WESTERN MINDANAO STATE UNIVERSITY

COLLEGE OF HOME ECONOMICS

DEPARTMENT OF NUTRITION AND DIETETICS

ND-106 NUTRITION CARE PROCESS

A CASE STUDY ON HYPERTENSION

Presented to:
Prof. Santiago T.K. de Leon, Jr. RND, M.A.Ed., PSM-FPM

Presented by:

BSND - 2

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 ACKNOWLEDGEMENT

First and foremost we would like to thank God, the Almighty for his blessing throughout

our case study. We are really grateful because we were able to finish our Case Study

on Hypertension within given period time.

We would like to express our deepest appreciation to our Prof. Santiago T.K. de Leon,

M.A.H.Ed., PSM-FPM for his guidance and encouraging words who help us make this

study possible.

And, we would also like to thank our family and friends for their constant source of

inspiration.

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 TABLE OF CONTENTS

CHAPTER I

PATHOPHYSIOLOGY 6

NATURE OF PATIENT’S ILLNESS 7

SYMPTOMS 7

CAUSES 8

RISK FACTORS 9

COMPLICATIONS 11

EPIDEMIOLOGY 13

CHAPTER II

INTRODUCTION 14

OBJECTIVES 15

AIMS 15

DEFINITION 15

TYPES OF REGULAR DIET 16

IMPORTANT CONSIDERATIONS AND REMINDERS 17

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 COMPLICATIONS 18

CHAPTER III

ANTHROPOMETRIC DATA 19

MEDICAL HISTORY 20

SOCIO-ECONOMIC BACKGROUND 20

DIETARY HISTORY 22

DIETARY NEEDS WHILE IN THE HOSPITAL 25

CHAPTER IV

DIETARY COMPUTATIONS 26

CHAPTER V

CONCLUSION 31

RECOMMENDATION 32

BIBLIOGRAPY 33

APPENDICES 34

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 LIST OF TABLES

TABLE PAGE

1. 24 hour recall play by the client 22

2. Composition of food exchanges 28

3. Transition of food menu 29

4. Sample menu 30

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 CHAPTER I

I. PATHOPHYSIOLOGY

Hypertension is a chronic elevation of blood pressure that, in the long-term,

causes end-organ damage and results in increased morbidity and mortality. Blood

pressure is the product of cardiac output and systemic vascular resistance. It follows

that patients with hypertension may have an increase in cardiac output, an increase in

systemic vascular resistance, or both. In the younger age group, the cardiac output is

often elevated, while in older patients increased systemic vascular resistance and

increased stiffness of the vasculature play a dominant role. Vascular tone may be

elevated because of increased α-adrenoceptor stimulation or increased release of

peptides such as angiotensin or endothelins. The final pathway is an increase in

cytosolic calcium in vascular smooth muscle causing vasoconstriction. Several growth

factors, including angiotensin and endothelins, cause an increase in vascular smooth

muscle mass termed vascular remodeling. Both an increase in systemic vascular

resistance and an increase in vascular stiffness augment the load imposed on the left

ventricle; this induces left ventricular hypertrophy and left ventricular diastolic

dysfunction.

Increase in cardiac output – Cardiac output is the amount of blood circulated by the

heart during a given time period. Cardiac output can be increased in order to increase

cardiac performance and improve survival from hypovolemic shock.

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Increase in systemic vascular resistance – is the resistance in the circulatory system

that is used to create blood pressure, the flow of blood and is also a component of

cardiac function. When blood vessels constrict (vasoconstriction) this leads to

an increase in SVR

II. NATURE OF PATIENT'S ILLNESS

Hypertension, also known as high or raised blood pressure, is a condition in

which the blood vessels have persistently raised pressure. Blood is carried from the

heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood

into the vessels. Blood pressure is created by the force of blood pushing against the

walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure,

the harder the heart has to pump.

III. SYMPTOMS

Hypertension is generally a silent condition. Many people won’t experience any

symptoms. It may take years or even decades for the condition to reach levels severe

enough that symptoms become obvious. Even then, these symptoms may be attributed

to other issues.

Symptoms of severe hypertension can include:

• Headaches

• Shortness of breath

• Nosebleeds

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 • Flushing

• Dizziness

• Chest pain

• Visual changes

• Blood in the urine

These symptoms require immediate medical attention. They don’t occur in everyone

with hypertension, but waiting for a symptom of this condition to appear could be fatal.

IV. CAUSES

There are two types of high blood pressure.

Primary (essential) hypertension

For most adults, there's no identifiable cause of high blood pressure. This type of high

blood pressure, called primary (essential) hypertension, tends to develop gradually over

many years.

Secondary hypertension

Some people have high blood pressure caused by an underlying condition. This type of

high blood pressure, called secondary hypertension, tends to appear suddenly and

cause higher blood pressure than does primary hypertension. Various conditions and

medications can lead to secondary hypertension, including:

• Obstructive sleep apnea

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 • Kidney disease

• Adrenal gland tumors

• Thyroid problems

• Certain defects you're born with (congenital) in blood vessels

• Certain medications, such as birth control pills, cold remedies, decongestants,

over-the-counter pain relievers and some prescription drugs

• Illegal drugs, such as cocaine and amphetamines

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-

causes/syc-20373410

V. RISK FACTORS

Hypertension has many risk factors, including:

• Age. The risk of high blood pressure increases as you age. Until about age 64,

high blood pressure is more common in men. Women are more likely to develop

high blood pressure after age 65.

• Race. High blood pressure is particularly common among people of African

heritage, often developing at an earlier age than it does in whites. Serious

complications, such as stroke, heart attack and kidney failure, also are more

common in people of African heritage.

• Family history. High blood pressure tends to run in families.

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• Being overweight or obese. The more you weigh, the more blood you need to

supply oxygen and nutrients to your tissues. As the amount of blood blow through

your blood vessels increases, so does the pressure on your artery walls.

• Not being physically active. People who are inactive tend to have higher heart

rates. The higher your heart rate, the harder your heart must work with each

contraction and the stronger the force on your arteries. Lack of physical activity

also increases the risk of being overweight.

• Using tobacco. Not only does smoking or chewing tobacco immediately raise your

blood pressure temporarily, but the chemicals in tobacco can damage the lining of

your artery walls. This can cause your arteries to narrow and increase your risk of

heart disease. Secondhand smoke also can increase your heart disease risk.

• Too much salt (sodium) in your diet. Too much sodium in your diet can cause

your body to retain fluid, which increases blood pressure.

• Too little potassium in your diet. Potassium helps balance the amount of sodium

in your cells. A proper balance of potassium is critical for good heart health. If you

don't get enough potassium in your diet, or you lose too much potassium due to

dehydration or other health conditions, sodium can build up in your blood.

• Drinking too much alcohol. Over time, heavy drinking can damage your heart.

Having more than one drink a day for women and more than two drinks a day for

men may affect your blood pressure.

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 If you drink alcohol, do so in moderation. For healthy adults, that means up to one

drink a day for women and two drinks a day for men. One drink equals 12 ounces

of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.

• Stress. High levels of stress can lead to a temporary increase in blood pressure.

Stress-related habits such as eating more, using tobacco or drinking alcohol can

lead to further increases in blood pressure.

• Certain chronic conditions. Certain chronic conditions also may increase your

risk of high blood pressure, including kidney disease, diabetes and sleep apnea

VI. COMPLICATION

The excessive pressure on your artery walls caused by high blood pressure can

damage your blood vessels as well as your organs. The higher your blood pressure and

the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to complications including:

• Heart attack or stroke

– High blood pressure can cause hardening and thickening of the arteries

(atherosclerosis), which can lead to a heart attack, stroke or other

complications.

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• Aneurysm

– Increased blood pressure can cause your blood vessels to weaken and

bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-

threatening.

• Heart failure

– To pump blood against the higher pressure in your vessels, the heart has

to work harder. This causes the walls of the heart's pumping chamber to

thicken (left ventricular hypertrophy). Eventually, the thickened muscle

may have a hard time pumping enough blood to meet your body's needs,

which can lead to heart failure.

• Weakened and narrowed blood vessels in your kidneys

– This can prevent these organs from functioning normally.

• Thickened, narrowed or torn blood vessels in the eyes

– This can result in vision loss.

• Metabolic syndrome

– This syndrome is a group of disorders of your body's metabolism,

including increased waist size, high triglycerides, decreased high-density

lipoprotein (HDL) cholesterol (the "good" cholesterol), high blood pressure

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 and high insulin levels. These conditions make you more likely to develop

diabetes, heart disease and stroke.

• Trouble with memory or understanding

– Uncontrolled high blood pressure may also affect your ability to think,

remember and learn. Trouble with memory or understanding concepts is

more common in people with high blood pressure.

• Dementia

– Narrowed or blocked arteries can limit blood flow to the brain, leading to a

certain type of dementia (vascular dementia). A stroke that interrupts

blood flow to the brain also can cause vascular dementia.

VII. EPIDEMIOLOGY

Hypertension is an epidemic affecting one billion people and is the commonest

risk factor for death throughout the world.

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 CHAPTER II

I.INTRODUCTION

hypertension is a medicating in which the pressure within the arteries is elevated.

It is one of the "big three" risk factors for cardiovascular disease, and it can often be

associated with other health conditions and diseases.

High blood pressure, which causes problems such as heart disease, stroke,

kidney failure, vision loss or blindness, and congestive heart failure may result from

hypertension or lead to hypertension in some people. The word "hypertension" actually

comes from combining two ancient Greek words meaning "high pressure". Or blood

pressure levels, can be categorised as either "normal, high normal or stage 1

hypertension" when the systolic/diastolic blood pressure is 140/90 mmHg or higher to

150/100 mmHg or higher. Hypertension is also determined by a person's age; there are

specific blood pressure values for normal adults that are categorized as being

significantly lower than the standard values per decade of a person's age.

The most common cause of hypertension is the increase of volume/pressure of

blood flow due to the stiffening and hardening of the arteries. Other causes include

elevated levels of cytokines, prominent among which are TNF-alpha and IL-6. There are

also genetic factors that predispose a person to hypertension, and endocrine

(hormonal) factors. The latter may include thyroid disease (hyperthyroidism or

hypothyroidism), an excess production of cortisol, or growth hormone (GH) deficiency.

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II. OBJECTIVES

• Acquire adequate knowledge on hypertension

• Identify the types of hypertension

• Evaluate the regular diet for hypertension

III. AIMS

This case study entitled “controlling hypertension” aims to provide relevant

and essential information for patients with hypertension on how to control

it, and it also provide knowledge about the causes and effects of

hypertension to individual. This study intends to guide patients on proper

regular diet to control their high blood.

IV. DEFINITION.

DASH stands for Dietary Approaches to Stop Hypertension.

The DASH diet is a lifelong approach to healthy eating that's designed to

help treat or prevent high blood pressure (hypertension). The DASH diet

encourages you to reduce the sodium in your diet and eat a variety of

foods rich in nutrients that help lower blood pressure, such as potassium,

calcium and magnesium. By following the DASH diet, you may be able to

reduce your blood pressure by a few points in just two weeks. Over time,

the top number of your blood pressure (systolic blood pressure) could

drop by eight to 14 points, which can make a significant difference in your

health risks. Because the DASH diet is a healthy way of eating, it offers

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 health benefits besides just lowering blood pressure. The DASH diet is

also in line with dietary recommendations to prevent osteoporosis, cancer,

heart disease, stroke and diabetes.

V. REGULAR DIET FOR HYPERTENSION

A regular diet is a healthy meal plan that includes a variety of healthy foods from

all the food groups. Follow this meal plan if you do not have any health conditions that

require a special diet. A healthy meal plan is low in unhealthy fats, salt, and added

sugar. It may decrease your risk of heart disease, osteoporosis (brittle bones), and

some types of cancer.

The diets below are used to stop hypertension and the method of feeding

is oral.

• Avoid Salt (Sodium)

– A high-sodium diet increases blood pressure in many people. In fact, the

less sodium you eat, the better blood pressure control you might have.

To lower the sodium in your diet, try these suggestions:

• Use a food diary to keep track of the salt in the foods you eat.

• Aim for less than 2,300 milligrams (about 1 teaspoon of salt) each day. Ask your

doctor if you should go lower, to 1,500 milligrams.

• Read the nutritional facts label on every food package.

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 o Select foods that have 5% or less of the “Daily Value” of sodium.

o Avoid foods that have 20% or more Daily Value of sodium.

• Avoid canned foods, processed foods, lunch meats, and fast foods.

• Use salt-free seasonings.

USE DASH DIET

– Dietary Approaches to Stop Hypertension (DASH) is an eating plan rich in

fruits, vegetables, whole grains, fish, poultry, nuts, legumes, and low-fat

dairy. These foods are high in key nutrients such as potassium,

magnesium, calcium, fiber, and protein. The DASH diet can

lower blood pressure because it has less salt and sugar than the typical

American diet. The DASH diet cuts out desserts, sweetened beverages,

fats, red meat, and processed meats.

VI. IMPORTANT CONSIDERATION AND REMINDERS

Having a healthy lifestyle can help you prevent and control high blood pressure.

A person can control and prevent their blood pressure to rise by eating healthy foods

that are high in nutrients like potassium, magnesium, calcium, fiber, and protein, by

lowering sodium intake, by doing regular exercise and by always monitoring their blood

pressure.

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VII. COMPLICATION

Poor Nutrition and lack of exercise can really affect your blood pressure. Poor

nutrition can impair our daily health and wellbeing and reduce our ability to lead an

enjoyable and active life. Poor eating habits include under- or over-eating, not having

enough of the healthy foods we need each day, or consuming too many types of food and

drink, which are low in fibre or high in fat, salt and/or sugar.

These unhealthy eating habits can affect our nutrient intake, including energy

(or kilojoules) protein, carbohydrates, essential fatty acids, vitamins and minerals as well

as fibre and fluid. In the short term, poor nutrition can contribute to stress, tiredness and

our capacity to work, and over time, it can contribute to the risk of developing some

illnesses and other health problems such as:

• being overweight or obese

• tooth decay

• high blood pressure

• high cholesterol

• heart disease and stroke

• type-2 diabetes

• osteoporosis

• some cancers

• depression

• eating disorders.

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 CHAPTER III

Mr. M.G is an 64-year-old male with obesity and diagnosed with Hypertension. Mr.

M.G loves to eat fried foods, he also smokes cigarette and drink alcohol. The

patient has no significant past illness aside from hypertension and he didn't

undergo any types of surgery and no history of hospital admission except getting

checked due to Hypertension. Mr. comes from a Muslim family. They live in an

owned house near the city, together with his wife and 2 children who takes care of

him. Mr. M.G has a regular eating pattern. The family doesn't worry about food

crisis because her children have stable job. He usually eats 4 times a day and was

advised to avoid fried foods and to avoid smoking and alcohol.

ANTHROPOMETRIC DATA

PATIENT’S INFORMATION

NAME: Mr. M.G

SEX: Male

AGE: 64 years old

MARITAL STATUS: Married

HEIGHT: 5’4”

WEIGHT: 72 kg.

DATE WHEN INTERVIEWED: June 2, 2021

INTERVIEWED BY:

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I. MEDICAL HISTORY

A. Present Illness and Chief Complains

The client is diagnosed with Hypertension.

B. Past Illness and Surgery, Allergies, Hospitalization, etc.

The client was diagnosed with Hypertension around his early 50's due

to his age and obesity. However, the client didn't undergo to any

surgeries and didn't have any allergies but was only hospitalized to

get checked regarding his High blood pressure.

C. Physical State of Health

Mrs. M.G is an 84-year-old ambulatory client wherein she can still do

all things such as; eating, walking, bathing, and etc.

D. History of Parent’s Illnesses

The client's both parents was also diagnosed with hypertension.

II. SOCIO-ECONOMIC BACKGROUND

A. Ancestry or Ethnic Background

The client stated that both of his parents are Muslim.

B. Composition of the Family

The client lives with his wife and 2 children.

C. Occupation

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 The client is a sari-sari store owner.
D. Educational Attainment

The client finished secondary level.

E. Religion (Emphasis on Food Taboos and Food Beliefs)

The client is a Muslim they do not eat pork because it is not allowed
on their religion and they considered it as ‘Haram’.

F. Type of Residence

The patient lives in an owned-house near the city.

G. Income Bracket (Indicated within Range)

The estimated daily income of the client ranges from 400 pesos to
500 pesos a day.

H. Recreation, Exercise, Hobbies, etc.

The client do walking from their residence to the market near them

that serves as his daily exercise.

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III. DIETARY HISTORY

A. Food likes and dislikes

The client prefers to eat fried foods as well as protein foods.

B. Typical Food Intake (Preferably 24-hour recall plan plus usual intake

for a typical weekday and weekend)

Breakfast (7:30 am)

Food and/or Details/Brand Amount Amount Preparation/

Drink (Household) Ingredients

Rice Jasmine Rice 1 ½ cup 378 grams Fried Rice

Tea Milo 1 glass 148 ml Sugar added

Water Mineral 1 glass 148 ml -----

Table 1.1 24-hour recall plan intake for Breakfast

Morning snack (10:00 am)

Food and/or Details/Brand Amount Amount Preparation/

Drink (Household) Ingredients

Banana Saba 1 piece 101 grams Fried Banana

Soft drink Coca Cola 1 Bottle 372 ml -----

Table 1.2 24-hour recall plan intake for Morning snack

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Lunch (12:00 pm)
Food and/or Details/Brand Amount Amount Preparation/

Drink (Household) Ingredients

Soup Shrimp 1 cup 250 ml Shrimp Soup

Rice Blue Harvest 2 cups 400 grams Cooked rice

Juice Tang orange 1 glass 148 ml -----

juice
Table 1.3 24-hour recall plan intake for Lunch

Afternoon snack (3:00 pm)

Food and/or Details/Brand Amount Amount Preparation/

Drink (Household) Ingredients

Banana Saba 1 piece 118 grams Fried Banana

Water Mineral 1 glass 148 ml -----

Table 1.4 24-hour recall plan intake for Afternoon snack

Dinner (7:30 pm)

Food and/or Details/Brand Amount Amount Preparation/

Drink (Household) Ingredients

Rice Blue Harvest 2 cups 500 grams Cooked rice

Chicken Magnolia 2 pieces 108 grams Fried Chicken

Water Mineral 1 glass 148 ml -----

Table 1.5 24-hour recall plan intake for Dinner

C. Frequency of the Meals and Time Eaten

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 The client follows the four-times a day eating pattern which is
Breakfast, Lunch, Snack and Dinner.

D. Cooking Facilities (& where meals away from home are eaten)

The client’s wife usually cooks for him. And sometimes they buy

cooked food outside.

E. Food Budget per Person

The food budget for the family depends on the daily income of the
client and on the salary of his 2 children.
F. Other Sources of Nutrients in Addition to Usual Food and Drink

(Minerals, Vitamins, Pills, and Other Dietary Supplements)

The client does not take any supplements and vitamins that can help

aid nutrients in the body.

G. Past Dietary Restrictions and Medical Reasons

The client was advised to avoid eating fried foods to lower cholesterol

consumption and he was advised to reduce oral intake.

H. Nutritional Knowledge and Where Obtained

The client follows nutritional advice from medical professionals like his

doctor.

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 IV. DIETARY NEEDS WHILE IN THE HOSPITAL

A. Food likes and Dislikes

The patient prefers to eat fruits and vegetable in adequate amount.

B. Present dietary prescription and rationale

The patient is ought to take her regular diet and doesn’t take any

medications.

C. Appetite: ability to chew; any vomiting, cramps or abdominal distention.

The patient has the ability to chew normally. There were no complaints due

to vomiting, cramps or any abdominal distention.

D.Any physical handicap (e.g., needs help in feeding)

The patient is normal and can eat by himself.

E. Food tolerance (i.e., 6 equal feedings rather than 3 meals and a snack)

Mr. M.G eats 3-4 times a day which includes; breakfast, lunch, snack and
dinner.

F. Need for dietary instruction (communicate with doctor for future diet

prescription so that ample time is given to the patient to understand the

principles of the diet and aid him in his family meal-planning).

The physician advised Mr. M.G to avoid eating fried foods and to reduce oral intake.

Page 25 of 34
 CHAPTER IV

DIETARY COMPUTATIONS

• Client’s data

Height: 5’4 ft.

Weight: 72 kg

• Desirable body weight (DBW) (NDAP Method)

Using the client’s data, we have;

Solution: 106lbs + 4 (4lbs)

106lbs + 16lbs
122lbs or 55 kg
DBW = 55 kg

• Body mass index (BMI)

BMI = Weight in kg
(Height in m)²

BMI = 84kg
(1.65)²

BMI = 84kg
2.7225

BMI = 30.85

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BMI Classification: OBESE CLASS I
• Total Energy Requirement

TER = DBW x Physical Activity

TER = 55 x 35

TER = 1,925 kcal or 1,900 kcal.

• Percentage distribution

CHO= 60%

CHON= 15%

FATS= 25%

• Distribution of CHO, CHON and fats

CHO = 1,925 kcal × .60 = 1,115 ÷ 4 = 288.75g

CHON = 1,925 kcal. × .15 = 288.75 ÷ 4 = 72.1 g

FATS = 1,925 kcal. × .25 = 481.25 ÷ 9 = 52.5g

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Composition of Food Exchanges

Food No. of HOUSEHOLD CHON FATS ENERGY

CHO (g)
Items Exchange MEASUREMENTS (g) (g) (kcal)

VEG A 6 2 cup cooked 18 6 - 96kcal

VEG B 6 3 cup cooked 18 6 - 96 kcal

FRUITS 9 Varies 90 - - 360 kcal

MILK

WHOLE - - - - - -

LOW 4 12 tsp. 48 32 20 500 kcal

SKIM - - - - - -

RICE 4 Varies 92 8 - 400 kcal

MEAT

LOW
3 Varies - 16 2 82 kcal
FAT

MID
1 Varies - 8 6 86 kcal
FAT

HIGH
- - - - - -
FAT

SUGAR 3 3 tsp 15 - - 60 kcal

FATS 3 3 tsp - - 15 135 kcal

TOTAL 281g 76 g 43g 1,801 kcal

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Meal Distribution

Food Item Breakfast AM Snack Lunch PM Snack Supper

VEG. A 2 - 2 - 2

VEG. B 2 - 2 - 2

FRUIT 2 2 2 1 2

MILK (LOW
1 1 - 1 1
FAT)

RICE 1 - 1½ ½ 1

MEAT (LOW
1 - 1 1 -
FAT)

MEAT (MID
- - - 1
FAT)

SUGAR 1 2 - - -

FAT 1 - 1 1 -

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Sample Menu
BREAKFAST LUNCH DINNER
• 1 pcs. Ripe Banana • 1 pc. Ripe Banana • Chicken-Malunggay
• 1 Cup Rice • Cucumber Salad soup
• 1 slice grilled fish • 1 cup Rice
• 1pcs. Boiled egg
• 1 ½ cup Rice
• 1 cup milk

AM SNACK PM SNACK

• 1 cup fruit salad

• 1 slice Biko
• I cup milk

Page 30 of 34
 CHAPTER V

CONCLUSION

A healthy diet provides the body with essential nutrition such as

fluid, macronutrients, micronutrients, and adequate food energy that will help us improve our

overall health. For an individual with hypertension they need to eat more fruits, vegetables, and

low-fat dairy foods. And they should eat moderately. As we conduct this study we, the

researchers were able to understand the main factors that contributes to the patient illness. The

researchers are also able to come up with an idea that in determining the nutrients needed by

an individual there are factors that we need to consider and these are the height, weight, body

composition, as well as the patient's physical activities, and the desirable body weight. The

patient’s BMI were classified as Obese Class I and the Total Energy Requirements which is

1925 kcal or approximately 1900 kcal. Carbohydrates (302.4 grams), Protein (72.1 g) and fats

(52.5 g).

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 RECOMMENDATION

In this case, we recommend to:

• Maintain a healthy weight by eating moderately.

• Eat fruits and Vegetables.

• Limit intake of fats.

• Avoid trans fats.

• Limit salt / sodium

• Exercise regularly

Page 32 of 34
 BIBLIOGRAPHY

JW sear, PhD FRCA (June 1,2004), Hypertension: Pathophysiology and treatment.

Retrieved from: https://academic.oup.com/bjaed/article/4/3/71/292146

High blood pressure (Hypertension) (July, 2019). Retrieved from:

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-

causes/syc-20373410

Regular Diet (March 2021). Retrieved from: https://www.drugs.com/cg/regular-diet.html

Adam Felman, (July 21, 2021), Everything you need to know about hypertension.

Retrieved from: https://www.medicalnewstoday.com/

Page 33 of 34
 APPENDICES

Member's Profile

Gumampang, Hanady A.

BSND-2

“ Always focus on the good “

Pantaleon, Erismae E.

BSND-2

“ Life is short, always choose

happiness”

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