Transcript Heart Disease

Chapter 21
Nutrition &
Disorders of the
Heart & Blood
Vessels
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CVD Deaths in the U.S.
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Athrosclerosis
• Artery walls become
progressively thickened
due to accumulation of
plaque
• Occurs due to minimal
but chronic injuries that
damage the inner
arterial wall
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© 2007 Thomson - Wadsworth
Consequences
• Lumen narrows
• Plaque can
rupture, forming
a clot (thrombus)
• Thrombus can
break free & shut
off blood flow
(embolism)
• Ischemia occurs
within the tissue
 Coronary arteries
(angina pectoris &
heart attack)
 Brain (stroke)
• Aneurysm (saclike distention of
blood vessel wall)
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Causes of Athrosclerosis
• Inflammation &
infection
• Hypertension
• Smoking
• Diabetes mellitus
• Aging
• Elevated LDL &
VLDL
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Coronary Heart Disease
• Most common type
• Leading cause of
death in U.S.
• Evaluating Risk
 Smoking
 High LDL
 High blood pressure
 Diabetes
 Obesity
 Inactivity
• Non-modifiable
risk factors
 Age
 Male gender
 Family history
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© 2007 Thomson - Wadsworth
Lifestyle Changes for CHD
• Cholesterol-lowering
diet (<200 mg)
• Weight reduction
• Regular physical
activity
• Decrease saturated
fat <7% total
kcalories
• Decrease total fat
25-35% of kcalories
• Decrease trans fat
• Increase soluble fiber
• Plant sterols &
stanols
• Eat soy products
• Increase fish &
omega-3 fatty acids
• Moderate alcohol
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Lifestyle Changes for
Hypertriglyceridemia
• Mild
• Severe
 Weight reduction
 Physical activity
 Quit smoking
 Avoid high-CHO
diet
 Restrict alcohol
 Weight reduction
 Physical activity
 Very-low-fat diet:
<15% of kcalories
 Medication
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Vitamin Supplementation
• No conclusive research results have
been obtained for vitamins being
preventative for CVD
• Study is underway for increasing:
Folate, vitamin B6 & B12 to decrease
homocysteine levels
Vitamin C and E for antioxidant effects
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Drug Therapies for
CHD Prevention
• Statins
 Reduce cholesterol
synthesis in the liver
• Bile acid
sequestrants
 Reduce cholesterol &
bile absorption in
small intestine
• Nicotinic acid
• Anticoagulants &
aspirin
 Suppress blood
clotting
• Blood pressure
medications
• Nitroglycerin for
angina
 Lowers triglycerides &
raises HDLs
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Treatment for Heart Attack
• Drug therapy
 Thrombolytics
 Anticoagulants
 Aspirin
 Painkillers
 Blood pressure
medications
 Rhythm stabilizers
• No food until
stable
 Soft foods
 Low sodium
 Low saturated fat
• Cardiac
rehabilitation
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Hypertension
• Desirable BP
• Affects 1/3 of adults
 < 120/80
in U.S.
• Prehypertension
• Factors influencing BP
 Cardiac output
 Peripheral resistance
 Secretion of hormones
by kidneys
 120-139/80-89
• Hypertension
 > 140/90
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Contributing Factors
• Salt sensitivity
• Aging
• Genetics
 30-50% of cases
 More prevalent in
African Americans
• Obesity
 Alters kidney
function &
promotes fluid
retention
• Alcohol
 3-4 drinks daily
• Diet
 Fruits, vegetables,
nuts, low-fat milk
can lower BP
 Potassium, calcium,
& magnesium can
lower BP
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Treatment of Hypertension
• Weight reduction
• Low-sodium diet
• Diet rich in
potassium, calcium,
& magnesium
• Regular physical
activity
• Moderate alcohol
• DASH Diet - Limits:
 Red meats
 Sweets
 Sugar-containing
beverages
 Saturated fat to <7%
 Cholesterol to 150
mg/day
• Drug therapy
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Congestive Heart Failure
• Heart’s inability to • Consequences
pump adequate
 Fluid accumulation in
liver, abdomen, & lower
blood
extremities
• Fluids build up in
 Chest pain; swelling
veins & tissues
legs, ankles, feet; SOB
• Heart enlarges
 Impaired liver & kidneys
• 75% are 65 or
 Heart failure
older
 Cardiac cachexia
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© 2007 Thomson - Wadsworth
Medical Management
•
•
•
•
Sodium & fluid restrictions
Diuretics
Small, frequent meals
Vaccinations for influenza
& pneumonia
• Adequate fiber
• Avoid alcohol
• Liquid supplements, tube
feedings, parenteral
support
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Stroke
• 3rd leading cause
of death
• Types
• Prevention
 Recognize risk factors
 Lifestyle changes
 Ischemic
• Management
 Hemorrhagic
 Thrombolytic drugs
 Transient ischemic
 Maintain nutrition status
attacks (TIAs)
 Problems
• Lack of coordination
• Difficulty swallowing
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