Cardio dz Flashcards
Obesity
increases total mortality in both men and women in all age strata from 35-89 years, CVD increases, most cancers increase and some decrease (cancer of lung, mouth, pharynx, larynx or esophagus)
Relative risk > 3 if obese
type II diabetes, HTN, breathlessness, gall bladder disease, insulin resistance, dyslipidemia, sleep apnea
Weight loss linked to
significant reduction in mortality, BP, risk of diabetes, risk of cancer deaths, decrease of body lipids
CVD
biggest killer of males (1/3 of male deaths) -> mostly CHD, also stroke and other diseases; risk is lower in females (1/4 of deaths)
CVD Mech
Atherosclerosis -> unstable plaque -> plaque rupture -> thrombosis -> ischemia and arrhythmia -> cell death and heart failure; influenced by clotting, BP, dyslipidemia, inflammation, vascular endothelial dysfunction
BMI
increases both diastolic and systolic as this increases; increases LDL and decreases HDL
Cholesterol
total plasma levels predict mortality -> increases mortality for CHD and overall mortality -> give statins -> marked difference between populations for CVD risk, poor discriminator of CHD risk within countries/populations
TAG
better indicator of CHD risk -> raised level = pro-inflammatory, pro-thrombotic state, reduced HDL, increased LDL (begins plaque) and causes intolerance to dietary fat -> measurements must be done in fasting state
Diet
66% of CVD is modifiable by this; this can modify clotting, BP, dyslipidemia, inflammation and vascular endothelial dysfunction
CVD and diet
main factors -> too much salt, too little potassium, amount and type of fat is inappropriate, inappropriate amount and quality of carbohydrates, too little dietary fiber, not enough fruit/veggies/nuts/oils (antioxidants)
Excess salt/low potassium
increases risk of hypertension -> fruit and veggies reduce risk (low salt, high potassium)
Olive oil and canola oil
have lots of MUFAs
Soy bean oil and corn oil
have primarily n-6 PUFAs (linoleic 18:2)
N-3 VLC PUFAs
decrease clotting, TGs, inflammation
N-6 PUFAs
increase clotting and inflammation but decrease cholesterol
MUFAs
decreases cholesterol (not as much as PUFAs)
Saturated FA and Trans FA
increase TGs and cholesterol
Atherogenesis (high LDL cholesterol) tx
reduce SFA/trans FA, increase PUFA/SFA ratios, increase MUFA/PUFA ratios
Atherogenesis (high TGs/postprandial lipidemia) tx
increase n-3 with oily fish
Decrease clotting and inflammation (eicosanoids balance: EPA/AA ratio)
increase n-3 with oily fish
CVD and carbohydrates
Keep glycemic index low, keep non-starch polysaccharides (NSP -> fiber) high
Glycemic index
incremental area under blood glucose response curve for the test food containing 50g of CHO / corresponding area after equal carbohydrate portion of white bread/glucose solution x 100 -> ripe bananas are high, whole wheat is low
Glycemic load
Glycemic index x amount of carbohydrates
Low glycemic index diets
improve blood lipids -> especially TGs
Viscous fiber
can help reduce LDL
High glycemic index, low fiber
glutinous rice, short grain white rice, fresh mashed potatoes -> increases cholesterol and triglycerides (dyslipidemia)
Low glycemic index, high fiber
red lentils, pinto beans, spaghetti, yellow split peas -> decrease cholesterol and triglycerides (reduce dyslipidemia)
Antioxidants (nuts and oils -> vitamin E is lipid soluble; fruits and vegetables)
protect against LDL oxidation -> can prevent atherosclerosis
HTN
excess NA (in processed foods), low K+ (not enough fruit, vegetables and unprocessed foods)
Dyslipidemia
excess SFA, Trans fat and dietary cholesterol (not a major player - except with people with ApoE4 genotype = bad; ApoE2 is resistant), low PUFA, MUFA and VLC n-3 PUFA, high glycemic index carbohydrates, low NSP, low antioxidants
Increased clotting and inflammation
excess n-6 PUFA, low n3 especially oily fish (same effect as aspirin but better)
