Exam 3 - CVD I Flashcards
What diseases are the leading cause of death in US?
Cardiovascular diseases
List five major forms of CVD
- Hypertension
- Atherosclerosis
- Ischemic heart disease
- Peripheral vascular disease
- Heart failure
Name the roles of the cardiovascular system
- Regulates blood flow to tissues
- Thermoregulation
- Hormone transport
- Maintenance of fluid volume
- Regulation of pH
- Gas exchange
Describe STROKE VOLUME
Volume of blood ejected with each contraction of left ventrical
- regulated by end-diastolic volume (EDV), mean aortic blood pressure (MAP), and strength of ventricular contraction
Describe PRIMARY and SECONDARY hypertension
PRIMARY: high bp for which the cause cannot be determined
SECONDARY: high pb as a result of an underlying disease, usually of the renal or endocrine nature. This may be curable.
Define HYPERTENSION
Persistently high arterial bp, defined as systolic bp (contraction phase of cardiac cycle) >/= 140 mmHG and/or diastolic bp (relaxation phase of cardiac cycle) >/= 90 mmHG
How is mean arterial pressure (MAP) determined? Name 4 things that affect it
By cardiac output and total peripheral resistance.
- sympathetic nervous system
- renin-angiotensin system
- renal function
- hormones involved: epinephrine, vasopressin, angiotensin II
Hypertension is indicated by readings equal to or greater than ____/____ mmHG
140/90 mmHG
What is hypertension a risk factor for?
Cardiovascular disorders and kidney disease
Name four factors that influence Essential HTN
- Excessive secretion of vasopressin and angiotensin II
- Smoking - interferes with NO, impairing endothelial relaxation and vasodilation
- Renal disease - renal artery atherosclerosis, increasing angiotensin II release, causing vasoconstriction and increased Na and H2O retention
- Adrenal disorders
Give the four parts of hypertension treatment
- Weight reduction
- Physical activity
- Nutrition therapy
- Pharmacological interventions: loop diuretics, thiazides, carbonic anhydrase inhibitors, potassium sparing diuretics
What can hypertension develop into over time?
Resistance can lead to increased effort by left ventricle to pump blood through system, which leads to VENTRICULAR HYPERTROPHY and eventually CONGESTIVE HEART FAILURE
What are the three parts of nutrition therapy assessment for HTN?
- ID dietary factors and patterns
- Evaluate need for weight control
- Prioritize methods to meed DASH dietary goals
What are the lifestyle factors that should be addressed in CVD Nutrition Therapy intervention?
- DASH
- Weight loss
- Sodium
- Alcohol
- K, Ca, and Mg
- Physical activity
- Smoking cessation
Describe how insulin is associated with BP
- High insulin levels increase Na and water reabsorption by the kidney
- Hypocaloric feeding results in insulin drop, decreasing Na and H2O reabsorption, dropping BP
Describe two main implications of the DASH studies
- Interventions consisting of reduced Na intake and increased F/V/low-fat dairy can effectively reduce BP with no adverse effects
- Those typically considered highest risk for HTN and cardiovascular events (elderly, A-As) had greatest reduction in BP with this diet
What three factors increase the strength of association of NaCl intake with BP?
- Increases with age
- BP level
- Among individuals with family history of hypertension
What are the two principal observations of the INTERSALT study?
- for individuals, a difference of 100 mEq/day in sodium intake is assoc with avg difference of 3-6mm Hg in SBP
- for populations, a 100 mEp/d lower sodium in take was assoc with attenuation in the rise in SBP by 10 mm Gh in persons aged 25-55
Who are groups most likely to be salt-sensitive?
- Stage 2 HTNs
- Obese HTNs
- African-Americans
- Those with DM or renal dysfunction
- The use of cyclosporine
- The elderly (>65)
- What is the recommended daily sodium intake to prevent HTN?
<2300 mg Na/day
How many teaspoons is the recommended daily NaCl intake?
1 1/4 teaspoons salt
Name three ways you can achieve >2300 mg Na/day
- not adding salt while cooking
- not adding salt at the table
- avoiding highly salted processed foods
Give the rule of thumb for salt intake in meals and food items
- Consume <700 mg of Na per meal
* <200 mg/food item
What does “Sodium-Free” on a label mean?
<5mg sodium per serving and contains no NaCl
