CVD Flashcards
part 3 of 3
What is CVD?
Disease of the arteries affecting the blood supply to the
Heart
Can cause coronary heart disease (CHD)
Brain
Can result in a stroke
Peripheral Regions
Can affect circulation especially to the legs
What is CHD?
Deposition of fatty substances in the arteries
Reduced blood flow to the heart
Chest pain (angina)
Further blockage
HEART ATTACK ! !
Risk Factors of CVD AND CHD- irreversible and reversible
Irreversible
Male gender
Increasing age
Genetics
Ethnicity
Potentially Reversible
Smoking
Abnormal blood lipid profile
Oxidization of LDL
Obesity – especially central
Hypertension
Physical inactivity
Diabetes
Enhanced platelet aggregation/blood clotting
High levels of inflammatory markers
Impaired foetal nutrition
High levels of homocysteine
Diet
Risk Factors- psychosocial and geographic
Psychosocial
Low SE class
Stress
Coronary-prone behaviour patterns: type A behaviour
Geographic
Climate & season : cold weather
Soft drinking water
Main Causes of CVD
Atherosclerosis - chronic
Thrombosis - acute
High blood pressure
Hypertension
Blood pressure is measured by
systolic pressure
(contraction of the heart ventricles)
/diastolic pressure
(relaxation of the heart ventricles)
Normal = 120/80 mmHg
High = + 140/90 mmHg
Affects a third of the population
Increase in blood pressure can cause damage to the blood vessels
Risk factor for stroke
How can Diet play a role in the Development of CVD?
Diet can influence:-
Blood pressure
Blood lipid profile
Platelet aggregation
Blood clotting
Lipid oxidation
Insulin resistance
Inflammation
Homocysteine levels
Arrythmia
Obesity
Possible Dietary Factors
Dietary cholesterol and fat
Oily fish
Fruit & vegetables
Fibre
B vitamins
Alcohol
Plant sterols and stanols
Soy protein
Calcium
Salt/potassium
Role of the Diet can be a
A triggering factor
Or a preventative factor
Cholesterol
Cholesterol is a fatty substance found in all cells and has many important functions
However high blood cholesterol levels increase the risk of developing CHD
There are two main carriers of cholesterol
low-density lipoproteins (LDL) and high-density lipoproteins (HDL)
LDL and HDL
LDL
High levels are involved with the deposition of cholesterol into the arteries
Triggers the formation of ‘plaques’
HDL
Acts as a ‘scavenger’ and picks up excess cholesterol and return to the liver for excretion
Hence LDL considered to be the ‘baddy’ & HDL the ‘goody
Aim to lower LDL and increase HDL
Fat in the diet
High cholesterol levels increase risk of CHD but which fats in the diet are implicated?
Fats in the diet include:-
Dietary cholesterol
Saturated fats
Monounsaturated fats
Polyunsaturated fats (omega 3 & omega 6)
Oily Fish
Contain omega 3 PUFAs which are thought to reduce risk of developing CHD and improves survival after a heart attack
Stabilises heart beat
Reduces clotting of blood
Aim to eat 2 portions of fish a week
One of which should be oily
Those with CHD no specific recommendations other than to follow a Mediterranean diet
There are restrictions on number of portions consumed for some people
Fruit and Vegetables - how do they recede early deaths from cancer and CHD
Rich in antioxidants
ACE vitamins & phytochemicals
Evidence less convincing for ‘popping a pill’ of ACE vitamins
May act as a ‘pro-oxidant’ in large doses
Insufficient evidence to recommend supplements
Therefore not recommended for prevention or treatment
High in fibre (especially soluble fibre)
Low fat therefore low in energy
Rich in potassium
Source of folate
There are 2 types of fibre
There are 2 types of fibre
Insoluble
Soluble
Insoluble fibre helps with bowel function
Found in ‘fibrous’ foods – are filling
Source of other nutrients such as folate & vitamin E
Soluble fibre is found in rich sources in:-
Soluble fibre is found in rich sources in:-
Fruit/vegetables
Pulses
Oats/rye/barley
Can help to reduce the levels of blood cholesterol by:-
Reducing absorption
Reducing reabsorption of bile salts
Use more cholesterol to make more
Reducing synthesis
(so) Colonic bacteria feed off soluble fibre & produce short chain fatty acids
(this) Reduces cholesterol synthesis
Alcohol
Can be beneficial in moderation in middle aged men & post menopausal women:-
↑ HDL
Reduces blood clotting
Red wine – contain additional antioxidants
De-stresses!
But in excess not good for the heart!
14 units per week
Calcium & Magnesium
CHD risk lower in areas that have hard water
Possible mechanisms:-
Combines with saturated fat to make soap which are unabsorbed
↓ blood clotting
Helps to reduce blood pressure
Calcium intakes especially from dairy produce reduce risk of CHD
But more evidence is needed
Hypertension risk factors
Increasing age
High BMI
Lack of physical activity
Excessive sodium
Excessive alcohol
Beneficial Factors of hypertension
Potassium
Calcium & magnesium
Diets rich in fruit & vegetables
Fish oils?
Exercise
Weight loss
Salt - what does high intake do
High intakes associated with increase in BP
Especially increases with age
Need to reduce intake
Public Health England campaigning to reduce salt by consumers as well as by food manufacturers
