due dopo
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Classificazione livelli pressione
Mancia. Eur Heart J. 2013; 34(28): 2159-2219
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Sommario linee guida
Mancia. Eur Heart J. 2013; 34(28): 2159-2219
Linee guida: occhio al particolare!
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Mancia. Eur Heart J. 2013; 34(28): 2159-2219
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Heart attack cafè
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Frontespizio Tesi
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Esercizio fisico e pressione Attività aerobica di resistenza
Riduzione PA ipertesi 7/5 mmHg
Consigliati 30 min 5/7 gg sett.
Cornelissen. Hypertension. 2005; 46: 667-675
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Fumo e pressione arteriosa
Bang. Blood Press Monit. 2000; 5: 271-274
Aumento PA media diurna nei fumatori!
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Sodio e liquidi extracellulari
Dahl. Am J Clin Nutr. 1972; 25: 231-244
Sodio: principale catione che regola i liquidi extracellulari
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Sodio e pressione arteriosa
Incremento PA con dieta ricca di Na
Riduzione PA con dieta povera di Na
Benefici dieta iposodica protratti per 10-15 anni
Sacks. N Engl J Med. 2001; 344: 3-10
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Sodio e sale1 grammo NaCl = 0,4 g Na +
0,6 g Cl
Conversione: Na = NaCl x 0,4
Es. 5 grammi NaCl x 0,4 = 2 g di Na
Conversione: NaCl = Na x 2,5
Es. 2 grammi Na x 2,5 = 5 g di NaCl
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Cibi salati e introito consigliato
USA consumo: Na 3,6 g NaCl 9 g
Consigliato Na 2,3 g NaCl 5,75 g
75% di NaCl da cibi preparati
Chobanian. Hypertension. 2003; 42: 1206-1252
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Controllare il sodio nella dieta
Sodio alimentare: 90% escreto con le urineSodio urinario: 1 mmol (mEq) = 23 mg Na100 mmol Na urinario = 2,3 g Na + 10% = 2,53 g Na2,53 g Na x 2,5 = 6,3 g NaCl die
Soggetti sani: mantenere sodiuria 24 ore sotto 100 mmol
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Alimenti ricchi di sodio
Maggio C. “100 anni da giovane”. L’Età dell’Acquario. Torino 2012
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Aging e peso
La mezza età è quando smetti di crescere alle estremità e cominci a crescere nel mezzo
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Peso e pressione arteriosa
Ipertensione: prevalenza doppia negli obesi
Aumento PA con incremento peso
Riduzione 1 mmHg ogni Kg di peso in perso (stima)
Neter. Hypertension. 2003; 42: 878-884
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Etanolo e pressione arteriosa
Non consumare oltre i 300 ml di vino per gli uomini e 150 ml per le donne
Marchi. World J Cardiol. 2014; 6(5): 283-294
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Proteine e PA Buon apporto proteico = riduzione PA
Soprattutto proteine vegetali
Calo pressorio 3,5 mmHg di pressione sistolica
Shay. Am J Clin Nutr. 2012; 96(3): 483-491
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Omega-3 e PA
Omega-3 3 grammi die riduzione PA 4,0/2,5 mmHg
Alti dosaggi
Consigliati se coesiste ipertrigliceridemia
Geleijnse. J Hypertens. 2002; 20: 1493-1499
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Carboidrati e pressione arteriosa 1
Riduzione bevande zuccherate =Diminuzione pressione arteriosa
Chen. Circulation. 2010; 121(22): 2398-2406
Ridurre i carboidrati semplici!
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Carboidrati e pressione arteriosa 2
Wang. Am J Clin Nutr. 2007; 86(2): 472-479
Prediligere i cereali integrali!
Aumento cereali integrali =Diminuzione pressione arteriosa
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Potassio e pressione Buon apporto potassio (4,7 g die) = riduzione PA Meglio frutta e verdura che integratori (dieta DASH)
Attensione se IRC, FANS, risparmiatori K Whelton. JAMA. 1997; 277: 1624-1632
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Calcio, magnesio e pressioneModeste riduzioni
PAcon calcio e magnesioConsiglio:
Alimenti naturaliricchi di calcio e
magnesioConsumare alimenti salubri ricchi di calcio e magnesio
Dickinson. Cochrane Database Syst Rev. 2006; (2): CD004639
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Aglio: risultati non univoci
“Non piangere”, disse l’aglio alla cipolla.“Non fiatare”, rispose la cipolla. Violetta Serreli
Simons. Neth J Med. 2009; 67(6): 212-219
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DASH diet
Dietary Approaches to Stop Hypertension riduzione PA
www.dietadash.it riduzione 5,5/3 mmHg 13,2/6,1 afro-americani
frutta, verdura cereali integrali, carne no zuccheri, 3 g Na
Svetkey. Arch Intern Med. 1999; 159: 285-293
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DietaGIFT
Speciani. DietaGIFT, dieta di segnale. Rizzoli 2009
Dieta di segnaleCronobiologiaFisiologiaSistema endocrinoAttività fisica
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Simf Villasimius
SIMF – www.simf.it Società Italiana Medicina Funzionale Branca della medicina che studia i processi fisiologici
Valuta le alterazioni funzionali prima che si manifesti la malattia
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Fight or Flight response
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Fight or flight responseEnergi
aCuor
eBronc
hiMeta
b Reni
↑ FC↑
PA
↑ AR
↑ DB
↑ glic
↓ pH
↓ Urine
↓ pH
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Hans Selye
Hans Selye (1907-1982)Medico austriacoMcGill University di Montreal1976 descrisse la Sindrome Generale di Adattamento (SGA)
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Sindrome Generale Adattamento
A
R
E
AdrenalinaNoradrenalina
CortisoloT3-T4
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Effetto camice biancoAnche 75-100 mmHg di PAS in pochi secondi
Guyton. Textbook of Medical Physiology. Saunders Elsevier. Philadelphia PA. 2011
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Misdiagnosis Hypertension
Ogedegbe. Arch Intern Med. 2008; 168(22): 2459-2465
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Hypertension device
Schein. J Hum Hypertens. 2001; 15: 271-278
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Breathing Zone Free
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SGA: tre fasi
Stressor
Allarme Resistenza Esaurimento
CaPhVIP
MgPhVAMP
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www.carlomaggio.it
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