Cardiovascular

Question 1

Flax seeds can reduce LDL by how much?

Answer 1

8-18%

Question 2

How long does it take for flax seeds to work?

Answer 2

More than 6 weeks

Question 3

2 Counselling tips for taking flax seed

Answer 3

1) Take with large amount of water

2) Take 1 hour before or 2 hours after oral medications

Question 4

Taking how much flaxseed can cause diarrhea?

Answer 4

> 45g/day - dose dependent

Question 5

Drug interactions of flaxseeds

Answer 5

1) Anticoagulant and antiplatelets due to ALA component (seed and oil)
2) Antidiabetes drug (Seed only)
3) Estrogen meds (Seed only)

Question 6

Contraindications of flaxseeds

Answer 6

• Avoid in pregnancy
• Diabetes
• Estrogen-dependent cancer
• Bleeding disorders?

Question 7

Flaxseed oil contains ____ and may be beneficial because…

Answer 7

ALA; it can increase proportion of omega-3 in plasma, raising the 6:3 ratio

Question 8

Effects of lignans in flaxseed

Answer 8

• hypoglycemic and laxative effects

- antiestrogenic/estrogenic effects

Question 9

Flax seed also contains omega-6. T or F

Answer 9

True

Question 10

Flaxseed can increase the levels of HDL. T or F.

Answer 10

False

Question 11

What percent of ALA is converted to EPA/DHA?

Answer 11

5-10%

Question 12

What is the ratio of EPA-DHA in omega-3?

Answer 12

Usually 3:2

Question 13

What is the MOA for omega-3?

Answer 13

They are the building blocks for hormones such as prostaglandins, leukotrienes so they possess anti-inflammatory effect.

Question 14

Effects of omega-6

Answer 14

Pro-inflammatory, cell proliferation, blood clotting

Question 15

What is the effect of fish oils?

Answer 15

• Lowers TG by 20-50% (effects greater in patients with severe hypertriglyceridemia)
• Decreases number of LDL particles but increases cholesterol it contains
• Increases HDL (1-3%)

Question 16

What is the effective dose range of EPA/DHA for lowering TG?

Answer 16

2-4g/day

Question 17

What is the RRR in primary endpoint for EPA+statin compared to statin therapy alone?

Answer 17

19% RRR favouring EPA+statin

Question 18

In terms of omega-3 supplements and all cause mortality, what are the results from studies?

Answer 18

• Older studies are more positive - one showed 20% decrease in mortality risk
• Fish source is better than supplements

Question 19

What would you recommend for a patient with no risk of heart disease?

Answer 19

Eat fatty fish at least 2x/week

Question 20

Can omega-3 treat hypertension?

Answer 20

NMCD: possibly effective

2 Meta-analysis showed more than 3g/d decreases BP modestly

Question 21

Fish oil interacts with Vitamin A and D. Why?

Answer 21

Vitamin A and D also contains fish liver oil - can lead to toxicity

Question 22

Taking more than 3g/day of fish oil may cause these SE:

Answer 22

• Bleeding
• Hypotension
• suppress immune and inflammatory responses
• Increase LDL

Question 23

What is the result of the MA on garlic hypertension?

Answer 23

Effective at lowering BP if hypertensive