Hypertension

HTN: Scope of Guideline (2008)

Guideline Scope Characteristics

Below, you will find a list of characteristics that describe the Scope of this Guideline.

Disease/Condition(s)

Guideline Scope Characteristics

Below, you will find a list of characteristics that describe the scope of this guideline.

The purpose of this guideline is to provide an evidence-based summary of effective practice in the nutrition management of hypertension.

Recommendations have been formulated for hypertension within the context of the nutrition care process. The major focus of this guideline is on dietary interventions for hypertension.

This guideline is intended for use by dietetics practitioners involved in hypertension. It may also be a valuable resource for registered dietitians involved in the care of people with other chronic conditions or disease states, such as cardiovascular disease and type 2 diabetes. It is hoped that the information in this guideline will be used to provide individualized nutrition care with practical nutrition recommendations that are based on the current state of the science for hypertension.

This guideline is not intended as a replacement for interventions typically within the scope of practice of a certified exercise physiologist or other professional, for which, adequate training in physical activity interventions and other therapies is necessary.

Guideline Category

Management, Prevention, Treatment

Clinical Specialty

Cardiology, Family Practice, Geriatrics, Internal Medicine, Nutrition, Pharmacology, Physical Medicine and Rehabilitation, Preventive Medicine

Intended Users

Registered Dietitians

Guideline Objective(s)

Overall Objective

To provide Medical Nutrition Therapy guidelines for hypertension.

Specific Objectives

  • To define evidence-based recommendations for registered dietitians (RDs) that are carried out in collaboration with other healthcare providers
  • To guide practice decisions that integrate medical, nutritional and behavioral elements
  • To reduce variations in practice among RDs
  • To promote self-management strategies that empower the patient to take responsibility for day-to-day management and to provide the RD with data to make recommendations to adjust Medical Nutrition Therapy or recommend other therapies to achieve clinical outcomes
  • To enhance the quality of life for the patient, utilizing customized strategies based on the individual’s preferences, lifestyle and goals
  • To develop content for intervention that can be tested for impact on clinical outcomes
  • To define the highest quality of care within cost constraints of the current healthcare environment.

Target Population

Adult (19 to 44 years), Middle Age (45 to 64 years), Aged (65 to 79 years), Male, Female

Target Population Description

Adults who are classified as having prehypertension (120 - 139/80 - 89 mmHg), stage 1 hypertension (140 - 159/90 - 99 mmHg), or stage 2 hypertension (>160/>100 mmHg).

Interventions and Practices Considered

This guideline is based on ADA's Nutrition Care Process and Model, which involves the following steps: 

  • Assessment
  • Diagnosis
  • Intervention
  • Monitoring and Evaluation.

This guideline addresses topics that correspond to the following areas of the Nutrition Care Process. Please refer to the Algorithms in this guideline for a more detailed view of the recommendations and their application within the Nutrition Care Process.

I. Referral to a Registered Dietitian

II. Medical Nutrition Therapy

A. Nutritional Assessment and Treatment

Below you will find the nutrition assessment terms related to hypertension care from International Dietetics & Nutrition Terminology Reference Manual: Standardized Language for the Nutrition Care Process, Second Edition

1. Medical history and relevant laboratory values for existing comorbidities

2. Nutrition-focused assessment including:

  • Height, weight, BMI, waist circumference and blood pressure 
  • Comprehensive diet history, including current dietary intake and receptivity to change
  • Physical activity pattern
  • Psychosocial and economic issues impacting nutrition therapy
  • Consideration of comorbid conditions and need for additional modifications in nutrition care plan.

B. Nutrition Diagnosis

Below you will find the nutrition diagnoses related to hypertension care from International Dietetics & Nutrition Terminology Reference Manual: Standardized Language for the Nutrition Care Process, Second Edition

C. Comprehensive Intervention (Planning and Implementation)

Below you will find the nutrition interventions related to hypertension care from International Dietetics & Nutrition Terminology Reference Manual: Standardized Language for the Nutrition Care Process, Second Edition

Individualized prescription based on:

  1. Dietary interventions
  2. Physical activity interventions
  3. Behavioral interventions
  4. Pharmacotherapy when indicated.

D. Monitoring and Evaluation

Below you will find the nutrition monitoring and evaluation terms related to hypertension care from International Dietetics & Nutrition Terminology Reference Manual: Standardized Language for the Nutrition Care Process, Second Edition

Nomenclature

Please note that the terms "patient" and "client" are used interchangeably throughout this guideline to describe an individual receiving care.