NUTRITIONAL COUNSELING FOR HYPERTENSIVE PATIENTS
Nutritional History Taking
The following questions need to be asked of a hypertensive patient: age, weight and history of weight gain, height, medical history, past history of CVD—for example, stroke/heart attack/diabetes, chest pain while exercising, leg muscle tightness or fatigue when walking or climbing stairs, kidney disease/protein in urine, smoking status, cholesterol levels, BP readings, family history of CVD, psychosocial and environmental factors (employment status, family situation [married/divorced/ single/children], education level)—and diet history (fat intake, servings of fruit and vegetables, fiber intake, dairy intake, intake of red meat, meal spacing, alcohol consumption, Na intake (use of salt/processed foods), fast-food consumption/eating out, reading nutrition labels).
This should consist of a BP measurement; an examination of the heart for increased rate, size, murmurs, or arrhythmias; an examination of the abdomen for enlarged kidneys and abnormal aortic pulsation; an examination of the neck for carotid bruits, an enlarged thyroid gland, and distended veins; a peripheral pulse measurement; checking the lower extremities for edema and pulses; a neurological assessment; and an examination of optic fundi. Investigations should include urinalysis, complete blood count, blood glucose, K, Ca, creatinine, uric acid, cholesterol, HDL, LDL, triglycerides, and electrocardiograph (ECG).