Cardiovascvular Disease
Terms
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- Five types of Cardiovascular Disease
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Coronary Heart Disease
Congestive Heart Failure
Hypertension
Stroke
Peripheral Artery Disease - Congestive Heart Failure
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Decrease in cardiac output (HRxSV) with consequent decreases in flow to the kidneys (inc. Na and H2O retention
Compensatory mechanisms designed to maintain tissue perfusion. - Right Sided CHF
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Congestion of Peripheral tissue
Edema and Ascites - Left Side CHF
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Pulmonary congestion
Pulmonary edema
MNT 2g Na diet, possible fluid restriction
"Heart Healthy Diet -
Coronary Heart Disease
Types and Causes -
CHD CAD IHD
Major Causes:
- Atherosclerosis
- Hypertension
- Inflammation -
Coronary Heart Disease
Pathophysiology 4 -
Injury to the Cell Wall Due to:
- High LDL Levels
- HTN
- Infection
- Homocysteine
INJURY=INFLAMMATION -
Inflammatory Response
Monocytes - Migrate into vessels stimulated by oxidized LDL, then differentiate into macrophages.
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Inflammatory Response
Macrophages - Produce cytokines, which increase smooth muscle cells (source of inflammation mediators such as CRP)
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Inflammatory Response
Foam Cell - A macrophage that has engulfed a lipid molecule. Which then leads to a fatty streak.
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Inflammatory Response
Atherosclerosis Plaque -
Formed through the hardening of fatty streaks and foam cells.
Causes:
- Blood Clots
- Narrowing of the Vessels -
Inflammatory Response
CRP Highest in? 5 -
Smokers
Obese Patients
Insulin Resistence
Metabolic Syndrome
DM II -
C-Reactive Protein CRP
Levels -
The most useful clinical marker of cardiovascular inflamation
<1mg/ml Low
1-3mg/ml avg
>3mg/ml High - Usefulness of CRP
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Use of CRP levels are at the discretion of the physician
Recommended in patients who present with risk factors in a global assessment. -
Lipoproteins
Levels (LDL HDL TG CHOL.) -
LDL <100 optimal; >160 High
HDL <40 Low; >60 High
TG <150 optimal; >200 High
Cholesterol <200 Desirable - How to Decrease LDL 2
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Decrease saturated fat intake
Lose Weight if overweight - How to Increase HDL 3
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Lose weight if overweight
Stop smoking
Increase Excercise - How Lower TG
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Lose weight if overweight
Increase intake of omega 3 FA
Increase excercise - Risk Factors
- Age, family history, diabetes, established CVD, elevated LDL, smoking, HTN, Low HDL, metabolic Syndrome, sedentary lifestyle.
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ATP Guideline
Sat Fat, Chol, Fiber -
Sat Fat (7%)
Chol: 200mg
Fiber 20-30g and high diet in fruits and vegetables.