Flashcards in Nutrition Module 10: CVD - HT and Other Risk Factors Deck (71)
What does BP refer to? What are the 2 factors that contribute to it?
Mean arterial pressure:
1. Cardiac output
2. Systemic vascular resistance
Common presentation of HT?
Normal cardiac output
with systemic vascular resistance
What 3 factors can affect systemic vascular resistance? Does each increase or decrease it?
1. Norepi (as an NT and circulating hormone): INCREASE
2. NO: DECREASE
3. Elasticity loss with aging: INCREASE
What are the 8 risk factors of HT?
3. Age above 65
4. Low SES
5. Sedentary lifestyle
6. Ethnicity = AA or hispanic
7. Alcohol abuse
8. Family history
What % of americans have elevated BP or are taking meds for it?
How does BP increase the risk for CVD?
CVD risk increases doubles for each 20/10 increment
How can diet modifications lower BP?
By more than 20/10 mmHg
By how much is the risk of stroke increased for people with untreated HT?
What are the 5 criteria to make a metabolic syndrome diagnosis? How many of these need to be met?
3 out of the 5:
1. Elevated waist circumference
2. High TAGs
3. Low HDLs
4. High BP
5. High FBG
What is another name for metabolic syndrome? What can this other name also refer to though?
Can refer to a problem with heart rate regulation
What diseases are metabolic syndrome closely associated with?
T2DM and CVD
What are the 3 underlying contributing factors of metabolic syndrome?
2. Insulin resistance
3. Sedentary lifestyle
What 4 minerals play an important role in HT?
What does it mean for someone to be salt-sensitive? What % of HT patients are salt-sensitive?
Their BP responds to dietary salt intake
What is the definition of HT Stages 1 and 2? Note?
STAGE 1: 140-159/90-99
STAGE 2: 160+/100+
Note: numbers can be higher averaged over 2 or more visits
What 8 factors increase the effect of NaCl restriction on BP?
1. Older peeps
3. High BP
6. Renal abnormalities
7. Abnormal RAA system
8. Low renin or slow renin response
How much does the typical American diet provide in sodium? What is the recommended intake?
Rec: below 2,300 mg/day
Where does most of the sodium in the american diet come from? %?
Food processing: 75%
How much salt intake is consumed while cooking/eating?
How much Na does table salt contain?
By how much is BP decreased on average if following rec Na intake? How does this reduce CVD risk?
Reduces systolic BP 2-8 mmHg: 5-20% decrease in CVD risk
How does excessive salt intake impact cancer risks?
Increase stomach cancer risks
How many mmol does 2300 g of Na correspond to?
How does K+ affect BP? How? How can you fix this?
Hypokalemia = renin secretion = vasoconstriction = higher BP
Eat more potassium in fruits, veggies, fresh meats, and milk
What meds can cause K+ depletion? What other deficiency do they cause? Why?
Also thiamin deficiency because increased losses with urine
How does Ca2+ affect BP?
Deficiency causes high BP
How many servings of calcium rich food should you have each day to lower BP?
Can you just take supplements for the minerals that help with HT?
NOPE, not the same effects
How does Mg2+ affect BP?
Deficiency causes high BP
How does alcohol affect HT?
1. Increased mean arterial pressure
2. Resistance to HT therapy
3. Increased stroke risks
What 6 cancer risks are higher with high alcohol intake?
What are the 2 proposed mechanisms for why obesity increases HT risk?
1. Increases salt-sensitivity
2. Hyperinsulemia causes Na retention and catecholamine release
What is an independent risk factor of HT?
Is weight loss as effective for lowering BP as first-line meds?
How much exercise to lower BP?
3-4 times/week for 40 min each
What kind of effect do caffeine and omega-3 FAs have on BP?
By how much will the BP be lowered for every 10 kg = 22 lbs lost?
By how much is HT risk increased for obese people?
Why are the 5 lifestyle interventions for HT?
1. Lose weight as appropriate
2. Regular aerobic PA
3. DASH eating pattern to obtain adequate K+, Ca2+, and Mg2+
4. Restrict Na
5. Limit alcohol to 1 drink day for women and 2 for men
What is the DASH eating pattern?
High fruits and veggies (9 servings/day) and low-fat dairy
Should the 5 lifestyle changes for HT be done if drug therapy is indicated?
BP for prehypertension?
STAGE 1: Systolic: below 120
Diastolic: below 80
What is the treatment for prehypertension?
What is the treatment for HT Stage 1 and 2?
Lifestyle modifications + drugs
How often should one eat cold water fish to cut the chances of dying from stroke in half?
What are 6 cold water fish?
How many grams a day should patients with established heart disease eat omega-3 FAs?
What are the 5 reasons for omega-3 FAs to reduce CVD risks?
1. Reduce TAGs
2. Moderate tachychardia and arrhythmia
3. Inhibit platelet aggregation
4. Lower BP
5. Prevent plaque formation in coronary artieries
What are the main 3 differences between omega 3 and omega 6 eicosanoids?
1. Omega 3 more vasconstrictive
2. Omega 6 more immunosuppressive
3. Omega 6 induce platelet aggregation
What leads to platelet aggregation? 2 factors
Cytokine secretion by cells in vascular lesions
2. Acute (catecholamines)
How does factor VII affect CVD risk? What causes this?
High fat intake = high factor VII = high blood coagulation cascade = increased CVD risk
How does Vitamin K play a role in coagulation?
A lot of the proteins in the coagulation cascade are vitamin K dependent
Where do we get our Vitamin K from?
1. Intestinal bacteria
What can cause Vitamin K deficiency?
What drugs are given to patients with high risk for thrombosis? Who are these patients?
Patients with mitral valve damage or artificial heart valves: coumadins = VK antagonists like warfarin
What should coumadin treatment be accompanied by?
NORMAL/CONSTANT Vitamin K intake
How does vitamin K affect CVD risk?
1. Low Vitamin K best to reduce coagulation and thrombosis risks
2. Vitamin K necessary to control arterial calcification
What 2 factors often combine to cause increased homocysteine levels?
1. Genetic variant of an enzyme in homocysteine metabolism
2. Lack of folate, B6, B12, or riboflavin
Is there evidence that homocysteine lowering interventions with vitamin supplements prevent CVD events?
Which is more bioavailable: synthetic or natural folate?
What is the form of naturally occurring folate?
What is the form of synthetic folate?
Free folic acid
How is homocysteine generated in the body?
Methionine => SAM => s-adenosylhomocysteine + methylated compound => homocysteine
How are homocysteine concentrations kept low?
1. Methyl transferase: 5-methyltetrahydrofolate + homocysteine + B12 => tetrahydrofolate + methionine
2. Cystathionine beta-synthase: homocysteine + B6 + serine => cystathionine + B6 => cysteine + alpha-ketoglutarate + NH4+
What are the 5 toxic effects of homocysteine in tissues and blood?
1. Endothelial cell damage
2. Cholesterol oxidation
3. Oxidation of apolipoproteins: more atherogenic
4. Platelet adhesion and aggregation
5. NO scavenging = inhibition of vascular motility
How does NO react with homocysteine to increase CVD risks?
They react together = s-nitrosohomocysteine =NO availability decreased = decreased vasodilation + lack of NO in platelets: promotion of venous and arterial thrombosis
How is NO synthesized in endothelial cells?
NO synthase: arginine => citrulline + NO
How can bleeding related to antiobiotic use be prevented?
Consumption of cooked greens and green veggies
Other than homocysteine what else can interfere with NO?
Oxidized lipids and lipoproteins