Chapter 22 Cardiovascular Disease

Explain how atherosclerosis develops

the artery walls become progressively thickened due to an accumulation of fatty deposits, fibrous tissue and smooth muscle cells (collectively known as plaque)

What is atherosclerosis?

a disease of the arteries characterized by the the build up of lipids and fibrous scar tissue on the inner wall of the arteries.

Describe the potential consequences of atherosclerosis

coronary disease (heart attack)

renal disease

cerebral disease (stroke)

peripheral vascular disease (damage to blood circulation in lower limbs)

Discuss the risk factors that contribute to the development of atherosclerosis (hint there are 9)

smoking

high cholesterol

high blood pressure

diabetes

stress

sedentary lifestyle

obesity

aging

Explain an individual's risk for coronary heart disease (CHD)

smoking: toxic chemicals damage endothelial cells (inflammation, vasoconstriction, etc..)

high cholesterol: too much animal fat leads to build up of fat in arteries

high blood pressure: causes stiffening of arteries

diabetes: causes damage to blood vessels

high saturated fat diet: leads to narrowing of blood vessels

stress: stress hormones damage blood vessels

sedentary lifestyle: lack of exercise leads to weakening of muscles

obesity: puts stress on heart

aging: normal wear and tear on heart

which of the atherosclerosis risk factors is the only one that is not modifiable

aging

thrombosis

when build up of plaque breaks off and blocks the blood vessel flow (i.e. blood clot)

Define Cardiovascular Disease

general term for disease of the heart and blood vessels

Discuss appropriate dietary and lifestyle changes for individual with mild to severe hypertriglyceridemia

mild hypertriglyceridemia: controlling body weight,

physical activity, restrict alcohol, limit intake of refined carbohydrates

severe hypertriglyceridemia: same dietary and lifestyle change plus medication

Explain the development of congestive heart failure (CHF)

-Major complication from high blood pressure (aka weak heart)

What is CHF

Hearts inability to pump adequate blood to meet the needs of the body due to prolonged high blood pressure

-heart muscles enlarge and then weakens (aka hypertrophy)

what are the symptoms and treatment for CHF

symptoms: fatigue, shortness of breath, and leg swelling

treatment: low sodium diet (this lowers blood volume which cause less strain on heart)

True or False ? Hypertrophy of the heart muscle is reversable.

False

Describe nutrition therapy for clients with CHF

-treatment of underlying diseases (high blood pressure, diabetes, or atherosclerosis)

-nutrition therapy include sodium, fluid, and alcohol restrictions and nutrient supplementation

Describe blood pressure measurements

systolic blood pressure measure ventricular systole (contraction)

diastolic blood pressure measures ventricular diastole (relaxation)

normal= 120/80

Identify the factors that influence blood pressure

-cardiac output and peripheral resistance influence blood pressure

-and heart rate (HR) and stroke volume (SV) can influence cardiac output (CO)

CO = HR * SV

Identify the risk factors for hypertension

Aging

Genetic Factors

Obesity

Salt Sensitivity

Alcohol

Dietary Factors

Discuss the DASH eating plan for hypertensive clients

adopt a diet that emphasizes vegetables, fruits, and whole grains; includes low fat milk products; and limits sugars and red meats

Describe medical treatment options for clients with hypertension

common medications used to treat hypertension include:

-diuretics

-calcium channel blockers

-ACE inhibitors

-angiotensin-receptor blockers

Name the different forms of stroke

Hemorrhagic stroke:

-blood vessels burst

-blood leaks into brain tissue

Ischemic stroke:

-plaque forms thrombosis and gets lodged in blood vessel of brain

-blood clot stop blood supply to are of the brain

(tissue dies)

Discuss risk factors for stroke

risk factors:

-pre-existing conditions like hypertension, diabetes, cholesterol

-high LDL levels

-smoking

Define metabolic syndrome and discuss the medical significance of this disorder

a cluster of interrelated disorders, including abnormal obesity, insulin resistance, high blood pressure, and abnormal blood lipids

Describe dietary and lifestyle changes for an individual with metabolic syndrome

-weight loss

-reduce intake of added sugars and refined grains

-increase servings of whole grains and high-fiber foods

Ischemia in the coronary arteries is a frequent cause of:

A. Angina pectoris

B. Hemorrhagic stroke

C. aneurysm

D. hypertension

A. Angina pectoris

Risk factors for atherosclerosis include all of the following except:

A. smoking

B. hypertension

C. diabetes mellitus

D. elevated HDL cholesterol

D. elevated HDL cholesterol

Which clinical test can help to diagnose peripheral artery disease?

A. Lipoprotein profile

B. Coronary artery calcium score

C. Ankle brachial

D. C reactive protein levels

C. Ankle brachial

Dietary lipids with the strongest LDL cholesterol raising effects are:

A. monounsaturated fats

B. polyunsaturated fats

C. saturated fats

D. plants sterols

C. saturated fats

Moderate alcohol consumption can improve heart disease risk, in part, because it:

A. lowers blood pressure

B. increases HDL cholesterol levels

C. offset the damage from smoking

D. improves nutrition status

B. increases HDL cholesterol levels

Patients with hypertriglyceridemia may improve their triglyceride levels by:

A. reducing sodium intake

B. reducing cholesterol intake

C. consuming moderate amounts of alcohol

D. limiting intakes of refined carbohydrates

D. limiting intakes of refined carbohydrates

Which medications reduce cholesterol synthesis in the liver?

A. Bile acid sequestrants

B. Statins

C. ACE inhibitors

C. Fibrates

B. Statins

Hemorrhagic stroke:

A. is the most common type of stroke

B. results from obstructed blood flow within brain tissue

C. comes on suddenly and usually lasts for up to 30 minutes

D. results from bleeding within the brain, which damages brain tissue

D. results from bleeding within the brain, which damages brain tissue

Hypertensive patients can benefit from all of the following dietary and lifestyle modifications except:

A. including fat free or low fat milk products in the diet

B. reducing total fat intake

C. consuming generous amounts of fruit, veggies, legumes and nuts

D. reducing sodium intake

B. reducing total fat intake

Nutrition therapy for a patient with heart failure usually includes:

A. weight loss

B. reducing total fat intake

C. sodium restriction

D. cholestrol restriction

C. sodium restriction