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HN 320 Clinical Nutrition I > Exam 3 - CVD I > Flashcards

Exam 3 - CVD I Flashcards

1
Q

What diseases are the leading cause of death in US?

A

Cardiovascular diseases

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2
Q

List five major forms of CVD

A
  • Hypertension
  • Atherosclerosis
  • Ischemic heart disease
  • Peripheral vascular disease
  • Heart failure
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3
Q

Name the roles of the cardiovascular system

A
  • Regulates blood flow to tissues
  • Thermoregulation
  • Hormone transport
  • Maintenance of fluid volume
  • Regulation of pH
  • Gas exchange
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4
Q

Describe STROKE VOLUME

A

Volume of blood ejected with each contraction of left ventrical
- regulated by end-diastolic volume (EDV), mean aortic blood pressure (MAP), and strength of ventricular contraction

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5
Q

Describe PRIMARY and SECONDARY hypertension

A

PRIMARY: high bp for which the cause cannot be determined

SECONDARY: high pb as a result of an underlying disease, usually of the renal or endocrine nature. This may be curable.

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6
Q

Define HYPERTENSION

A

Persistently high arterial bp, defined as systolic bp (contraction phase of cardiac cycle) >/= 140 mmHG and/or diastolic bp (relaxation phase of cardiac cycle) >/= 90 mmHG

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7
Q

How is mean arterial pressure (MAP) determined? Name 4 things that affect it

A

By cardiac output and total peripheral resistance.

  • sympathetic nervous system
  • renin-angiotensin system
  • renal function
  • hormones involved: epinephrine, vasopressin, angiotensin II
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8
Q

Hypertension is indicated by readings equal to or greater than ____/____ mmHG

A

140/90 mmHG

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9
Q

What is hypertension a risk factor for?

A

Cardiovascular disorders and kidney disease

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10
Q

Name four factors that influence Essential HTN

A
  • Excessive secretion of vasopressin and angiotensin II
  • Smoking - interferes with NO, impairing endothelial relaxation and vasodilation
  • Renal disease - renal artery atherosclerosis, increasing angiotensin II release, causing vasoconstriction and increased Na and H2O retention
  • Adrenal disorders
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11
Q

Give the four parts of hypertension treatment

A
  • Weight reduction
  • Physical activity
  • Nutrition therapy
  • Pharmacological interventions: loop diuretics, thiazides, carbonic anhydrase inhibitors, potassium sparing diuretics
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12
Q

What can hypertension develop into over time?

A

Resistance can lead to increased effort by left ventricle to pump blood through system, which leads to VENTRICULAR HYPERTROPHY and eventually CONGESTIVE HEART FAILURE

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13
Q

What are the three parts of nutrition therapy assessment for HTN?

A
  • ID dietary factors and patterns
  • Evaluate need for weight control
  • Prioritize methods to meed DASH dietary goals
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14
Q

What are the lifestyle factors that should be addressed in CVD Nutrition Therapy intervention?

A
  • DASH
  • Weight loss
  • Sodium
  • Alcohol
  • K, Ca, and Mg
  • Physical activity
  • Smoking cessation
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15
Q

Describe how insulin is associated with BP

A
  • High insulin levels increase Na and water reabsorption by the kidney
  • Hypocaloric feeding results in insulin drop, decreasing Na and H2O reabsorption, dropping BP
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16
Q

Describe two main implications of the DASH studies

A
  • Interventions consisting of reduced Na intake and increased F/V/low-fat dairy can effectively reduce BP with no adverse effects
  • Those typically considered highest risk for HTN and cardiovascular events (elderly, A-As) had greatest reduction in BP with this diet
17
Q

What three factors increase the strength of association of NaCl intake with BP?

A
  • Increases with age
  • BP level
  • Among individuals with family history of hypertension
18
Q

What are the two principal observations of the INTERSALT study?

A
  • for individuals, a difference of 100 mEq/day in sodium intake is assoc with avg difference of 3-6mm Hg in SBP
  • for populations, a 100 mEp/d lower sodium in take was assoc with attenuation in the rise in SBP by 10 mm Gh in persons aged 25-55
19
Q

Who are groups most likely to be salt-sensitive?

A
  • Stage 2 HTNs
  • Obese HTNs
  • African-Americans
  • Those with DM or renal dysfunction
  • The use of cyclosporine
  • The elderly (>65)
20
Q
  • What is the recommended daily sodium intake to prevent HTN?
A

<2300 mg Na/day

21
Q

How many teaspoons is the recommended daily NaCl intake?

A

1 1/4 teaspoons salt

22
Q

Name three ways you can achieve >2300 mg Na/day

A
  • not adding salt while cooking
  • not adding salt at the table
  • avoiding highly salted processed foods
23
Q

Give the rule of thumb for salt intake in meals and food items

A
  • Consume <700 mg of Na per meal

* <200 mg/food item

24
Q

What does “Sodium-Free” on a label mean?

A

<5mg sodium per serving and contains no NaCl

25
Q

What does “Very Low Sodium” on a label mean?

A

35 mg or less per serving

26
Q

What does “Reduced (or less) Sodium” on a label mean?

A

At least 25% less sodium per serving than usual sodium level

27
Q

What does “Light in Sodium” on a label mean?

A

Sodium reduced by at least 50%

28
Q

What are some ways to maintain a low sodium diet?

A
  • 2000 to <2400 mg Na per day
  • <200 mg/serving or 700 mg/meal
  • Replace salt shaker with herb shaker
  • Stock kitchen with fresh, unprocessed foods
  • Avoid restaurants
  • Be patient - tastes change
29
Q

What are 6 sources of Na?

A
  1. Table salt
  2. Foods with Na or Na compounds added
  3. Chemically softened water
  4. Foods with natural Na
  5. Specific modifications
  6. 77% of Na intake is from processed food
30
Q

How do animal products relate to sodium intake?

A

All animal products have some Na in them

31
Q

How do you calculate fluid restriction for a low sodium diet?

A

Calculate daily needs (1mL per Kcal), then reduce intake:

Calculated fluid needs - 500mL = initial restriction

HN 320 Clinical Nutrition I (10 decks)

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