Chapter 19: Coronary Heart Disease and Hypertension

Question 1

The underlying pathologic process in coronary heart disease appears to be

a. atrophy of the heart muscle.
b. weakened coronary vessels.
c. fibrous plaques in coronary vessels.
d. inadequate nutrition to the heart muscle.

Answer 1

c. fibrous plaques in coronary vessels.

This process is characterized by the formation of fatty fibrous plaques that may begin in childhood and develop into fatty streaks, largely composed of cholesterol, on the inside lining of major blood vessels.

Question 2

The underlying pathologic process in coronary heart disease is known as

a. angina.
b. atherosclerosis.
c. hypertension.
d. myocardial infarction.

Answer 2

b. atherosclerosis.

This process is characterized by the formation of fatty fibrous plaques that may begin in childhood and develop into fatty streaks, largely composed of cholesterol, on the inside lining of major blood vessels.

Question 3

An infarct in a major artery supplying the brain results in

a. a myocardial infarction.
b. a coma.
c. a cerebrovascular accident.
d. hypertension.

Answer 3

c. a cerebrovascular accident.

Cells die when deprived of their normal blood supply. The local area of dying or dead tissue is called an infarct. If the affected blood vessel is a major artery supplying vital blood nutrients and oxygen to the brain, it is called a cerebrovascular accident.

Question 4

A localized area of dying or dead tissue is called a(n)

a. atheroma.
b. infarct.
c. thrombus.
d. lesion.

Answer 4

b. infarct.

Cells die when deprived of their normal blood supply. The local area of dying or dead tissue is called an infarct.

Question 5

A risk factor for coronary heart disease that cannot be controlled is

a. obesity.
b. family history.
c. lack of exercise.
d. smoking.

Answer 5

b. family history.

Risk factors associated with heart disease are sex, age, family history, elevated serum cholesterol, and dietary fat as well as compounding diseases such as diabetes, hypertension, and metabolic syndrome. Family history, age, and sex cannot be controlled.

Question 6

Two general principles of diet therapy for coronary heart disease and lipid disorders are to

a. avoid foods that contain cholesterol and animal fats.
b. reduce total fat intake and substitute unsaturated fats for some saturated fats.
c. reduce intake of cholesterol and sodium.
d. reduce intake of total fat and substitute saturated fats for some unsaturated fats.

Answer 6

b. reduce total fat intake and substitute unsaturated fats for some saturated fats.

Diets aimed at lowering saturated fat and cholesterol intake help control the progression of the disease as well as serum cholesterol and triglyceride levels.

Question 7

Dietary modifications during the first 24 to 48 hours after myocardial infarction include

a. increasing fiber intake.
b. avoiding cholesterol.
c. reducing energy intake.
d. reducing fluid intake.

Answer 7

c. reducing energy intake.

is aimed at ensuring cardiac rest so that the damaged heart can be restored to normal functioning.

Question 8

Congestive heart failure results in

a. difficulty breathing.
b. anemia.
c. dehydration.
d. myocardial infarction.

Answer 8

a. difficulty breathing.

In chronic heart disease, congestive heart failure may develop over time. The progressively weakened heart muscle is unable to maintain an adequate cardiac output to sustain normal blood circulation. The resulting fluid imbalances cause edema, which makes breathing difficult and places more stress on the laboring heart.

Question 9

Nutrition therapy for hypertension includes

a. reduced sodium intake and control, low fat intake, and decreased calcium intake.
b. high fiber intake, high sodium intake, and increased calcium and phosphorus intake.
c. reduced sodium intake and control, increased calcium and magnesium intake, and adequate potassium intake.
d. high iron intake, high fiber intake, and increased potassium and magnesium intake.

Answer 9

c. reduced sodium intake and control, increased calcium and magnesium intake, and adequate potassium intake.

Nutrition therapy for hypertension includes sodium control to control fluid accumulation. Potassium intake is important, especially if diuretics are prescribed because they can cause loss of potassium along with the increased loss of water from the body. Some evidence also suggests that increased calcium and magnesium intake is beneficial for some persons with hypertension.

Question 10

Hypertension is called the “silent disease” because

a. it has not been well publicized.
b. no signs indicate its presence.
c. it affects the vocal cords.
d. it cannot be heard with a stethoscope.

Answer 10

b. no signs indicate its presence.

Question 11

The function of lipoproteins is to carry

a. proteins to the liver for metabolism.
b. proteins to the cells for metabolism.
c. fat and cholesterol to the cells for energy and metabolism.
d. cholesterol to adipose tissue for storage.

Answer 11

c. fat and cholesterol to the cells for energy and metabolism.

Because fat is not soluble in water, it is carried in the bloodstream in small wrapped packages of protein called lipoproteins. The function of lipoproteins is to carry fat and cholesterol to the cells for energy and metabolism.

Question 12

The type of fat that should be in the diet in the greatest proportion is

a. saturated.
b. polyunsaturated.
c. monounsaturated.
d. fish oil.

Answer 12

c. monounsaturated.

should not exceed 20% of the total fat intake of 25% to 35% of total calories.

Question 13

The Therapeutic Lifestyle Changes (TLC) diet recommends limiting daily cholesterol intake to no more than _____ mg.

a. 200
b. 300
c. 400
d. 600

Answer 13

a. 200

The TLC diet includes not exceeding a total fat intake of 25% to 35% of total calories, with saturated fat contributing no more than 7%, polyunsaturated fat no more than 10%, monounsaturated fats no more than 20%, and a total of 200 mg dietary cholesterol.

Question 14

The nutrition therapy for congestive heart failure may include restricting what type of food?

a. Shredded wheat cereal
b. Salted potato chips
c. Tofu
d. Angel food cake

Answer 14

b. Salted potato chips

Because of sodium’s role in tissue fluid balance, sodium foods may be restricted in the treatment of cardiac edema.

Question 15

The cause of essential hypertension is

a. chronic coronary heart disease.
b. stress.
c. hormone imbalance.
d. unknown.

Answer 15

d. unknown.

The cause of essential hypertension is unknown, although injury to the inner lining of the blood vessel wall appears to be an underlying link.

Question 16

For a patient who comes to the clinic, hypertension is indicated by a blood pressure reading greater than _____ mm Hg.

a. 120/80
b. 140/90
c. 140/85
d. 140/80

Answer 16

b. 140/90

Question 17

The diagnosis of stages 1, 2, and 3 hypertension is based on the _____ blood pressure.

a. systolic
b. diastolic
c. systolic and diastolic
d. resting

Answer 17

c. systolic and diastolic

Current hypertension screening and treatment programs identify persons with hypertension according to the severity of the systolic and diastolic pressures. Categories are prehypertension, stage 1 hypertension, and stage 2 hypertension.

Question 18

The main source of dietary sodium is

a. common table salt.
b. found naturally in foods.
c. found in cooking compounds.
d. found as a mineral in drinking water.

Answer 18

a. common table salt.

The main source of dietary sodium comes from table salt, or sodium chloride. The taste for salt is acquired. Besides the salt used in cooking or added at the table, a large amount is used in food processing.

Question 19

The best way to control coronary heart disease is

a. by early diagnosis.
b. to meet regularly with a dietitian.
c. to eliminate fat from the diet.
d. to develop a heart-healthy lifestyle during childhood.

Answer 19

d. to develop a heart-healthy lifestyle during childhood.

Question 20

A diet that restricts sodium intake to 2 g/day is considered a _____ restriction.

a. mild
b. moderate
c. strict
d. severe

Answer 20

a. mild

Question 21

The Dietary Approaches to Stop Hypertension (DASH) encourages intake of

a. foods high in monounsaturated fats.
b. foods high in soluble fiber.
c. fruits, vegetables, and low-fat dairy products.
d. breads, cereals, rice, and pasta.

Answer 21

c. fruits, vegetables, and low-fat dairy products.

The DASH diet recommends eating four to six servings of fruits, four to six servings of vegetables, and two to three servings of low-fat dairy foods per day.

Question 22

Women’s risk of coronary heart disease increases with

a. pregnancy.
b. working full time.
c. exercise.
d. menopause.

Answer 22

d. menopause.

After menopause, women catch up with men in cholesterol level and potential heart disease risk.

Question 23

Hypertension is common in some ethnic groups, including

a. Europeans.
b. Asians.
c. African Americans.
d. Native Americans.

Answer 23

c. African Americans.

There is a high incidence of hypertension in African Americans, with the highest incidence among older African American women.

Question 24

A food that can be used freely on a sodium-restricted diet is

a. canned salmon.
b. peanut butter sandwiches.
c. biscuits.
d. fresh apple.

Answer 24

d. fresh apple.

Fruits contain negligible amounts of sodium in their natural state. Processed foods, including canned, frozen, and other packaged items, contain various amounts of sodium. Meats and milk also contain various amounts of sodium.

Question 25

An example of a food that is a good source of calcium is

a. olive oil.
b. skim milk.
c. oatmeal.
d. lemonade.

Answer 25

b. skim milk.

A good source of calcium is found in milk. If following sodium restrictions, milk may need to be limited.

Question 26

An example of a low-sodium food is

a. canned salmon.
b. peanut butter sandwiches.
c. biscuits.
d. shredded wheat cereal.

Answer 26

d. shredded wheat cereal.

Low-sodium foods include shredded wheat cereal. Processed foods such as canned, frozen, and baked products contain higher amounts of sodium.

Question 27

A rich source of potassium is provided by

a. lemonade.
b. a fresh orange.
c. a potato roll.
d. bottled water.

Answer 27

b. a fresh orange

Rich sources of potassium are provided by unprocessed foods such as oranges and bananas, vegetables such as broccoli and leafy greens, fresh meats, whole grains, and milk products.

Question 28

Examples of foods high in soluble dietary fiber are

a. whole-wheat bread and crackers.
b. pureed fruits and vegetables.
c. potatoes and yams.
d. oat bran and legumes.

Answer 28

d. oat bran and legumes.

The diet should include 10 to 25 g of soluble fiber daily.

Question 29

The lipoprotein with the highest lipid content is

a. very-low-density lipoprotein (VLDL).
b. cholesterol.
c. low-density lipoprotein (LDL).
d. high-density lipoprotein (HDL).

Answer 29

a. very-low-density lipoprotein (VLDL).

VLDL cholesterol carries a relatively large load of fat to the cells but also includes approximately 15% cholesterol.

Question 30

Protection against coronary heart disease is associated with a high-density lipoprotein (HDL) value of at least _____ mg/dL.

a. 30
b. 40
c. 60
d. 80

Answer 30

c. 60

HDL cholesterol carries less total fat and more protein. It transports cholesterol from the tissues to the liver for catabolism and elimination from the body. HDL cholesterol is not found in food; it is produced in the body. The optimal level for HDL is 60 mg/dL or greater; a range of 40 to 59 mg/dL is considered desirable.