Lecture 15: Nutrition and CVD Prevention and Management

Question 1

Cardiovascular Disease (CVD)

Answer 1

• A class of disease that affects the heart or blood vessels
  
  • coronary artery disease
  • heart attack
  • abnormal heart rhythms or arrhythmias
  • heart failure
  • heart valve disease
  • congenital heart disease

Question 2

Development of Atherosclerosis

Answer 2

• Atherosclerosis: a disease in which plaque builds up within the arteries
• Oxidized LDL cholesterol leads to inflammation
• increase in WBC, macrophages, and foam cells
• leads to increase in arterial stiffness
• then plaque builds up due to the increased stiffness and fibrous cap forms
• blot clots form in artery, due to blockage from fibrous cap/fibrous cap rupture

Question 3

Hypertension and CVD

Answer 3

• high blood pressure is leading risk factor for CVD
• there is an increased resistance to blood flow
• Causes vessels to weaken and rupture
• SBP >130mmHg, DBP > 80mmHg

Question 4

Risk factors for Heart Disease

Answer 4

• age
• family history
• disease factors
  
  • Diabetes
  • Hypertension
  • Overweight
• blood lipids
  
  • HDL
  • LDL
  • total cholesterol
  • triglycerides
• lifestyle
  
  • smoking
  • exercise
  • nutrition/diet
  • income (low income, high risk)

Question 5

Framingham Risk Score

Answer 5

• 10 year CVD estimate
  
  • predictors: Age, gender, smoking, HDL, SBP, diabetes, hypertension, total cholesterol

Pros:

 - Identify areas for improvement
 - likely benefits of prevention

Limitations:

 - Age >75, <30
 - validated in European Americans and African Americans (risk of over/underestimation)

Question 6

DASH diet

Answer 6

-

Question 7

Mediterranean diet

Answer 7

-

Question 8

Effects of fatty acids on cholesterol levels

Answer 8

• saturated
  
  • Decrease LDL receptors in liver
  • increase in LDL in blood
• trans
  
  • Increase LDL cholesterol synthesis in liver
  • increase LDL, decrease HDL in blood
• Omega 6 (veggies)
  
  • Increase LDL receptors in liver
  • Eicosanoids –> promote inflammation and blood clotting
  • decrease LDL in blood
• Omega 3 (fish)
  
  • Increase VLDL uptake in adipose tissue
  • Eicosanoids –> suppress inflammation and blood clotting
  • decrease VLDL and therefore LDL in blood

Question 9

Dietary Approaches to Stop Hypertension (DASH)

Answer 9

-

Question 10

Mediterranean diet affects

Answer 10

-