Nutrition & CVD Flashcards
Week 9
What are the aetiologies/risk factors for CVD? (9 answers)
- Genetics (specifically affecting lipid metabolism)
- Ageing and gender (men)
- Physical inactivity
- Hypertension
- Dyslipidaemia
- Obesity (particularly central adiposity)
- Smoking and alcohol
- Stress
- Low-socioeconomic status
*mix of biological, physiological and geographical characteristics
What is the definition of CVD?
CVD includes all diseases of the heart and circulation including CHD, myocardial infarction, ichemia, angina, stroke and heart failure (british heart foundation 2013).
What are the 2 primary causes of CVD? (2 answers)
- thrombosis
- atherosclerosis
What is the prevalence of CVD (globally)?
Ischemic/coronary heart disease is leading cause of death globally followed by stroke (WHO 2019). Both are most prevalent in middle countries.
>4 million deaths/year in EU. (BHF 2019)
What is the prevalence of CVD (UK)?
1 in 7 men and 1 in 12 women die from CHD, 1 death every 8 minutes. However, deaths have halved since 1960s.
What is the pathophysiology of CVD?
Atherosclerosis - hardening of the arteries and narrowing of the lumen due to lipid containing plaque build up on arterial wall. Can cause thrombosis from plaque erruption and reduce blood flow to heart.
LDL-c is most atherogenic.
What are the aetiologies/risk factors for CVD?
- Hypertension
- High cholesterol/dyslipidaemia
- Smoking
- Alcohol
- Diabetes
- Overweight/obesity
- Physical Inactivity
- Ageing
- Family history/genetics
What are some dietary risk factors for CVD?
- High saturated fatty acids
- Trans fatty acids
- high sodium intake
- Obesity
- High alcohol intake
- high cholesterol (LDL)
What are some dietary prevention strategies for CVD?
- increase in alpha-linoleic acid and linoleic acid
- fatty fish intake
- Increased fibre
- wholegrains, veg
- potassium intake
Why is nitric oxide important for the cardiovascular system?
Promotes vasodilation
inhibits platelet aggregation
Regulatory component of endothelial cells.
Has uses in almost all other physiological systems.
What is atherosclerosis?
A hardening of the arteries and narrowing of the lumen due to the build up of lipid containing (LDL) (atherosclerotic) plaques. Limits the supply of blood to the heart and can result in angina or myocardial infarction.
Sequences of atherosclerotic process
Adhesion of circulating leukocytes (monocytes) to dysfunction/damaged endothelium
Adherent monocytes migrate into intima and transform into macrophages, joined by other leukocytes, such as T lymphocytes, in mediating a complex inflammatory response
Macrophages take up lipid and change into lipid-laden foam cells, forming a lesion, i.e. fatty streak or plaque
Fatty streaks are detectable in aorta and coronary arteries from a very young age
Fatty streak becomes a mature atherosclerotic plaque via the secretion of cytokines and growth factors by the inflammatory cells inside it
Platelets adhering to adjacent endothelium provide another source of cytokine and growth factors
Smooth-muscle cells migrate from the media to intima in response to growth factors and form the bulk of plaque
Macrophages continue to accumulate lipid, principally in the form of cholesterol esters
LDL is the specialised carrier for cholesterol
What are the two major clinical conditions that could occur following atherosclerosis (with and without thrombus)?
Angina pectoris (without thromubus)
Myocardial infarction (with thrombus)
What are 2 inflammamatory biomarkers seen/used to predict atherosclerosis?
c-reactive protein (CRP) and Interleukin-6 (IL-6)
What fatty acids have shown benifical effects for CVD? (2) What do they do?
n-3 and n-6 omega fatty acids (PUFAs). They reduce platelet aggregation
