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SMP - MNE Exam 2 > Nutrition Module 10: CVD - HT and Other Risk Factors > Flashcards

Nutrition Module 10: CVD - HT and Other Risk Factors Flashcards

1
Q

What does BP refer to? What are the 2 factors that contribute to it?

A

Mean arterial pressure:

  1. Cardiac output
  2. Systemic vascular resistance
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2
Q

Common presentation of HT?

A

Normal cardiac output

with systemic vascular resistance

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3
Q

What 3 factors can affect systemic vascular resistance? Does each increase or decrease it?

A
  1. Norepi (as an NT and circulating hormone): INCREASE
  2. NO: DECREASE
  3. Elasticity loss with aging: INCREASE
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4
Q

What are the 8 risk factors of HT?

A
  1. Obesity
  2. DM
  3. Age above 65
  4. Low SES
  5. Sedentary lifestyle
  6. Ethnicity = AA or hispanic
  7. Alcohol abuse
  8. Family history
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5
Q

What % of americans have elevated BP or are taking meds for it?

A

33%

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6
Q

How does BP increase the risk for CVD?

A

CVD risk increases doubles for each 20/10 increment

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7
Q

How can diet modifications lower BP?

A

By more than 20/10 mmHg

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8
Q

By how much is the risk of stroke increased for people with untreated HT?

A

2-3x

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9
Q

What are the 5 criteria to make a metabolic syndrome diagnosis? How many of these need to be met?

A

3 out of the 5:

  1. Elevated waist circumference
  2. High TAGs
  3. Low HDLs
  4. High BP
  5. High FBG
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10
Q

What is another name for metabolic syndrome? What can this other name also refer to though?

A

Syndrome X

Can refer to a problem with heart rate regulation

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11
Q

What diseases are metabolic syndrome closely associated with?

A

T2DM and CVD

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12
Q

What are the 3 underlying contributing factors of metabolic syndrome?

A
  1. Obesity
  2. Insulin resistance
  3. Sedentary lifestyle
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13
Q

What 4 minerals play an important role in HT?

A
  1. Na
  2. Ca
  3. K
  4. Mg
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14
Q

What does it mean for someone to be salt-sensitive? What % of HT patients are salt-sensitive?

A

Their BP responds to dietary salt intake

50-60%

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15
Q

What is the definition of HT Stages 1 and 2? Note?

A

STAGE 1: 140-159/90-99

STAGE 2: 160+/100+

Note: numbers can be higher averaged over 2 or more visits

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16
Q

What 8 factors increase the effect of NaCl restriction on BP?

A
  1. Older peeps
  2. AAs
  3. High BP
  4. Genes
  5. Obesity
  6. Renal abnormalities
  7. Abnormal RAA system
  8. Low renin or slow renin response
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17
Q

How much does the typical American diet provide in sodium? What is the recommended intake?

A

2,300-4,700 mg

Rec: below 2,300 mg/day

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18
Q

Where does most of the sodium in the american diet come from? %?

A

Food processing: 75%

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19
Q

How much salt intake is consumed while cooking/eating?

A

10%

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20
Q

How much Na does table salt contain?

A

40%

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21
Q

By how much is BP decreased on average if following rec Na intake? How does this reduce CVD risk?

A

Reduces systolic BP 2-8 mmHg: 5-20% decrease in CVD risk

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22
Q

How does excessive salt intake impact cancer risks?

A

Increase stomach cancer risks

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23
Q

How many mmol does 2300 g of Na correspond to?

A

100

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24
Q

How does K+ affect BP? How? How can you fix this?

A

Hypokalemia = renin secretion = vasoconstriction = higher BP

Eat more potassium in fruits, veggies, fresh meats, and milk

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25
What meds can cause K+ depletion? What other deficiency do they cause? Why?
Diuretic meds | Also thiamin deficiency because increased losses with urine
26
How does Ca2+ affect BP?
Deficiency causes high BP
27
How many servings of calcium rich food should you have each day to lower BP?
2-4
28
Can you just take supplements for the minerals that help with HT?
NOPE, not the same effects
29
How does Mg2+ affect BP?
Deficiency causes high BP
30
How does alcohol affect HT?
1. Increased mean arterial pressure 2. Resistance to HT therapy 3. Increased stroke risks
31
What 6 cancer risks are higher with high alcohol intake?
1. Mouth 2. Esophagus 3. Pharynx 4. Larynx 5. Liver 6. Breasts
32
What are the 2 proposed mechanisms for why obesity increases HT risk?
1. Increases salt-sensitivity | 2. Hyperinsulemia causes Na retention and catecholamine release
33
What is an independent risk factor of HT?
Obesity
34
Is weight loss as effective for lowering BP as first-line meds?
YUP
35
How much exercise to lower BP?
3-4 times/week for 40 min each
36
What kind of effect do caffeine and omega-3 FAs have on BP?
Minor effects
37
By how much will the BP be lowered for every 10 kg = 22 lbs lost?
5-20 points
38
By how much is HT risk increased for obese people?
2-6x
39
Why are the 5 lifestyle interventions for HT?
1. Lose weight as appropriate 2. Regular aerobic PA 3. DASH eating pattern to obtain adequate K+, Ca2+, and Mg2+ 4. Restrict Na 5. Limit alcohol to 1 drink day for women and 2 for men
40
What is the DASH eating pattern?
High fruits and veggies (9 servings/day) and low-fat dairy
41
Should the 5 lifestyle changes for HT be done if drug therapy is indicated?
YUP
42
BP for prehypertension?
Systolic: 120-139 Diastolic: 80-89
43
Normal BP?
STAGE 1: Systolic: below 120 | Diastolic: below 80
44
What is the treatment for prehypertension?
Lifestyle modifications
45
What is the treatment for HT Stage 1 and 2?
Lifestyle modifications + drugs
46
How often should one eat cold water fish to cut the chances of dying from stroke in half?
1/week
47
What are 6 cold water fish?
1. Salmon 2. Trout 3. Herring 4. Mackerel 5. Sardines 6. Halibut
48
How many grams a day should patients with established heart disease eat omega-3 FAs?
1g/day
49
What are the 5 reasons for omega-3 FAs to reduce CVD risks?
1. Reduce TAGs 2. Moderate tachychardia and arrhythmia 3. Inhibit platelet aggregation 4. Lower BP 5. Prevent plaque formation in coronary artieries
50
What are the main 3 differences between omega 3 and omega 6 eicosanoids?
1. Omega 3 more vasconstrictive 2. Omega 6 more immunosuppressive 3. Omega 6 induce platelet aggregation
51
What leads to platelet aggregation? 2 factors
Cytokine secretion by cells in vascular lesions 1. Chronic 2. Acute (catecholamines)
52
How does factor VII affect CVD risk? What causes this?
High fat intake = high factor VII = high blood coagulation cascade = increased CVD risk
53
How does Vitamin K play a role in coagulation?
A lot of the proteins in the coagulation cascade are vitamin K dependent
54
Where do we get our Vitamin K from?
1. Intestinal bacteria | 2. Diet
55
What can cause Vitamin K deficiency?
Oral antibiotics
56
What drugs are given to patients with high risk for thrombosis? Who are these patients?
Patients with mitral valve damage or artificial heart valves: coumadins = VK antagonists like warfarin
57
What should coumadin treatment be accompanied by?
NORMAL/CONSTANT Vitamin K intake
58
How does vitamin K affect CVD risk?
1. Low Vitamin K best to reduce coagulation and thrombosis risks 2. Vitamin K necessary to control arterial calcification
59
What 2 factors often combine to cause increased homocysteine levels?
1. Genetic variant of an enzyme in homocysteine metabolism | 2. Lack of folate, B6, B12, or riboflavin
60
Is there evidence that homocysteine lowering interventions with vitamin supplements prevent CVD events?
NOPE
61
Which is more bioavailable: synthetic or natural folate?
Synthetic
62
What is the form of naturally occurring folate?
Folylpolyglutamate
63
What is the form of synthetic folate?
Free folic acid
64
How is homocysteine generated in the body?
Methionine => SAM => s-adenosylhomocysteine + methylated compound => homocysteine
65
How are homocysteine concentrations kept low?
1. Methyl transferase: 5-methyltetrahydrofolate + homocysteine + B12 => tetrahydrofolate + methionine 2. Cystathionine beta-synthase: homocysteine + B6 + serine => cystathionine + B6 => cysteine + alpha-ketoglutarate + NH4+
66
What are the 5 toxic effects of homocysteine in tissues and blood?
1. Endothelial cell damage 2. Cholesterol oxidation 3. Oxidation of apolipoproteins: more atherogenic 4. Platelet adhesion and aggregation 5. NO scavenging = inhibition of vascular motility
67
How does NO react with homocysteine to increase CVD risks?
They react together = s-nitrosohomocysteine =NO availability decreased = decreased vasodilation + lack of NO in platelets: promotion of venous and arterial thrombosis
68
How is NO synthesized in endothelial cells?
NO synthase: arginine => citrulline + NO
69
How can bleeding related to antiobiotic use be prevented?
Consumption of cooked greens and green veggies
70
Other than homocysteine what else can interfere with NO?
Oxidized lipids and lipoproteins
71
How can serum [K+] affect BP?
1. High K+: increase BP through RAA system | 2. Low K+: increases BP through renin and vasoconstriction

SMP - MNE Exam 2 (17 decks)

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