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Feb 20, 2024

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ENG-302-M60 How do diets and health literacy influence hypertension, the leading cause of heart disease and strokes in America? The #1 cause of death in America for both men and women is cardiovascular or heart disease. The leading cause of heart disease is hypertension, or high blood pressure. Hypertension is also referred to as the silent killer because no symptoms are seen or felt while the high levels of blood are rushing through the arteries, eventually leading to cardiovascular disease. An estimate of 660,000 people die from heart disease each year, that’s 1 in every 4 deaths, a death every 40 seconds. Heart disease costs the United States about $219 billion each year. 1 This number includes the cost of health care services, medications, and premature death. That kind of money could provide a shelter for every homeless person in America, but instead it’s spent towards a disease that is very much preventable. Besides the inevitable factor such as age and sex, we need to focus on the lifestyle component that is causing this epidemic disease. Smoking, lack of sleep, obesity, lack of physical activity, diabetes, alcohol consumption, high cholesterol, and hypertension are all factors that one can control, and over half of them related to diet. Focusing on the manageable causes of hypertension like diet, will help the almost half the U.S. population diagnosed with hypertension lower the chance of heart disease and stroke, along with promoting a healthier lifestyle for our future generation. This literature review is centered around the research question, “How do diets and health literacy influence hypertension?” The purpose of this literature review is to look at the correlation between diet, health literacy, hypertension, and ways to prevent having high blood pressure.

Hypertension has been associated with lifestyle factors such as lack of physical activity, a high calorie intake, high-sodium and low-potassium diets, caffeine, smoking, alcohol consumption and obesity (Mantry, R. et, al, 2022). There’s a strong resemblance between the lifestyle factors that cause hypertension and the conventional western diet, which is rich in saturated fats, sucrose, and fructose, along with excessive alcohol consumption. A study done to evaluate childhood hypertension in 2022 shows the same lifestyle factors have been linked to adolescent hypertension and obese children with primary hypertension. This abnormally high levels of blood pressure not caused by a medical condition, were historically more frequent in adults and rarely in children. With how common childhood obesity is today and that number only increasing, there is an urgent need to address this epidemic now more than ever. Through numerous controlled trials and studies, the DASH diet (Dietary Approaches to Stop Hypertension) show a wide-range of health benefits such as reducing blood pressure. According to the National Library of Medicine, the DASH diet consists of foods rich in protein, fiber, potassium, magnesium, and calcium, such as fruits and vegetables, beans, nuts, whole grains, and low-fat dairy. A chart of this diet is provided by the National Heart, Lung, and Blood Institute based on age, activity level, and calorie levels for a day. A sample guideline for a 2,000 calories-a-day would be 4-6 servings of grains, ≤6 servings of meat, fish, poultry, 4-5 servings of vegetables, 4-5 servings of fruits, 2-3 servings of low-fat or fat-free dairy products, 2-3 servings of fats and oils. It also includes weekly goals of 5 servings of nuts, seeds, dry beans, peas, and 5 or less servings of sweets. According to Bazzano et al. (2013), dietary strategies for the prevention of hypertension include reducing sodium intake, limiting alcohol consumption, increasing potassium intake, and adopting an overall dietary pattern such as the DASH diet. Mantry et al. (2022) supports that

claim by presenting a study that showcases a statistically significant difference between those who consumed junk food more than twice a week and those who consumed it less than twice a week when it came to hypertension and high blood pressure - found that people with high blood pressure and those at risk of developing hypertension consumed more fried meals. The DASH diet has proven to reduce blood pressure and the benefits of adhering are substantial. So why is it not more prevalent? Why are there still so many diagnoses of hypertension? As previously mentioned, the current US food environment promotes highly accessible and inexpensive foods. Browsing through the McDonalds app, it’s possible to purchase a Quarter pounder® with cheese, medium fries, and medium soft drink for $6 (around 1,000 calories and very little nutritional value). A bag of apples at Wegmans costs around the same amount. Despite these barriers, research has shown that DASH can be adopted at low cost and among low-income individuals; foods such as dried beans or frozen vegetables are inexpensive and DASH accordant (Steinburg et, al. 2017). Health literacy is the ability to understand health information and make an educated decision based on the material. A cross-sectional study showed that high health literacy and greater health accordance to a DASH diet is based on the level of the participant’s education (Lou, S. et, al. 2023). In simple terms, an individual has a higher chance of complying with the DASH diet and not being diagnosed with hypertension if they are better educated on how their food choices have an impact on their health. Seeing that education is the tie between greater health literacy and a better ability to adhere to the DASH diet, better implementation of health literacy is needed for the half of the U.S. population who are diagnosed with hypertension. With technology molding our society today and the use of smartphones being omnipresent, it’s possible to reach even the historically

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