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Diet Therapy 2380 > Ch. 27 Cardiovascular Diseases > Flashcards

Ch. 27 Cardiovascular Diseases Flashcards

1
Q

Leading Causes of Death in the U.S.?

A
  1. Heart disease (leading cause of death as you get older)
  2. Cancer
  3. Chronic lower respiratory disease
  4. Stroke
  5. Accidents
  6. Alzheimer’s disease
  7. Diabetes
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2
Q

Atherosclerosis

A

Hardening of the arteries

Monocytes circulate in the bloodstream and respond to injury on the artery wall

Monocytes slip under blood vessel cells and engulf LDL cholesterol, becoming foam cells. The thin layers of foam cells that develop on artery walls are known as fatty streaks.

A fatty streak thickens and forms plaque as it accumulates additional lipids, smooth muscle cells, CT, and cellular debris.

The artery may expand to accommodate plaque. When this occurs, the plaque that develops often contains a large lipid core with a thin, fibrous covering and is vulnerable to rupture and thrombosis.

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3
Q

Major Risk factors for chronic heart disease (CHD) (not modifiable)

A

Increasing age
Male gender
Family history of premature heart disease

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4
Q

Major Risk factors for CHD (modifiable)

A 
High blood LDL cholesterol
Low blood LDL cholesterol
HTN
T2 Diabetes
Obesity ("apple shape")
Physical inactivity
Cigarette smoking
"Atherogenic diet" (high in saturated fats and low in vegetables, fruits, and whole grains)
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5
Q

Consequences for Atherosclerosis

A

In coronary arteries:

  1. Angina: pain in the chest
    - stable-predictable/reliable stressor: pattern in heart pain >4 weeks (ex. every time they exercise)
    - Unstable- first time,
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6
Q

Ischemic Stroke

A

85-90% of strokes fall within this category

Brain cells can die within minutes

Blood flow to brain is temporarily RESTRICTED

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7
Q

Hemorrhagic Stroke

A

LEAK/RUPTURE in blood flow to brain –> hemorrhagic stroke

Problems leading to this:

  • -uncontrolled HTN - can cause weakening of blood vessels and lead to hemorrhage
  • -aneurysm
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8
Q

The Minnesota Vikings punt return team runs ____. This is also an acronym for stroke intervention.

A

FAST

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9
Q

Stroke: FAST

A

F: face
–smile - does face droop?

A: arm
–can the individual lift their arms?

S: speech
–does the individual slur their words? Confusion may go along with this…

T: time
–call 911

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10
Q

Other warning signs of stroke

A

Vision related issues (blurred vision, blackened vision, unable to see out of one eye, seeing double)

Sudden severe headache like no other

Any kind of weakness (not restricted to just arms…can be in legs –> difficulty walking)

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11
Q

Lipoproteins

A

• Major carriers of lipids in the plasma
• Clusters of lipids associated with proteins that serve as transport vehicles for lipids in the lymph and blood (fat + proteins)
• Primarily transport lipids from liver
–> Made of triglycerides, cholesterol, and phospholipids

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12
Q

Classes of Lipoproteins

A

Chylomicrons: transport of lipids from gut to various tissues

VLDL: very low density lipoprotein

IDL: intermediate density lipoprotein

LDL: low density lipoprotein

HDL: high density lipoprotein (GOOD)

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13
Q

Classes of Lipoproteins: LDL

A

Low density lipoprotein…impacted by diet

“most atherogenic”

Transports cholesterol to cells in the body (essentially putting the cholesterol out into the circulation)

We don’t eat LDL, we consume cholesterol associated with this carrier

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14
Q

Classes of Lipoproteins: HDL

A

High density lipoprotein…impacted by physical inactivity

Taking cholesterol from tissues and sending it back to liver

We don’t eat HDL, we consume cholesterol associated with this carrier

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15
Q

Managing LDL and HDL levels

A

A lower LDL and a higher HDL is preferred

Soluble fiber (such as oatmeal) can decrease LDL cholesterol

Trans fats can increase LDL cholesterol

HDL: physical inactivity is the lifestyle intervention we look for to increase HDL
–not impacted by diet as strongly as LDL

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16
Q

Dietary Intervention: Total Fat

A

20-35% total kcal from fat

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17
Q

Dietary Intervention: Saturated Fat

A

less than 10% total kcal from saturated fat

less than 7% total kcal from saturated fat if at risk for CVD

Animal products, palm kernel oil, coconut oil, palm oil, lard, butter are products high in saturated fats

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18
Q

Dietary Intervention: Monounsaturated Fat (MUFA)

A

less than 20% total kcal from MUFA

Olive oil, canola oil, peanut oil

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19
Q

Dietary Intervention: Polyunsaturated Fat (PUFA)

A

less than 10% total kcal from PUFA

Omega 3 (oily fish, flaxseed)

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20
Q

Dietary Intervention: Dietary Cholesterol

A

less than 300 mg/d for general population

less than 200 mg/d for LDL-cholesterol or preexisting CVD

Animal products

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21
Q

Cholesterol is produced by the ____?

A

Liver; hence a rich source of cholesterol is animal products

22
Q

Dietary Intervention: Trans Fat

A

Hydrogenated and partially hydrogenated vegetable fats, commercially baked goods

Naturally occurring lower levels in meat, diary

23
Q

Dietary Intervention: Soluble Fiber

A

Oatmeal, oranges, bananas, legumes

24
Q

Dietary Intervention: Plant Sterols and Stanols

A

Compete with dietary cholesterol for absorption

Specifically margarines

25
Q

Hypertension (HTN)

A

About 70 million American adults have HTN (that’s 1/3 adults)

About half of people with HTN have their condition under control

Nearly 1 out of 3 American adults has prehypertension

26
Q

Why worry about HTN?

A

Silent killer
Prevalence
Complications

27
Q

Complications of uncontrolled HTN

A

Bleeding within brain (hemorrhagic stroke)

Blood clot within narrowed carotid artery (ischemic stroke)

Memory loss (dementia)

Bleeding within eye (retinal hemorrhage)

Obstructed blood flow to heart muscle (heart attack)

Enlarged (failing) heart

Shrunken (failing) kidney

28
Q

Consequences of HTN

A 
Heart attack
Heart failure
Stroke
Aneurysm
Kidney disease
Peripheral artery disease
Retinopathy
Dementia
29
Q

HTN Risk Factors: Unmodifiable

A

Age
Race/ethnicity (AA/hispanics at greater risk)
Family history
Gender

30
Q

HTN Risk Factors: Modifiable

A 
Obesity
Physical inactivity
Metabolic syndrome
Tobacco
Sodium
Low potassium
ETOH
Stress
Diabetes
Hypercholesterolemia (high cholesterol) - excess LDL
Sleep apnea - body deprived of O2, heart works harder to get more O2 to organs → HTN
31
Q

Classifications of BP (blood pressure)

A

Normal
Pre-HTN
HTN, stage 1
HTN, stage 2

32
Q

Systolic vs Diastolic

A

Systolic [working]: “top number”

Diastolic [resting]: “bottom number”

33
Q

Normal BP

A

systolic (mmHg): less than 120
AND
diastolic (mmHg): less than 80

34
Q

Pre HTN BP

A

systolic (mmHg): 120-138
OR
diastolic (mmHg): 80-89

35
Q

HTN, stage 1 BP

A

systolic (mmHg): 140-159
OR
diastolic: 90-99

36
Q

HTN, stage 2 BP

A

systolic: greater than or equal to 160
OR
diastolic: greater than or equal to 100

37
Q

What does DASH stand for?

A

Dietary Approaches to Stop Hypertension

38
Q

DASH Food/Nutrients: What is emphasized?

A 
Whole grains
Fruits and vegetables
Food sources of magnesium, potassium, and calcium
Low fat dairy
Lean meats, fish, poultry
Nuts, seeds, legumes
39
Q

In terms of magnesium, potassium, and calcium, which one has been shown to have the greatest impact on blood pressure?

40
Q

Legumes are a good source of ____ ____.

A

Soluble fiber

41
Q

DASH Food/Nutrients: What is limited?

A

Saturated fat, total fat, cholesterol, oils
Sodium (2,300 mg, 1,500 mg menus/recipes)
Sweets, added sugars

42
Q

Should you gradually work your way into the DASH diet or just jump right in?

A

Gradually work your way into the DASH diet

43
Q

Define Thrombus.

A

A blood clot formed within a blood vessel that STAYS PUT its place of origin.

44
Q

Define Embolus.

A

An abnormal particle, such as a blood clot or air bubble, that TRAVELS in the blood.

45
Q

Define Thrombosis.

A

The formation or presence of a blood clot in the blood vessels.

46
Q

CHD

A

Heart damage that results from an inadequate supply of blood to the heart
• A.k.a. CAD (coronary artery disease) or IHD (ischemic heart disease)
• Most common form of CVD and death (53%)
• Usually involves atherosclerosis and HTN
• Strategies to decrease CHD aim to PREVENT and TREAT atherosclerosis and HTN

47
Q

Causes of Athlersclerosis

A
  • Plaque forms in response to injuries to endothelial wall → narrowing of arterial lumen → restricted blood flow to tissues
  • What causes plaque to develop? Still under investigation…
  • Tissue damage
  • Inflammatory response
48
Q

Causes of Endothelial Injury

A
  • Hypercholesterolemia: LDL vs HDL
  • HTN
  • Smoking
  • Diabetes: circulating concentrations of glucose/Hb = damage
  • Obesity
  • High sat fat/cholesterol diets
49
Q

Embolism

A

obstruction of a blood vessel caused by a traveling clot

50
Q

Lifestyle Modifications to treat HTN

A
  • Weight reduction: 5-20 mmHg decrease/10 kg lost
  • DASH eating plan: 8-14 mmHg decrease
  • Na restriction: 2-8 mmHg decrease
  • PA: 4-9 mmHg decrease
  • Moderate ETOH consumption: 2-4 mmHg decrease

Diet Therapy 2380 (28 decks)

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