CV Disease Flashcards
what is the endothelium?
lining of the blood vessels
covered by the glycocalyx (carb rich layer). The GX:
- regulates permeability
- controls NO production
Endothelium functions
Semi permeable barrier - fluid balance, host defence, movement of substances
Regulates vascular tone
Enzymes- contains ACE (angiotensin converting enzyme)
Angiogenesis
Haemostasis (prevents platelet adherence and coagulation)
Immune defence
Role of NO in CV health
NO:
regulates vascular tone
reduces platelet aggregation
reduces VSMC proliferation (responsible for CV pathologies inc. HTN and atherosclerosis)
Generated from L-arginine by eNOS enzyme (endothelial NO synthase)
Vit D regulates NO synthesis
AGES (Aged Glycation End Products) can block synthesis of NO by L-arginine and can create free radicals
RAAS
Responsible for regulating blood pressure and blood volume
Natural approaches to HTN
increase potassium/sodium ratio >3:1
include fresh fruit and veg
Potassium encourages vasodilation, reduces sensitivity to angiotensin II, lowers SNS activity
Potassium lowers NADPH oxidase, decreases ROS in vascular wall
DASH diet - PUFA/MUFA, low sodium, fruit, veg, nuts, seeds, whole grains, fish, lean meat, low fat dairy
ACE inhibitory peptides - naturally occurring in spiruluna, mushrooms, spinach, hemp seeds. They encourage ACE to react with peptides, reducing vasoconstriction via angiotensin II
Optimise sleep - anti-hypertensive effects of melotonin through GABA stimulation, angiotensin II inhibition and increased NO.
Optimise weight, stress management, support PSNS
Vitamins and minerals for HTN
Vit D
Magnesium (Glycinate/ Taurate)- 500-800mg/day
alterations in intra/extra cellular Mg affect cardiac and vascular tone and reactivity
L-arginine 1000 - 3000mg x 3/day
Principle substrate for vascular NO synthesis. Modulates RAS, inhibits ACE activity, ⬇️ angiotensin II. Arginase (breaks down arginine) is increased in HTN patients.
Vit B6 100mg 1-2/day
Important Co-factor (eg. NA, adrenaline, serotonin). Increases cysteine synthesis, glutathione, blocks Ca channels and reduces SNS tone.
Vit C, CoQ10, hawthorn: anti- hypertensive, anti-oxidant, endothelial protective properties
Manage stress - diaphragmatic breathing, waking barefoot on sand/grass lowers nighttime cortisol
Gentle exercise.
Functions of vit D in HTN
⬇️ Vit D leads to overexpression of Renin: ⬆️ vasoconstriction and retention of sodium and water. ⬇️ pro inflammatory cytokines, ⬆️ NO, better ED function and arterial elasticity, reduced hs-CR
Role of vit D in HTN
Vit D leads to overexpression of Renin: ⬆️ vasoconstriction and retention of sodium and water. ⬇️ pro inflammatory cytokines, ⬆️ NO, better ED function and arterial elasticity, reduced hs-CR
