ch 22 CVD

Atherosclerotic CVD (ASCVD)

• caused by atherosclerosis

• A progressive narrowing and hardening of blood vessels that may lead to blocked blood flow to the heart (heart attack), brain (cerebrovascular accident), or legs (peripheral arterial disease)

• Can also cause a ballooning out of blood vessel walls (aneurysm)

• largely a result of modifiable risk factors

Risk factors for secondary CVD

• Obesity

• Hypercholesterolemia

• Hypertension

• Diabetes

“Life’s Simple 7”

• Points are rewarded based on how many of this criteria are met

• 4 health behaviors

  • non-smoker

  • BMI <25

  • physical activity

  • healthy diet

• 3 health factors

  • cholesterol <200

  • BP <120/80

  • fasting glucose <100

• Achieved without the use of meds to control blood glucose, blood cholesterol, and BP

DASH diet pattern

• high in fruits/veg/whole grains

• low Na+, added sugar

• fish 2x/wk

• “Ideal” eating pattern, specifically for HTN

Heart healthy eating patterns

• Emphasize intake of veggies, fruit, legumes, nuts, whole grains, vegetable oils, and fish

• Limit intake of red and processed meat, refined grains, added sugars, butter, high sodium foods, and commercial trans fat

• Increase fiber, vitamins, antioxidants, minerals, phytonutrients, and unsaturated fat

• Lower in glycemic index, glycemic load, salt, and trans fat than the typical Western diet

Mediterranean diet is often recommended for ____________

CVD and diabetes

Hypertension is defined as:

130/80

Hypercholesterolemia

• Serum cholesterol and the lipoproteins that carry it (LDL, VLDL, and HDL) are linked to ASCVD (Atherosclerotic cardiovascular disease)

• ideal total: <200 mg/dL

• Optimal LDL is <100 mg/dL

• Recommended HDL level:

  • ≥40 mg/dL for men

  • ≥50 mg/dL for women

Hypercholesterolemia - Nutrition therapy

• Emphasis on veggies, fruit, whole grains, legumes, healthy protein sources, and non-tropical vegetable oils (these are unsaturated)

• More fiber (specifically soluble)

  • Oats, beans, legumes, cheerios

• Less Saturated fat

Metabolic syndrome (MetS)

• Multicomponent risk factor for CVD and type 2 diabetes

• abnormalities: elevated TG, low HDL-C, HTN, high fasting blood glucose levels, and central obesity

• Mediterranean diet is recommended

• Calories should be appropriate to maintain weight, or client should lose weight if overweight or obese

Heart failure

• A complex progressive syndrome characterized by dyspnea, fatigue, fluid retention caused by the heart's inability to pump blood properly

• Treatment: drug therapy and lifestyle modifications

• High adherence to a Mediterranean diet has been associated with a lower risk and mortality in men

Cardiac cachexia

• fatigue, SOB, decreased sensation of hunger, diet restrictions, nausea, anxiety, or malabsorption related to GI edema

• Characterized by loss of lean tissue, muscle mass, and bone mass

Sarcopenia

• Characterized by progressive and generalized loss of skeletal muscle mass and strength

• Exacerbated in older adults who have HF AND poor intakes

HF - Nutrition therapy

• Individualized calorie intake

• Protein intake: at least 1.1 g/kg to prevent catabolism

• Clients who are malnourished may need 1.1-1.4 g/kg/day

• Sodium and fluid intake are individualized

  • recommended sodium intake: 1500-2000 mg/day (restriction)