CVD Flashcards
Conditions
CHD TIA Stroke Aortic disorders Peripheral arterial disease
SIGN 2017
Salt <6g/d
Overweight -3kg + maintain
Fish 2x140g/wk (one oily)
Mediterranean diet pattern for high risk/developed
Low sat fat - men <30g/d and women <20g/d
Non-modifiable RFs
Male
Increasing age
Body build
Other RFs
Stress
Low socioeconomic class
Climate
Modifiable RFs
Obesity Smoking P.A High Hcy Hypertension Dyslipidaemia
Top priorities (6)
Diet change (salt, sat fat) Blood pressure + lipid management Weight management Smoking cessation Physical activity
Prevention
Support whole person Educate on modifiable RFs Diet change Screening Drug therapies Health promotion at all stages Education - food labels/food prep tech/portion control Exercise programmes
Mediterranean Diet
High F+V, wholegrains, oily fish, unsaturated fat
Low sat + trans fat
Assessment with Med diet score tool
Influences - artery injury risk, plaque formation, thrombosis
Dietary cholesterol
Eggs, liver, shellfish
Large quantities may increase serum levels
Reduce intake if high levels
Always ask in diet history
Lipid profile (high risk)
Total chol <4
LDL <2
HDL >1.0
TAG <1.7
Signs of high lipid
High TAG
High chol x2
High TAG - eruptive xanthoma (skin nodules)
High chol
- corneal arcus (white ring in eye)
- xanthelasma (eyelid deposits)
Hypertension
Normal v stage 1 b.p
Normal = 130/85
Stage 1 = 140-149/90-99
Soluble fibre
Encourage high intake
F+V, beans, pulses, oats, barley
Lowers total + LDL chol
CHO
Ensure adequate % energy (keep fat low)
Refined CHO may increase TAG (swap to low GI foods)
Dietary fat
Sat fat <10% energy Trans fat <2% energy Reduction not always necessary MUFA - olive oil/rapeseed oil/nuts/avocado PUFA - oily fish/soybeans/margarines
Practical - cooking method/cut fat off meat/low dairy options/popcorn>crisps
N-3 FAs
Anti-thrombotic Anti-inflammatory Prevention - 1 portion/wk Treatment - 2-4 portions/wk Veggie sources - walnuts, kidney beans, edamame, flaxseed
Alchohol
May increase TAG
<14u/wk
Direct relationship with increase blood pressure (regular, heavy, binge)
Plant sterols
Inhibit chol absorption so reduce circulating chol levels Lowers LDL 6-15% Max effects at 2-3g/d Nuts/seeds/grain/veg oils Health claim: reduces chol
SIGN: no evidence long-term
Salt
<6g/d
DASH diet - high F+V, wholegrains, fish, low sat, trans fat, salt
Soya protein
Low GI Interferes with LDL chol synthesis Use to replace sat fat + animal protein when in mixed diet Practical 1/2 and 1/2 SIGN: no recommendations for use
Dietary management
Cheap/safe/alter lipid profile BUT low compliance
Keep advice practical + achievable
Consider - motivation, lifestyle, social circumstances, other medical conditions
Cardiac failure
Causes
Prolonged HT Injury Alcohol abuse MI/IDH Viral damage
Cardiac failure
S+S
Oedema SOB Fatigue Fluid imbalance Poor cardiac failure
Cardiac failure
Medical…
Surgical…
Oxygen + drugs
Dialysis, heart transplants, cardiomyopathy, mechanical support
Cardiac Cachexia
Abnormally low weight
Loss skeletal + heart muscle, fat + bone tissue
Poor prognosis
symptoms - fatigue, anorexia, chronic infection
Cardiac failure
Dietetic intervention
Maximise energy intake if malnourished Fluid restriction Na restriction Alcohol Smoking Weight loss for obese
