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High Risk Nutrition Care Plan Guidelines 6

• Emphasize appropriate portion size and variety to avoid nutrient to nutrient interaction. For example, excessive calcium intake inhibits the absorption of iron. • Provide education on foods that contain the specific nutrient(s) of concern, as well as on preparing foods that are part of the WIC food package.

Risk 345 Hypertension and Prehypertension

Hypertension (HTN) is defined as high blood pressure which may eventually cause health problems and includes chronic hypertension during pregnancy, preeclampsia, eclampsia, chronic hypertension with superimposed preeclampsia, and gestational hypertension. Prehypertension is defined as being at high risk for developing hypertension, based on blood pressure Levels. Untreated HTN leads to many degenerative diseases, including congestive heart failure, end-stage renal disease, and peripheral vascular disease. People with HTN are often asymptomatic; diagnosis is based on measuring levels of blood pressure. • Normal blood pressure: <120/<80 mmHg (millimeters of mercury) • Prehypertension: consistent readings of 120-139/80-89 mmHg • Hypertension: consistent readings of ≥140/≥90 mmHg

Risk factors for HTN include: • Race/ethnicity (In the United States, people of African descent experience disproportionately higher rates of HTN compared to other races/ethnicities. Causes for this racial disparity in rates of HTN are complex and multifactorial.) • Overweight or obesity (This causes more blood to be pumped by the heart.) • Physical inactivity (This is associated with a higher heart rate, which increases the force of blood against arteries.) • Tobacco use (This increases blood pressure during use. Chemicals in tobacco also lead to narrowing of arteries.) and secondhand exposure to smoke from tobacco products. • Excessive alcohol intake (This can damage the heart over time.) • Excessive sodium intake (This causes fluid retention, which increases blood pressure.) • Inadequate potassium intake (This causes an excessive amount of sodium in the blood.) • Pregnant women and individuals with prehypertension.

HTN is a serious condition that can lead to health problems, such as: • Heart attack, stroke, and heart failure • Chronic kidney disease • Eye damage or vision loss • Memory/understanding problems and dementia • Gestational diabetes, preeclampsia, and perinatal mortality.

Assessment, counseling, and referral guidelines: • Complete nutritional assessment according to WIC protocol. • Assess diet, noting any criteria making the participant at risk for hypertension.