chapter 16 - CVD Flashcards
what is the leading cause of death and permanent disability in the US
CVD
acute CVD
MI
compensated heart disease
heart maintain blodo circulation
requires heart beat unusually fast so heart enlarges
decompensated heart disease
heart cant maintain circulation
CHF occurs
what may be affected in heart disease
myocardium
endocardium
pericardium
what is arterioscleroris
general term for vascular disease which arterires harden, making passage of blood difficult and sometimes impossible
athersclerosis
form of arteriosclerosis
most freuqnelt occurs in developed countries
chronic inflammatory porcoess, begins in childgood and is considered one of the major causes of MI
what are atherosclerotis plaques
deposites of cholesterol, fats, and other substances that accumulate over time
thickening and weakening artery walls
develop within walls and driven by inflammatory process
plaquye deposits gradually reduce the size of the lumen of the artery and amount of blood flow = inadequate supply of nutrients and oxygen delivery and waste removal known as ischemia
angina pectoria
reduced oxygen supply causes pain and if occurs in chest and raidates down left arm it’s a warning
infarct
lumen narrows so that a thrombus occurs in coronary artery and blood flow is cut off = dead tissue called infarct
called acute MI
treatment for MI
surgery to bypass clogged artery
CABG (coronary artery bypass graft)
CVA
cerebrovascular accident
blood flow 9to brain is blocked or blood vessels burst and blood flows into the brain
stroke
peripheral vascular disease (PVD)
occurs in tissue some distance from heart
risk factors of CVD
hyperlipidemia
hypertension
smoking
obesity and unhelathy diet
diabetes, pre-diabetes
family history (heart diesase in father or brother before age 55 or in mother or sister before age 65)
high stress lwvels
male sex
age (men 45+, women 55+)
physical inactivity
food and hyperlipidemia
dietary cholesterol and trigylcerics (fats in foods and in adipose tissue) contributeto hyperlipidemia
foods containing sat fat and trans fat increase serum cholesterol while unsat fat tends to reduce it
what are lipoproteins + types
- carry choesterol and fats in blood to body tissues
- LDL carries most of choelsterol to cells and elevated LDL blood levels contributes to atherosclerosis
- HDL carries cholesterol from tissues to liver for eventual excretion, low serum levels of HDL can contribute to atherosclerosis
total cholesterol classification
less than 200 mg/dL desirible
200-239 mg/dl borderline high
240 mg/d and above high
ldl cholesterol classification
less than 100 mg/dl optimal
100-129 mg/d near optimal
130-159 borderline high
160-189 mg/d high
190 mg/dl and above very high
hdl cholesterol classification
less than 40 mg/dl major heart disease risk factor
60 mg/dl and avoce gives some protection against heart disease
triglycerides classification
<150 mg/dl optimal
150-199 mg/dl borderline high
>200 mg/dL high
medical nutrition therapy for hyperlipidemia
reduce quantity and type of fats and often cal in diet
in overweight indv wt loss alone will help reduce serum cholesterol levels
<200 mg of cholsterol per day and fat provide no more than 20-35% of cal w max 7% of fat comeing from sat fat
carb should make up 50-55$ of cal and proteins from 12-20% of them
40% of cal in avg us diet comes from fats
types of diet for heart diesease
vegetarian
semi-vegetarian
vegan diet
Mediterranean diet
DASH diet
Omni Heat study foods
how long does it take to adjust to new food choices (heart-heatlhy eating plan)
2-3 months
vegetables, fruits, and legumes to eat
variety of fresh, forzen, and canned veg and fruit wo added salt or sugar
eat more legumes such as lentils and kidney beans
vegetables, fruits, and legumes to avoid
veg w high-fat sauces, friet, or salted
fruits prpared w added sugars
limit starchy beans prepared w pork fat
grains to eat
choose fiver-rich whole grains for most grain servings (brown rice, barley, oats, cracked wheat, coardse bread, brain)
grains to avoid
refine grains, such as white rice, white breads/ bagels, low-fiber cereals, crackers, baked goods, buttery crackes, commercially prepared garlci bread, croissants, etc.
poultry, fish, meats, and eggs to eat
poultry (white meat) and fish w/o skin
fish - 2x a week (high in omega 3s such as salmon and trout)
lean red meats - preferably less than 2s weekly
eggs - two to three times per week
poultry, fish, meat, and eggs to avoid
fatty cuts of meat, dark poultry meat ror poulrty w skin on
fried meat, fish, or poultry
salted processed meats such as bologna hot dogs, bratwursts, bacon
eggs >4 weekly
dairy to eat
fat-free (skim) and 1% dairy products, yourts, low-fat chees occasionally
dairy to avoid
2% and whole milk, cream, high fat cheeses, ice cream, cream soups
fats and oils to eat
olive, canola oils, nut, nut butters, seeds in moderation
mayo, oil/ vinegar dressings in moderatio n
fats and oils to avoid
butter, cream, lard, partially hydrogenated fats and trans fats
commercially made creamy salad dressings
desserts to eat
water, tea, and coffee
1 drink alc for women, 2 drinsk for men
prudent amounts of healthfully made desserts, small amount of dark chocolate
desserts to avoid
limit sugar sweetened beverages such as soda, lemondae , punch, coffee drinks, energy drinks
most regularlyprepared desserts and sweets
water soluble fiber and cholesterol-containg substances
water-soluble fiber (such as that found in oats, oat bran, legumes, and fruit (esp cirturs, berries, apples, and bananas) binds w cholesterol-containing substances and prevent their reabsorption by blood
10-25 g soluble fiber is prepared
increase fiber intake by ____ g each day had ___% drop in LDL
5-10 g
5%
cholesterol lowering drugs
atorvastatin (Lipitor)
Simvastatin (Zocor)
could interact w other drugsm like grapefruit and its juices w Lipitor and Zocor
what is MI
blockage of coronary artery sipplying blood to heart, causing heart tissue to die
atheroscleoris is primary cause
hypertension, abn blood clotthing and rhematic fever infection could contribute
MI and food
after attack pt in shock, cuasing fluid shift and thirst but pt is NPO so IV infusions to prevent dehydration
after several horus client may begin to eat, liquid diet for 4 hours then low-cholesterol-low-sodium given
no ext hot or cold food, easy to chew and digest and contain little roughage
chewing and increased activity of gi tract following high fibers foods = extra work ofr heart
restricttypes and amounts of fat and sodium to prevent fluid accumulation and amount of caffeeing as goal is to allow heart to rest and tissue to heal
CHF
decompensation; severe heart disease
caused by CAD, MI, cardiomypothahy, valve disease, bith heart defects, diabetes mellitus, chronic renal disease
amt of ixygen intake is insufficient for body needs (SOB + chest pain on exertion)
tissue retain fluid bc reduced circuliaton = sodium built up = edema and to compensate heart beats faster and enlarges (when edema affects lungs, death can occur)
potassium rich fruits
apricots
oranges
bananas
avocados
cantaloupe
dates
figs
raisins
honeydew melon
grapefriut
kiwifruit
peaches pineapple
prnes
straberries
potassium rich vegetables
asparagus
broccoli
cabbage
green beans
pumpkin
squash
tomatoes
spimach
potatoes, sweet potatoes, yams
treat edema in CHF
diuretics to aid in excretion of water and sodium
diuretics can cause excessive loss of potassium so carefully monitor clients blood potassium to prevent hypokalemia (can uspet heartbeat)
what is hypertension
chronically high bp
90% cause is unknown; essential/ priamry hypertension
10% cause is known; secondary hypertension (kidney disease, problems of adrenal glands, oral contraceptives)
hypertension stages
normal <120/<80
prehypertension 120-139/80-88
stage 1 hypertension 140-159/90-99
stage 2 hypertension 160/100
who does hypertension affect
frequency inc w age
more prevalance among AA
heredity and obesity
smoking and tress
excessive use of table salt (40$ sodium + chloride)
treatment for hypertension
fluid balance upset so sodium and fluid collect in body tisues, causing edema, extra pressure is placed on blood vessels
siudm restricted diet + diuretics
DASH
Dietary Approach to Stop Hypertension
clinically shown to reduce high bp while increasing serving of fruits and veg to 8-12 sevigs per day
higher intake of frutis and veg, adequate calcium servings, prducent w protein, include nuts, seeds, and legumes in diet 3-4 times per week, limit fats and oils, keep sweets and added sugars down to five sevings or fewer and week for adults
4.7g potasisum
thickened mucle in heart found in ___% of obese child population
40
sodium intake (rec for americans and those diagnosed w HTN)
americans: 3400 mg/ day li
AA, diagnosed w HTN: 1500 mg/day
sodium-restriced diet limit
food and nutrition board says no less than <2300 mg/day and safe minimum is 500 mg/day
populator sodium-containg products frequently added to foods
Monosodium glutamate - flaovr enchancer
baking powder - leven quick breads nd cake
baking soda - leaven breads and cakes
brine - freeshing and canning certain fodos and for flavor
disodium phospate - quick-cookingcereals and processed cheeses
sodium alginate - choc milkand ice cream for smooth texture
sodium benzoate - preservate in many condiments
sodium hydroxide- food processing to softena nd lossens skins of ripe olives, hominy, and certain fruits and veg
sodium propionate - pastreurzied cheeses and in spme breads and cakes to inhibit growth of mold
sodium sulfite - bleach certain fruits and veg, preservaties in some dried fruit
AHA sodium intake vs Dietary guildeline for americans
AHA - 1500 mg/day
dietary guidelines for americans - 2300 mg/da
v low restirction of siudm
1.5-2 g a day
mod restirction to siudm
2-3 g a day
foods permitted on most sodium resticted diets
fruits wo additives
low-sodium veg juices
fresh fruits
fresh veg
frozen veg wo salt
dried peas or beans
fat-free milk
ready to eat breakfast cereals low in sodium
regular cooked cereals wo added salt, sugar, or falvorings
plain pasta or rice
bread, english muffins, and bagels
unsalted, uncoated popcorn
fresh fish, fresh unsalted meats
unsalted margarie
oil
vinegar spices containing no salt, herbs such as basil oregano garlic powder, lemon juice
unsalted nuts
jams, jellies, honey
coffee tea
foods to limit or avoid on soidum restricted diet
tomato jucie and veg cocktail
canned veg if not salt ree
saukerurats, pickes, oives, frozen veg prepared w soudm
canned starchy beans
driedm breadsedm smoked, or canned fish or meats
cheeses, salted butter or margarine
salt topped crackers or breads
salty foods such as potato chips, salted nuts, penaut butter, pretzels
canned soups
ham, hot dogs, sausage, corned beef, lunch meats
[repared relishes, salad dressings, catsup, soy suace
bouillon, baking soda, baking powder, MSG
commerically prepared meals
fast foods ,restaurant foods
