Cardiovascular Health Flashcards
(104 cards)
1
Q
What is the endothelium?
A
The endothelium is a monolayer of endothelial cells lining the blood interface throughout the cardiovascular system including cardiac chambers
2
Q
A
3
Q
What is Cardiovascular Disease (CVD)?
A
CVD is a genera term for conditions affecting the heart and blood vessels such as atherosclerosis, hypertension, angina, myocardial infarction and stroke.
4
Q
What is the function of the glycocalyx?
A
The glycocalyx (GX), is a carbohydrate-rich protective layer covering the ED, regulates permeability, control nitric oxide production and acts as a mechanosensor of blood shear stress.
5
Q
Name some things that can damage the GX
A
The GX is easily damaged by inflammation, hyperglycaemia, endotoxemia, oxidised low-density lipoproteins and abnormal blood shear stress.
6
Q
What does shear stress mean?
A
Shear stress is frictional force of blood on ED cells
7
Q
Name the Key Functions of the endothelial
A
- Semi-permeable barrier:
Role of fluid balance, host
defence and movement of substances e.g. glucose and oxygen - Regulates vascular tone:
Secretes vasodilators e.g. NO and vasoconstrictors e.g. endothelin - Enzymes:
Contains angiotensin-converting enzyme (ACE) - plays a key role in regulating blood pressure - Angiogenesis:
ED cells are the origin of all new blood vessels - Haemostasis:
The luminal surface of ED prevents platelet adherence and coagulation - Immune defence:
Healthy ED cells deflect leukocyte adhesion and oppose local inflammation.
8
Q
What is the role of Vascular Smooth Muscle cells? (VSMCs).
A
Located in the tunica media, VSMCs play a key role in vessel contraction and dilation (regulate blood circulation and pressure).
With the ED, VSMCs maintain the integrity and elasticity of blood vessels whilst limiting immune cell infiltration.
These changes are central to vascular disease, especially atherosclerosis and hypertension.
9
Q
What role does Nitric Oxide play in cardiovascular health?
A
Regulates vascular tone, reduces platelet aggregation and VSMC proliferation, inhibits leukocyte adhesion and inflammatory cytokines and opposes oxidation of LDLs.
10
Q
Name the amino acid that generates NO
A
L-arginine by the ED enzyme eNOS
11
Q
Where does NO exert tis main physiological effect?
A
NO diffuses easily from the ED into VSMCs and the bloodstream, exerting its main physiological effects in large blood vessels
12
Q
Which vitamin regulates NO synthesis?
A
Vitamin D, by mediating eNOS
13
Q
What is the effect of oxidative stress and inflammation on the ED?
A
- increased permeability cytokines and leukocyte adhesion.
- Reduced vasodilator molecules.
- Increased risk of thrombosis
14
Q
What is the effect of oxidative stress and inflammation on VSMCs?
A
- Increased inflammatory cytokines and extracellular matrix synthesis.
- Migration into the tunica intima and proliferation of VSMCs.
15
Q
What are Peroxisome proliferator-activated receptors (PPARs)?
A
PPARs are nuclear transcription factors that control gene expression involved in adipogenesis, lipid and glucose metabolism, cellular proliferation and apoptosis .
16
Q
What role do PPARs play in CVD?
A
PPARS decrease inflammation and promote ED health
PPARa activation increases HDL-C, decreases TG and inflammation and is anti-atherosclerosis.
17
Q
Name some PPARa agonists
A
Green Tea
Resveratrol
Oregano
Thyme
Rosemary
Naringenin
Omega 3
18
Q
Name some PPRA-y agonists and what they do
A
PPAR-y reduces blood glucose, fatty acids and insulin.
Natual PPAR-y agonists include:
apigenin
hesperidin
curcumin
resveratrol, EGCG (polyphenol from green tea).
19
Q
Name some risk factors of CVD?
A
Family History
Siblings = 40% risk
Offspring of parents with premature CVD= 75% risk
Genetics:
MnSOD, NOS3, MTHRF and ACE
Ethnicity:
South Asian
Sub-Saharan African origin have enhanced risk
Gender:
Predominantly a male pathology but mortality is increasing in women
20
Q
Name some of the vague physical symptoms of CVD in women
A
Lightheaded with exertion and heartburn
21
Q
Name 3 other risk factors of CVD
A
Dyslipidaemia:
increases total cholesterol = increased LDL, VLDL, IDL, Lp(a). Decreased HDL: increased triglycerides
Hypertension:
CVD pathologies tend to appear 5 years earlier in those with hypertension.
Mitochondrial dysfunction:
ATP is required to pump ions out of myocardial cells, allows relaxation oand maintains electrochemical gradient across myocardial cell membrane.
Consider statins/CoQ10.
22
Q
How does homocysteine play a role in CVD
A
Homocysteine is associated with LDL oxidation, monocyte adhesion and ED dysfunction.
23
Q
Name some nutrient depletions that can be a risk factor for homocysteine
A
Low folate and B12 -
needed for re-methylation of homocysteine to methionine.
Vitamin B6 is a co-factor is conversion of homocysteine to cystein in the methylation cycle
24
Q
How can genetic polymorphisms affect homocysteine levels
A
MTHFR needed to methylate B12 in methionine cycle.
FUT2, TCN impact B12 (all forms) absorption.
MTR, MTRR impact B12 activation
PEMT and CHDH and BHMT (betaine) are depended upon for methylation from other routes
25
How can changes in thyroid hormones have an impact on CVD?
Thyroid hormone (TH) receptors are present in the myocardium and vascular tissue and minor TH changes can alter CV homeostasis. Hypo and hyperthyroidism are linked with ED dysfunction, dyslipidaemia and BP changes
26
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27
Explain how inflammation contributes to ED dysfunction
Inflammation has various origins including dyslipidaemia, dysbiosis and intestinal permeability, ROS, diabetes, excess adipose tissue and smoking.
In turn, ED dysfunction, subintimal cholesterol accumulation and recruitment of monocytes and T-cells drives inflammatory response.
28
In what way is obesity a risk factor for CVD?
Excess adipose tissue perpetuates inflammation contributing to vascular breakdown and metabolic complications
Adiponectin, a peptide that influences expression of ED cells, protecting against CVD is decreased in obesity.
Adiponectin also increases insulin sensitivity, thus low levels contribute to insulin resistance (IR).
Obesity is associated with high levels of leptin, which activates the SNS causing sodium retention, vasoconstriction and increases blood pressure
29
How does insulin resistance contribute to obesity (IR)
IR generates chronic hyperglycaemia leading to oxidative stress, inflammation and cellular damage
IR contributes to the lipid triad and dyslipidaemia.
Dyslipidaemia along with ED damage (due to dysfunctional insulin signalling) leads to athersclerotic plaque formation.
IR means that glucose is not cleared from the bloodstream as quickly as needed, increasing the risk of glycosylation reactions and the production of damaging compounds - Advanced glycation end products (AGEs)
30
What are AGES and explain how they contribute to CVD
AGEs are harmful compounds formed when protein or lipids become glycated after exposure to glucose. They exert their effects via tow main mechanisms
1. Receptor-mediated
2. Non-receptor mediated
This leads to oxidative stress, vascular ED and immune cell dysfunction.
31
Name some lifestyle risk factors for CVD
Smoking:
Increases oxidative stress and lowers antioxidants (1 cigarette= 25mg loss of vitamin C).
Nicotine increases Sympathetic Nervous System and increases blood pressure
Sedentary Lifestyle:
Exercise Increases insulin sensitivity and nitric oxide production. It has a positive effect on lipid profile and blood pressure
Chronic stress may cause ED dysfunction
Periodontal disease - increases systemic inflammation which impair vasodilation, promotes endothelial dysfunction, artierial stiffness and increases fibrinogen (plaque formation).
Heavy metals induce oxidative stress, lipid peroxidation and inflammatory cytokines. Cadmium and lead compete with zinc. A zinc deficiency increases atherosclerosis risk
32
Explain how the Gut-brain axis plays a role in CVD
SCFAs produced by the microbiota decrease risk of metabolic endotoxaemia by maintaining intestinal barrier integrity. SCFAs reduce serum lipids by inhibiting cholesterol synthesis or redirecting lipids to the liver.
33
What dietary considerations are risk factors for CVD
1. High PRAL (potential renal acid load)
Foods rich in protein (e.g. meat and cheese) may induce low-grade metabolic acidosis, a risk factor for IR and CVD.
2. Trans fats promote dyslipaemia, increase inflammation, contribute to ED dysfunction, encourage visceral adiposity and increase risk of IR
3. Fructose - high fructose intake promotes de nova iipogenesis, increase fatty acids, in particular palmitic acid. Palmitic acid is a major driver of atherosclerosis and CAD.
4. Nutrient deficiences (e.g. vitamin C, D, E, CoQ10, magnesium)
34
Name 3 markers for Cardiovascular disease
1. Cardiac risk tools
2. Cardiac troponin
3. Lipid profile
4. Lp-PLA 2
5. hsCRP
6. MPO
35
How does a plant-based and Mediterranean-style diet reduce CVD risk
36
What is the RDA of Vitamin D for cardiovascular health
600-1000iu per day
37
Name 2 functions of Vitamin D in relation to CV health
1. Modulates NO synthesis and influences cells involved in atherogenesis e.g. ED, VSMCs, monocytes and cardiac myocytes
2. Modulates RAAS and lowers BP
38
What is the RDA of omega 3 in relation to CV
3-6 grams per day
39
What is the function of Omega 3 fatty acids in relation to CV health
1. Improve lipid and lipoprotein profiles
2. Involved in the synthesis of key regulators of inflammation, vasodilation and platelet aggregation.
3. EPA stabilises cellular membranes allowing neutrilisation of extracellular ROS.
4. DHA supports membrane fluidity
40
What is the recommended amount of Magnesium Glycinate/taurate in relation to CV health
500-800mg
41
Name 2 function of magnesium glycincate/ taurate
1. Through regulation of ion transporters e.g. potassium and calcium channels plays a central role in modulating neuronal excitation, intracardiac conduction and myocardial contraction.
2. Helps regulate vascular tone and stabilise heart rhythm.
42
How much Co-Q 10 per recommended per day in relation to CV health
60-300mg
43
What is the function of Co-enzyme Q10 in relation to CV health
1. Protects against endothelial dysfunction and reduces LDL oxidation (decreases atheroscelosis risk).
2. Increases superoxide dismutase activity which preserves the activity of NO (decreases risk of high BP).
3. Supports mitochondrial health and production of ATP.
44
How many mgs of hawthorn is recommended to promote CV health
1000-1500mg
45
How does hawthorn promote CV health
Cardiac tonic: strengthens and improves vascular elasticity
Has ACE-inhibiting actions (decreases BP)
Hawthorn reduces ET-1 and increases NO levels, hence having vasodilatory effects.
Antioxidant (e.g. SOD)
Anti-inflammatory (inhibits NF kB).
46
How much garlic is recommended to promote CV health
2-5g per day
47
How does garlic promote CV health
Antihypertensive effects by stimulating NO production in ED cells.
Lowers homocysteine.
Decreases arterial calcification (stiffness).
Reduces LDL cholesterol and LDL oxidation.
Enhances glutathione and SOD.
Protects against abnormal platelet aggregation
48
Name 2 natural approaches to promoting CVD
Exercise: Significantly reduces CVD risk and is associated with a reduction in all-cause mortality.
1. Leads to a more favourable lipoprotein profile (decreases TGs)
2. Improves insulin sensitivity and insulin signalling in the vascular endothelium, activating eNOS, which increases NO synthesis.
3. Promotes a net reduction in blood pressure at rest (cardiac output and BP transiently increase during exercise.
49
Explain how stress management can promote CV health
Diaphragmatic breathing, humming, singing promote parasympathetic activity.
Include herbal teas to relieve stress e.g. chamomile, passionflower, lemon balm, lime flower tea.
50
What nutrients are depleted by the following CVD drugs
*Statins: Blcok HMG CoA-reductase, decreasing Q10 synthesis.
*Cholestyramine (cholesterol lowering drug) - A bile acid sequestrant. Decreases absorption of fat soluble vitamins and beta carotene
*Loop and thiazide diuretics: increase excretion of potassium, calcium, thiamine and zinc.
ACE inhibitors: Bind with zinc, preventing utilisation in the body
*Beta-blockers: decrease melatonin production by inhibiting adrenergic beta 1 receptors: block the biological pathway of Co-Q10-dependent enzymes
51
What is the meaning of Blood pressure?
Blood pressure (BP) reflects the force of blood against the walls of the arteries (CO + total PR)
52
What does CO + total PR stand for
Cardiac Out + Peripheral resistance
53
What is systolic BP
The pressure blood exerts on arterial walls when the heart contracts)W
54
What is diastolic BP?
(pressure when the heart relaxes)
55
What is definition of Hypertension in the UK
140/90mmHg or higher
56
Name 4 symptoms of hypertension
Fatigue, headache, dizziness, visual disturbance, however is often asymptomatic
57
What is the difference between essential and secondary hypertension
Essential:
No specific underlying cause. Drivers include vascular resistance (due to vasoconstriction, atheroscelerosis, loss of blood vessel elasticity, increased blood viscosity, obesity, stress and anxiety, smoking, high salt intake.
Secondary:
due to diseases of the kidneys, adrenals, thyroid, diabetes
58
What is malignant hypertension
Pressure over 180/120, which risks damaging organs e.g. kidneys (medical emergency)
59
Give 10 causes and risk factors for Hypertension
1. Genetic
2. Obesity (especially increased abdominal adiposity) - activates RAAS causing vasoconstrition and water retention.
3. Excess alcohol - Decreases barorecptor reflex, increases sympathetic outflow and increases heart rate and blood pressure.
4. Stress - increases SNS activity
5. Nutritional Deficiences - especially magnesium (vasodilates), potassium (increases excretion of sodium, decreases blood volume
6. HIgh table salt - or low potassium
7. Inactivity
8.Smoking
9.Drugs - raise blood pressure
10. Raised uric acid
60
How does good potassium levels in the body prevent hypertension
Potassium increases natriuresis (excretion of sodium), encourages vasodilation, reduces sensitivity to angiotensin 2 and lowers SNS activity
Potassium lowers NADPH oxidase, decreasing ROS in the vascular wall
61
What is the upper limit of daily sodium intake
1.5g/day
62
What is the DASH diet?
The DASH diet consists of fresh vegetables and fruits, legumes, nuts, seeds, whole grains, fish, lean meat and low-fat dairy and limits saturated fats and salt. Polyunsaturated and monounsaturated fatty acids are preferred. Sodium is restricted
63
What are ACE inhibitory peptides and give some examples
Naturally occurring ACE inhibitory peptides can be found in certain plants and foods and act like a decoy encouraging ACE to react with peptides, reducing vasoconstriction via angiotensin 2.
Sources include spirulina, mushrooms, spinach, hemp seeds, walnuts and bitter melon seeds.
64
Can how sleep help prevent hypertension?
Melatonin is associated with anti-hypertensive effects through GABA stimulation, angiotensen-2 inhibition and increases in NO.
65
How can deficiency in Vitamin D effect blood pressure
Deficiency of Vitamin D increases vasoconstriction (overexpression of renin, activating RAS) and retention of sodium and water.
Vitamin D lowers proinflammatory cytokines, increases nitric oxide, endothelial function and arterial elasticity and dcreases hs-CR
66
How does magnesium effect blood pressure
Deficiency is associated with hypertension. Alterations in intracellular and extracellular magnesium affects cardiac and vascular tone and reactivity.
67
How can L-arginine help prevent Hypertension
Arginine is the principal substrate for NO
It decreases angiotensin 2
68
How can dandelion help to lower blood pressure
Dandelion leaf is a diuretic and naturally rich in potassium. 1-2 teaspoons infused, 2-3 cups daily or 3-4 fresh leaves in salad/smoothies
69
Name 3 ways to naturally prevent hypertension
Stress management:
Diaphragmatic breathing
Earthing: walking on grass or sand, improves heart rate variability, lowers night-time cortisol and promotes parasympathetic state
Exercise: start gently and gradually increase CV fitness eg. walking, swimming, cycling and jogging. Avoid intense exercise
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71
What is Atherosclerosis
Atherosclerosis is the narrowing and hardening of large and medium arteries, which reduces blood flow
72
Explain what happens for Atherosclerosis to occur
Endothelial dysfunction plays a central role in the formation of fatty streaks, a primary event in atherosclerosis
Increased permeability facilitates entry of LDL into the intima. LDL becomes trapped within the vessel wall and is oxidised ito mLDL (modified LDL)
mLDL recruit leucocytes expressing high levels of pro-inflammatory cytokines. Also trigger cytokine release from ED and VSMC (vascular smooth muscle cells) cells
Macrophages imbibe lipoproteins to form foam cells. Cellular debris is incorporated and inflammation drives plaque formation.
A cap is formed over the plaque to wall off the plaque from blood.
73
Name 4 causes of Atherosclerosis
1. Endothelial dysfunction (precedes Atherosclerosis)
2. Inflammation: Plays a critical role in the genesis, progression and manifestation of atherosclerosis
3. Dyslipidaemia - Lipids are a fundamental componant of atherosclerotic plaques. Thus, dyslipidaemia is a significant risk factor and is marked by: increased total cholesterol - decreased LDL, VLDL, IKL, Lp(a) and decreased HDL and increased TGs
74
When applying a natural approach to CVD, name 4 key considerations
1. Avoid high saturated fat to reduce risk of CV events.
2. Increase omega-3 FAs and MUFAs e.g. avocado, unrefined olive oil. Regular EVOO consumption reduces LDL-C and oxidised LDLs and improves post-prandial glycaemic profiles
3. Red yeast rice (2400-4800 mg/day) - contains monocolin K, an inhibitor of cholesterol synthesis via HMG CoA reductase
75
How can dietary fibre help in the prevention of Atherosclerosis
-Soluble fibre (vegetables, fruits, psyllium husk, pectin, gums) are associated with a decrease in TC and LDL-C
- Dietary sources of beta glucans (oats, mushrooms, seaweed and barley) interact with lipids and biliary salts in the bowel and lower LDL-C, non HDL cholesterol and ApoB.
SCFAs decrease liver cholesterol synthesis and increase bile excretion, and interact with innate immunity receptors to modulate immune function.
76
Name 4 ways of supporting endothelial health and vasodilation
- Hawthorn berries, bilberry, blueberries and blackcurrants are antioxidant and support blood vessel integrity and tone.
-Lower ET-1-levels by enhancing citrus flavanoids, quercetin, epcatechins, garlic, olive oil, ginkgo, folate, blackcurrant
-Beetroot - contains inorganic nitrates that convert to NO in the body
-L-theanine increases nitric oxide production in ED cells through eNOS phosphorylation (green tea is a source).
77
Name 2 ways of supporting endothelial health
1.Reduce homocysteine
- B6, folate and B12 (methylfolate and methylcobalamin supplementation), TMG (3g daily)
2. Lower fibrinogen levels
- mediterranean-style diets promote healthy levels. Garlic reduces fibrinogen
-mild to moderate exercise reduces fibrinogen levels)>
78
How can promoting and supporting liver detoxification help prevent atherosclerosis?
Poor liver detoxification can increase circulation of inflammatory mediators, impede cholesterol metabolism and comprise essential fatty acid status.
79
Name a herb that supports liver detoxifaction
Schisandra fruits supports liver function and is a powerful activator of phase 1 detoxification without increasing bioactivation. Enhances phase 2 detoxification
80
Name some natural stratagies for CVD and HTN
Stress management
Exercise
Sauna - increases circulation and arterial vasodilation. Avoid in unstable angina/MI and hypertension
Dry skin brushing: supports circulation and toxin elimination
Contrast hydrotherapy - improves circulation and removal of toxins. If circulation is compromised, end on warm
Tai Chi Chaun, yoga and acupuncture have shown to reduce ET-1 levels.
81
What is angina?
Chest pain caused by insufficient supply of oxygenated blood supply to the myocardium by the coronary arteries
82
Name is the difference between stable and unstable angina?
Stable angina:
Predictable transient chest pain during exertion or emotional distress> Ischaemia with symptoms resolve once oxygen balance is restored.
Unstable Angina:
Unpredictable/occurs at rest. Plaque disruption initiates platelet aggregation, thrombus formation and vasoconstriction. May be a precursor to acute Myocardial Infarction
83
What is the difference between myocardial infarction and myocardial ishaemia
Myocardial infarction = a heart attack. When the heart muscle doesn't get enough oxygenated blood
Myocardial ishaemia - When there is a partial or complete blockage of a coronary artery but the build up of plaques (atherosclerosis). If plaque ruptures you can have a heart attack
84
Name the signs/symptoms of stable angina
Constricting chest pain (can radiate to the neck, left shoulder/arm and jaw), worsened by exertion, relieved by rest.
Shortness of breath (SOB), sweating, nausea.
85
Name 3 causes/risk factors of Angina
Cigarette smoking:
-endothelial dysfunction
Coronary heart spasm
-vessel wall injury
-oxidative stress
elevates fibrinogen
-platelet activation and inflammation
Vitamin D deficiency:
significant correlation between vitamin D deficiency and chronic angina.
Improves endothelial function by signalling for the transcription of eNOS: modulates the RAAS to lower blood pressure
Family history of IHD (ishaemic heart disease) is a strong risk factor for angina
86
Name the various orthodox methods of diagnosis of Angina
ECG
Cardiac stress testing
angiography
87
Name 4 allopathic approaches for angina
Nitrates (e.g. GTN)
Calcium channel blockers (amlodipine)
Beta-blockers (e.g.atenolol)
Revascularisation (angioplasty, stents and coronary artery bypass graft surgery).
88
What is myocardial infarction?
MI= acute blockage of a coronary artery usually due to a thrombus, resulting in the death of myocardial tissue
89
List some main causes and risk factors for Myocardial Infarction
Male: 3 times more likely to experience MI. High androgen levels contribute to development of atherosclerosis
Stress
e.g. financial, loss of life control, sudden life events eg. job loss, marital separation) increase risk
Others:
Drug induced e.g. cocaine
Severe MI demand eg oxygen demand (in hypertension)
Reduced oxygen supply (e.g. severe anaemia)
90
What are the signs and symptoms of MI
Severe prolonged crushing retrosternal chest pain:
Pain radiates down left shoulder, jaw/neck or arms. Sweating, cool/clammy skin. Feeling of 'impending doom'. Dyspnoea and syncope. Nausea, vomiting, weakness.
91
What the allopathic approaches to MI
Fibrinolysis
Oxygen therapy
Nitrates
Beta blockers
Aspirin
92
Name somWae natural approaches to Ischaemic Heart Disease
Natural approach to CVD with focus on supporting myocardial blood flow:
Vitamin D - supports endothelial health and promotes vasodilation
Warming herbs:
Ginger cayenne
Increasing movement - gentle exercise i.e. Tai Chi, Qi Gong, walking. Gradually increase
Address stress: Breathing exercises, nervine herbs e.g. passionflower - 1-2 tsps 2-3 times per day (infusion).
93
What is the definition of heart failure?
Heart failure (HF) = a syndrome in which the heart is impaired as a pump - failing to supply sufficient blood flow
94
Name some signs and symptoms of heart failure
Breathlessness (on exertion, at rest, orthopnea)
Nocturnal dyspnoa
Fluid retention (e.g. ankle oedema, abdominal swelling
Fatigue
Exercise intolerance
Lightheadedness
Syncope
Tachycardia
95
Name 4 complications of heart failure
Atrial fibrillation
Ventricular arrhythmias
Sudden cardiac death
96
What is the allopathic approach to heart failure
Digoxin (synthetic form of digitoxin, from foxglove that increases the force of myocardial contraction, diuretics, calcium channel blockers, ACE-inhibitors
97
Name 4 causes/risk factors of heart failure
- Results from various CV conditions eg IHD (most common), hypertension, AF, cardiomyopathy, LVF, pulmonary hypertension, heart valve abnormalities
- smoking, raised homocysteine, sedendary etc
-Co-morbidities eg CKD, anaemia, T2DM, thyrotoxicosis, hypothyroidism, COPD
- Insulin resistance
- Obesity
- Nutrient deficiencies e.g. Coq10, vit D, B1, B2, folate, B12, Ca,Cu, Mg, Mn,K, Se, Fe
98
What are varicose veins
Varicose veins are dilated/distorted superficial veins in the lower limbs where the pressure is higher due to gravity.
99
Name some symptoms of varicose veins
Visible vein dilation: aching, burning, throbbing, heaviness. Worse for prolonged standing and at the end of the day.
100
What complications can arise from having varicose veins
- increased venous pressure = fluid leakage into surrounding tissues ('varicose eczema'). Slow healing varicose ulcers.
101
What are haemorrhoids?
dilated veins in the anal canal. Internal or external
102
Name 4 causes/risk factors for varicose veins or hemorrhoids.
1. Increased abdominal pressure - constipation, obesity, pregnancy, childbirth and post-labour, ascites
2. Inherited value defects - an absence of some valves or faulty valves.
3. Cigarette smoking (=hypoxia, which results in endothelial damage, vessel wall inflammation and a loss of elasticity).
4. Being sedentary (increasing venous pressure).
5. Lack of connective tissue support - e.g. low vitamin C (increases type 1 collagen synthesis), low bioflavonoids (supports connective tissue integrity).
6. Portal hypertension - increased portal vein pressure e.g. due to liver cirrhosis and heart failure.
7. Increased blood viscosity and stagnation
8. Abdominal bloating
9. Structural - e.g. poor diaphragm motion
103
Name some natural approaches to support prevent and treatment of varicose veins/haemmoroids
1. CNM diet
- reduce inflammation, increase blood flow and speed up repair of damaged veins/valves. Correct root causes.
2. Vitamin C-rich foods (support collagen synthesis).
3. Bioflavanoids - rutin, proanthocyanidins and anthocyanins which improve the integrity of ground substance and the vascular system, whilst also acting as antioxidants. Food sources include: buckwheat, (rutin), grapes, apples, cranberry, blueberries, figs, blackcurrants, capers, asparagus, green tea.
4. Enhance fibrinolytic activity - garlic, onions, ginger, cayenne, bromelain
5. Optimise liver function
6. Raise feet above heart (20 mins per day) to prevent blood pooling
7. Lymphatic drainage/massage - for mild cases only
8. Reduce weight.
9. Regular exercise
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