Exam 4: MNT for CVD hypertension Flashcards
blood pressure normal values
<120/<80 mm Hg
blood pressure elevated values
systolic between 120-129mm Hg and diastolic <80 mmHg
stage 1 hypertension values
systolic between 130-139mm Hg and diastolic 80-89 mmHg
stage 2 hypertension values
systolic between >= 140mm Hg and diastolic >= 90 mmHg
Hypertension Risk factors
- age
- genes
- smoking
- obesity
- atherosclerosis
- stress
- inactivity
- diabetes
- hyperhomocysteinanemia
- endothelial dysfunction
- high sat/cholesterol diet
- ehtnicity
patients with hypertension are at an increased risk for developing ?
- heart failure
- MI
- stroke
- renal disease
Which ethnicity at risk for H
AA
T/F hypertension typically have no symptoms
True, called silent killer
how does the body regulate pressure
what are the 2 mechanisms does the body have for controlling BP?
-Sympathetic Nervous system
- Kidneys
What are the SNS 2 main components in bp regulation
s________-__________ ________
(hormone?)
- short-term control
- norepinephrine (vasoconstrictor) (also epi)
E and NE can ___________ blood vessels.
vasoconstrict
when body is in flight or fight mode, the SNS short term response will be for the body to release NE which will _____________ BP
raise
the kidney is responsible for the __________-_________ control of BP
long-term
the kidney is responsible for the long-term control of BP via the _____-_________ cascade
renin-angiotensin
how can the kidney regulate bp?
kidney role is to filter blood so when there is less blood flow it senses a blood pressure drop so kidneys with stimulate the production of renin. Renin will stimulate the conversion of angiotensinogen to angiotensin 1. Angiotensin 1 is converted to angiotensin 2. angiotensin 2 is a vasoconstrictor. thus raise bp. angiotensin 2 can also stimulate adrenal gland to secrete aldosterone. aldosterone will promote kidneys to reabsorb Na and H20. reabsorb H20 increases blood volume thus inc bp
list medications that lower bp
diuretic
beta-blockers
ACE inhibitors
diuretics is a medication to lower bp, what are the typeslnames of diuretic medications
Lasix and Aldactone
Beta-blockers is a medication to lower bp, what are the types/names of diuretic medications
drugs that end in -olol
ACE inhibitors is a medication to lower bp, what are the types/names of diuretic medications
drugs that end in -pril
how does the medication diuretics lower bp?
- inc urination
- dec blood volume
- thus lower bp
how does the medication beta-blocker lower bp?
-act on SNS
- prevent release of NE thus prevent vasoconstriction
how does the medication ACE inhibitors lower bp?
- most powerful
- prevent Na and H20 reabsorption so lower blood volume
- prevent vasoconstriction
MNT for hypertension, 3 main goals
- limit dietary Na and Alc
- consume adequate amounts of O3, Ca, Mg, K
- promote DASH diet, physical activity and weight loss
MNT for hypertension goal - limit Na, why?
- inc blood volume, retain water, increase bp
- not all are Na sensitive
- AA, obesity, age, can affect Na sensitivity
MNT for hypertension goal - limit alcohol, why?
- raise bp above and beyond the normal range
- associated with inc level of renin promote vasoconstriction and Na/H20 retension
MNT for hypertension goal - consume adequate amounts of O3, why?
- help ________ blood
- dec _________ to blood flow
- promote ________ of ______ ________ (vasodialator)
- _________-_____________
- __________ bp
- help thin blood
- dec resistance to blood flow
- promote secretion of nitric oxide (vasodilator)
- anti-inflammatory
- lower bp
MNT for hypertension goal - consume adequate amounts of Ca, why?
calcium plays a role in smooth muscle ________________ and ________________. can promote ________________ of blood vessels. is found in __________, _________________, ________________, __________________
- smooth muscle contraction and relaxation
- promote vasodialator
- dairy, dark leafy not spinach, tofu w calciu,, non dairy with calcium,
MNT for hypertension goal - consume adequate amounts of Mg, why?
(similar to calcium)
- smooth muscle contraction and relaxation
- all green vegie, chlorophyll
- nuts and seeds
- whole grains, brown rice
- dark chocolate
MNT for hypertension goal - consume adequate amounts of K, why?
- works opposite of Na
- lower bp
- found in bananas, avocado, spinach, potatoes, sweet potatoes, tomatoes
- general fruits and vegetables
- dairy
- ## legumes
DRI for K
4700 mg/d
MNT for hypertension promote DASH diet why?
dietary approach stop hypertension
Which nutrients may help regulate bp?
D, E, C, CoQ10, Garlic, Resveratrol, beet extract, hawthorn berry, hibiscuss
MNT for hypertension goal - consume adequate amounts of D, why?
- ## can help depress renin (associated high levels of alcohol)
MNT for hypertension goal - consume adequate amounts of C and E, why?
- anti-oxidants
- promote elasticity of blood vessels
- prevent vascular resistance in blood vessels due to oxidation
MNT for hypertension goal - consume adequate amounts of CoQ10, why?
- anti-oxidants
- mitochondria
- vasodialator
MNT for hypertension goal - consume adequate amounts of garlic and resveratrol and beet extract, why?
- inc NO production and promot vasodialation
resveratrol found in
anything with grape skin
MNT for hypertension goal - consume adequate amounts of hawthorn berry and hisbiscus, why?
Act like calcium and magnesium… smooth muscle and vasodilation
T/F With vitamins such as D, E, C, CoQ10, Garlic, Resveratrol, beet extract, hawthorn berry, and hibiscus, it is recommended to take a daily supplement to help lower blood pressure.
F, eat balanced food to get nutrients
What is the EPA and DHA health claim
ability to reduce the risk of hypertension and coronary artery disease, as well as lower blood pressure
a product must contain at least _________ EPA and DHA per serving to use the EPA/DHA health claim
0.8g
current dietary guideline for seafood is
8oz/week ~250mg/d
what does ACC/AHA mean:
American College of Cardiology and American Heart Association
ACC/AHA recommendations:
Reduce calories from ___________ _______ to 5-6%
saturated fat
ACC/AHA recommendations:
Reduce consumption of _____ ______
trans fat
ACC/AHA recommendations:
__________ dietary cholesterol _____ necessary
decreasing dietary cholesterol not necessary
ACC/AHA recommendations:
Consume no more than ____________mg of Na/day
Consume no more than 2,400mg of Na/day
ACC/AHA recommendations:
Eat appropriate calories for ________ ________ or maintenance
eat appropriate calories for weight loss or maintenance
ACC/AHA recommendations:
Follow ______ therapy for other diseases
diet
ACC/AHA recommendations:
Emphasize ____, _____, _____, w________ g________, __is_, _____try, n_____, ________ ___ils, ____-______ da___
emphasize f, v, legume, whole grains, fish, poultry, nuts, veg oils, low fat diary
ACC/AHA recommendations:
Antioxidant rich foods not _________
not supplements
ACC/AHA recommendations:
_______ intake of red meat
limit
ACC/AHA recommendations:
limit intake of ________, especially sugar-sweetened beverages
sweets
ACC/AHA recommendations:
limit added sugars to ___g or __ tsp per day for women , ____g or ___ tsp per day for men
limit added sugars to 25g or 6tsp per day for women , 37.5g or 9tsp per day for men
ACC/AHA recommendations:
achieve through ______ diet or USDA _________ food pattern
dash diet or USDA my plate
ACC/AHA recommendations:
moderate to vigorous intensity ______ exercise 40 min 3-4x/week
aerobic
which organization came up with the TLC dietary pattern
national cholesterol education program NCEP
T/F NCEP is focused on improving blood lipids and lowering risk for atherosclerosis
T
TLC or therapeutic lifestyle change
Toal fat range
25-35% of kcals
TLC or therapeutic lifestyle change
sat fat range
<7% of kcals
TLC or therapeutic lifestyle change
trans fat range
zero
TLC or therapeutic lifestyle change
PUFA range
up to 10% of kcal
TLC or therapeutic lifestyle change
MUFA range
up to 20%
TLC or therapeutic lifestyle change
CHO range
50-60% of kcals
TLC or therapeutic lifestyle change
Fiber range
25-30 g/d
TLC or therapeutic lifestyle change
soluble fiberrange
10g/d
TLC or therapeutic lifestyle change
plant sterols range
2g/d
TLC or therapeutic lifestyle change
cholesterol range
<200mg/d
Mufa sources
olive oil, olives, avocados, avocado oil, canola oil,
PUFA O3 sources
fish flax hemp walnut
PUFA O6 sources
corn soy seed oils
PUFA o6 are ___________ and 03 are ___________
pro-inflammatory and anti-in
T/F Mediterranean diet is the best translation for the TLC diet
T
Mediterranean diet describe
bottom to top
- high ______ diet
- consumed on daily basis ________ ____, ______, _______
-what should be consumed everyday, every meals, per week, and what is limited?
- MUFA
- olive oil, olive, nuts, seeds
- seafood
primary protein sources - every meal should include 1-2 servings of fruits, more than 2 servings of vegetables, variety colors and textures, olive oil, grain or potatoe
once a day: olive, nuts, seeds, herbs, spice, garlic, onions, legumes - dairy 2 serv
- lean proteins eggs couple times per week
- red no more than 2
- procseed no more than 1
- sweets no more than 3x /wk
Dash diet when compared to Med diet
- group all oils together and rec to limit them
- sweet are limited
- bulk is fruit, veg, whole grains
- leg nuts seed are grouped together and less often vs med diet rec to eat more often
- group all animal protein together
- dairy highly rec vs med its yogurt or fermented
Low-fat vegan diet can reverse _____
CAD
Low fat vegan diet
_____ of kcal from fat
10%
Low fat vegan diet allowed:
whole grains
legumes
vegetables
fruits
b12 supplement
flaxseeds for omega3
low vegan fat diet not allowed:
meatl poultry fish
dairy products and eggs
refined grains
sugars
fruit juice
oils
avocados
nus
olives