Nutrition Module 10: CVD - HT and Other Risk Factors Flashcards Preview

SMP - MNE Exam 2 > Nutrition Module 10: CVD - HT and Other Risk Factors > Flashcards

Flashcards in Nutrition Module 10: CVD - HT and Other Risk Factors Deck (71)
1

What does BP refer to? What are the 2 factors that contribute to it?

Mean arterial pressure:
1. Cardiac output
2. Systemic vascular resistance

2

Common presentation of HT?

Normal cardiac output
with systemic vascular resistance

3

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

4

What are the 8 risk factors of HT?

1. Obesity
2. DM
3. Age above 65
4. Low SES
5. Sedentary lifestyle
6. Ethnicity = AA or hispanic
7. Alcohol abuse
8. Family history

5

What % of americans have elevated BP or are taking meds for it?

33%

6

How does BP increase the risk for CVD?

CVD risk increases doubles for each 20/10 increment

7

How can diet modifications lower BP?

By more than 20/10 mmHg

8

By how much is the risk of stroke increased for people with untreated HT?

2-3x

9

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

10

What is another name for metabolic syndrome? What can this other name also refer to though?

Syndrome X
Can refer to a problem with heart rate regulation

11

What diseases are metabolic syndrome closely associated with?

T2DM and CVD

12

What are the 3 underlying contributing factors of metabolic syndrome?

1. Obesity
2. Insulin resistance
3. Sedentary lifestyle

13

What 4 minerals play an important role in HT?

1. Na
2. Ca
3. K
4. Mg

14

What does it mean for someone to be salt-sensitive? What % of HT patients are salt-sensitive?

Their BP responds to dietary salt intake

50-60%

15

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

16

What 8 factors increase the effect of NaCl restriction on BP?

1. Older peeps
2. AAs
3. High BP
4. Genes
5. Obesity
6. Renal abnormalities
7. Abnormal RAA system
8. Low renin or slow renin response

17

How much does the typical American diet provide in sodium? What is the recommended intake?

2,300-4,700 mg
Rec: below 2,300 mg/day

18

Where does most of the sodium in the american diet come from? %?

Food processing: 75%

19

How much salt intake is consumed while cooking/eating?

10%

20

How much Na does table salt contain?

40%

21

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

22

How does excessive salt intake impact cancer risks?

Increase stomach cancer risks

23

How many mmol does 2300 g of Na correspond to?

100

24

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

25

What meds can cause K+ depletion? What other deficiency do they cause? Why?

Diuretic meds
Also thiamin deficiency because increased losses with urine

26

How does Ca2+ affect BP?

Deficiency causes high BP

27

How many servings of calcium rich food should you have each day to lower BP?

2-4

28

Can you just take supplements for the minerals that help with HT?

NOPE, not the same effects

29

How does Mg2+ affect BP?

Deficiency causes high BP

30

How does alcohol affect HT?

1. Increased mean arterial pressure
2. Resistance to HT therapy
3. Increased stroke risks

31

What 6 cancer risks are higher with high alcohol intake?

1. Mouth
2. Esophagus
3. Pharynx
4. Larynx
5. Liver
6. Breasts

32

What are the 2 proposed mechanisms for why obesity increases HT risk?

1. Increases salt-sensitivity
2. Hyperinsulemia causes Na retention and catecholamine release

33

What is an independent risk factor of HT?

Obesity

34

Is weight loss as effective for lowering BP as first-line meds?

YUP

35

How much exercise to lower BP?

3-4 times/week for 40 min each

36

What kind of effect do caffeine and omega-3 FAs have on BP?

Minor effects

37

By how much will the BP be lowered for every 10 kg = 22 lbs lost?

5-20 points

38

By how much is HT risk increased for obese people?

2-6x

39

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

40

What is the DASH eating pattern?

High fruits and veggies (9 servings/day) and low-fat dairy

41

Should the 5 lifestyle changes for HT be done if drug therapy is indicated?

YUP

42

BP for prehypertension?

Systolic: 120-139
Diastolic: 80-89

43

Normal BP?

STAGE 1: Systolic: below 120
Diastolic: below 80

44

What is the treatment for prehypertension?

Lifestyle modifications

45

What is the treatment for HT Stage 1 and 2?

Lifestyle modifications + drugs

46

How often should one eat cold water fish to cut the chances of dying from stroke in half?

1/week

47

What are 6 cold water fish?

1. Salmon
2. Trout
3. Herring
4. Mackerel
5. Sardines
6. Halibut

48

How many grams a day should patients with established heart disease eat omega-3 FAs?

1g/day

49

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

50

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

51

What leads to platelet aggregation? 2 factors

Cytokine secretion by cells in vascular lesions
1. Chronic
2. Acute (catecholamines)

52

How does factor VII affect CVD risk? What causes this?

High fat intake = high factor VII = high blood coagulation cascade = increased CVD risk

53

How does Vitamin K play a role in coagulation?

A lot of the proteins in the coagulation cascade are vitamin K dependent

54

Where do we get our Vitamin K from?

1. Intestinal bacteria
2. Diet

55

What can cause Vitamin K deficiency?

Oral antibiotics

56

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

57

What should coumadin treatment be accompanied by?

NORMAL/CONSTANT Vitamin K intake

58

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

59

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

60

Is there evidence that homocysteine lowering interventions with vitamin supplements prevent CVD events?

NOPE

61

Which is more bioavailable: synthetic or natural folate?

Synthetic

62

What is the form of naturally occurring folate?

Folylpolyglutamate

63

What is the form of synthetic folate?

Free folic acid

64

How is homocysteine generated in the body?

Methionine => SAM => s-adenosylhomocysteine + methylated compound => homocysteine

65

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+

66

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

67

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

68

How is NO synthesized in endothelial cells?

NO synthase: arginine => citrulline + NO

69

How can bleeding related to antiobiotic use be prevented?

Consumption of cooked greens and green veggies

70

Other than homocysteine what else can interfere with NO?

Oxidized lipids and lipoproteins

71

How can serum [K+] affect BP?

1. High K+: increase BP through RAA system
2. Low K+: increases BP through renin and vasoconstriction