U.S. Dept of Health and Human Services. National High Blood Pressure Education Program. Seventh Report of Joint National Committee on Prevention, Detection, Evaluation and Treatment on High Blood Pressure (JNC7 Express)

Cardiovascular Disease Risk Hypertension Cigarette smoking Obesity (body mass index ≥30 kg/m2) Physical inactivity Dyslipidemia Diabetes mellitus Microalbuminuria or estimated GFR <60 mL/min Age (older than 55 for men, 65 for women) Family history of premature cardiovascular disease (first degree relative men under age 55 or women under age 65) U.S. Dept of Health and Human Services. National High Blood Pressure Education Program. Seventh Report of Joint National Committee on Prevention, Detection, Evaluation and Treatment on High Blood Pressure (JNC7 Express)

Metabolic Disease Definition (Risk for CVD even though not yet hypertensive) RF 1: abdominal obesity (waist circumference >40 inches in men or >35 inches in women) RF 2: glucose intolerance (fasting glucose >110 mg/dL), RF 3: BP >130/85 mmHg, RF 4: high triglycerides (>150mg/dL) RF 5: low HDL (<40 mg/dL in men or <50 mg/dL in women). Treatment: lifestyle modification U.S. Dept of Health and Human Services. National High Blood Pressure Education Program. Seventh Report of Joint National Committee on Prevention, Detection, Evaluation and Treatment on High Blood Pressure (JNC7 Express)

I have high blood pressure and some risk factors for CVD! What can I do? Adapt DASH/ TCL Diet  safe to do so now If your blood pressure is still higher than 120/80 the next time we see you, go seek medical help, you may need to be put on a blood pressure medication Increase physical activity  first see a doctor before you do so SHRC case management team is here to help!

U.S. Dept of Health and Human Services. National High Blood Pressure Education Program. Seventh Report of Joint National Committee on Prevention, Detection, Evaluation and Treatment on High Blood Pressure (JNC7 Express)

Touro-CA SRHC Case Management CVD and Diabetes Risk Prevention Protocol Triage :get BMI, BP, Random Glucose test Normal <120/80 Prehypertensive >120/80 Hypertensive >140/90 CC: CP? SOB? BP 2X CC: Thirst, recent weight loss Random BS >200 Refer to case manager if BS> 200 0r BMI>25 0r BP >120/80 BMI >30 obesity BMI>25 overweight Intake form, county referral, recommend diet change, and weight reduction Identify risks for metabolic syndrome Intake form, recommend diet changes, and weight reduction If more than 1 risk factors, such as high BP BS<200 RF 1: abdominal obesity (waist circumference >40 inches in men or >35 inches in women) * RF 2: glucose intolerance (fasting glucose >110 mg/dL), * RF 3: BP >130/85 mmHg, * RF 4: high triglycerides (>150mg/dL) RF 5: low HDL (<40 mg/dL in men or <50 mg/dL in women). If more than one 1 RF RF 1: Age (male > 45 yrs, female> 55 yrs) RF 2: BP > 140/90 mm/Hg RF 3: HDL < 40 mg/dl in male; < 50 female RF 4: Family history of premature CHD Identify risk for CHD