Transcript 2. CVD - WordPress.com

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Heart : The most hard-working muscle of our
body – pumps 4-5 liters of blood every
minute during rest
Supplies nutrients and oxygen rich blood to
all body parts, including itself
Coronary arteries surrounding the heart keep
it nourished with blood
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Chambers: The heart is divided by a septum
into two halves.
The halves are in turn divided into chambers.
The upper two chambers of the heart are
called atria and the lower two chambers are
called ventricles .
Valves allow blood to flow in one direction
between the chambers of the heart.
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Atherosclerosis
Hyperlipidemias
Coronary heart disease
Myocardial infraction
Congestive heart failure
Hypertension
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No. 1 killer disease worldwide
◦ 12 Million deaths annually
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During last 30 years large declines in developed
countries -rising health awareness and government
programmes
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Alarming increase in developing countries especially
India
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It is a general term that denotes an elevation
of one or more lipids in the blood.
Hypercholesterolemia: is a serum cholesterol
in excess of 260mg/dl.
Hypertriglyceridemia when fasting triglyceride
level exceeds 250mg/dl.
These elevated levels results in rapid & severe
development of atherosclerosis & in turn
coronary disease.
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Coronary artery disease (CAD), These are
diseases of the arteries that supply the heart
muscle with blood.
Coronary heart disease (CHD), a disease of
the heart itself caused by the accumulation of
atheromatous plaques within the walls of the
arteries that supply the myocardium.
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No symptoms for long period
Severe Chest pain for short period on
exertion also known as Angina Pectoris or
minor heart attack
Infract is localized area of necrosis result
when blood supply is inadequate. An infract
oh heart is known as Myocardial Infarction
or major heart attack-Severe chest pain,
death of heart muscle, heart failure,
irregular heart beats
Sudden Ischaemic Death (deficient blood
supply)
Heart failure , often called congestive heart
failure, is a condition in which the heart can't
pump enough blood to the body's organs and
tissues.
 It doesn't mean the heart has failed and can't
pump blood at all. With this less effective
pumping, vital organs don't get enough blood
 Causing signs and symptoms as:
1.
shortness of breath
2.
fluid retention (edema) in extremities first
& with increasing failure to abdomen &
chest
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and fatigue.
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Genetic predisposition
Poor handling of fats
Metabolic syndrome
◦ Diabetes, obesity, high BP, Coronary artery
disease
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Urbanization
Sudden change in lifestyle
Cholesterol
Two sources of cholesterol: Food & made in your
body
 Too much cholesterol can deposit in the arteries in
the form of plaque and block them
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Hypercholesteraemia occurs when cholesterol level
exceed 240mg/dl
Cholesterol & Triglyceride are the main forms of fat
carried in blood with the help of lipoproteins.
Lipoproteins are made up of protein & lipids.
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Chylomicrons, carry triglyceride,
monogylcerides, glycerol & small amount of
cholesterol & phospholipids.
VLDL also transport triglyceride but mainly
endogenous triglyceride formed in liver.
They travel through blood vessels &
circulate fat throughout the body.
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LDL main carrier of
cholesterol, it
stuck to blood
vessels
HDL takes away
cholesterol from
tissues to liver for
conversion or
excrete
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Saturated fats raise LDL & total cholesterol
levels
Increase the risk of CVD
Sources:
 Meat & dairy products
 Hydrogenated fats: hydrogenation of
vegetable oils alter the geometric structure of
PUFA from natural ‘cis’ to ‘trans’ form.
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Trans fats raise LDL
Lowers HDL
Thus are atherogenic
Low calorie, low fat, low CHO, high fiber diet
 Energy: patient whose weight is normal,
maintenance level of calorie.
Loss of weight for obese people is advisable
A1000-1200 kcal diet is suitable for obese
patient in bed.
 Fats: first step is restriction of fat to not more
than 20% of total calories
 Important n-3 PUFA are a-linolenic acid, EPA
& DHA
n-6 are linoleic acid & arachidonic acid
They are also known as omega 6 & omega 3.
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Promote esterification of cholesterol
Reduces thrombosis
Prevent accumulation of cholesterol in blood
Decrease synthesis of VLDL, LDL, triglycerides
Specially food rich in ω-3 fatty acid have
cardio protective effects
Such as fish, specially salmon, fish oil
Vegetable sources: flaxseed, canola oil,
mustard oil, walnuts
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Present in vegetable sources such as olive oil,
canola, almond oil.
Lower LDL without lowering HDL
& do not raise triglyceride levels
Cholesterol
Cholesterol level should not exceed 300mg in
diet as liver also synthesis cholesterol
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CHO: Include complex CHO in diet. About
60% of total calorie from CHO
Protein, vitamins & minerals
Normal allowances are recommended
Avoid animal protein
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Sodium is restricted when there is
hypertension. Usually a restriction of Na of
1600-2300mg is satisfactory for CHD
patients. When Na is restricted other sources
of iodine should be given. It also reduces
intake of vit A.
WHO recommends 6gm of salt for normal
person.
Very low Sodium diet: 250mg sodium diet, salt
is not used for cooking, selection of low
sodium foods
Strict sodium restriction: 500mg Na diet, no
salt for cooking
Moderate Na restriction: 1000mg Na diet
Mild Na restriction: 2400-4500mg Na diet
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Hypertension is elevated blood pressure.
Hypertension impairs the pumping action of
heart & if untreated damages heart, brain &
kidneys.
Predisposing factors
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Heredity
Stress
Obesity
Smoking
High viscosity of blood
Narrowing of blood
vessel
Other factors
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CVD
Renal disease
Tumor of brain
Thyroidism
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Mild hypertension: DBP is 90 to 104mm Hg.
Moderate Hypertension: DBP is 105 to
119mm Hg.
Severe Hypertension: DBP 120- 130mm Hg &
above
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Many person have no symptoms
Headache
Dizziness
Impaired vision
Failing memory
Shortness of breath
GIT disturbances
Unexplained tiredness
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Low calorie, low fat, low sodium diet
Energy : Obese patient must be reduced to
normal body weight with low calorie diet.
Protein: normal allowance
Fats: about 20gm vegetable oil is permitted.
as they are at risk of atherosclerosis, too
much fats should be avoided
Sodium restriction
Include high amount of fruit & vegetables for
fiber, potassium
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Table salt or excess salt in cooking
MSG (Monosodium glutamate)
Baking powder
Salt preserved foods, pickles canned foods
Highly salted foods, potato chips
Salted butter, cheese
Biscuits, cakes etc
In strict sodium restriction, choose
vegetables judicly
Thank you