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Questions and Answers
How do Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve symptoms?
How do Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve symptoms?
By reducing extra fluid in the body
Which of the following are examples of Diuretics? (Select all that apply)
Which of the following are examples of Diuretics? (Select all that apply)
What is Cardiac Cachexia?
What is Cardiac Cachexia?
Severe body weight, muscle, and fat loss
Cardiac Cachexia can lead to the loss of lean body mass.
Cardiac Cachexia can lead to the loss of lean body mass.
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What is the mortality rate associated with Cardiac Cachexia in 18 months?
What is the mortality rate associated with Cardiac Cachexia in 18 months?
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What type of fats are considered better than saturated fats for decreasing cardiovascular risk?
What type of fats are considered better than saturated fats for decreasing cardiovascular risk?
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What is the recommended maximum number of eggs per week for those with existing elevated LDL cholesterol or T2DM?
What is the recommended maximum number of eggs per week for those with existing elevated LDL cholesterol or T2DM?
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Reduced fat dairy products are recommended for those with existing elevated cholesterol and those with existing CHD.
Reduced fat dairy products are recommended for those with existing elevated cholesterol and those with existing CHD.
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Phytosterols are useful for people with a high absolute risk of CVD, such as familial hypercholesterolemia. The recommended daily intake is 2-3g to reduce LDL by approximately ________.
Phytosterols are useful for people with a high absolute risk of CVD, such as familial hypercholesterolemia. The recommended daily intake is 2-3g to reduce LDL by approximately ________.
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Match the lipid-lowering drug with its examples:
Match the lipid-lowering drug with its examples:
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What are the 3 main topics related to cardiovascular disease discussed in the content?
What are the 3 main topics related to cardiovascular disease discussed in the content?
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What are some possible causes of atherosclerosis mentioned in the content?
What are some possible causes of atherosclerosis mentioned in the content?
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A low level of HDL cholesterol is a less powerful risk factor for coronary heart disease (CHD) than a high level of LDL cholesterol.
A low level of HDL cholesterol is a less powerful risk factor for coronary heart disease (CHD) than a high level of LDL cholesterol.
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What are some health problems that can result from chronic high blood pressure?
What are some health problems that can result from chronic high blood pressure?
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Total cholesterol is a poor indicator of CVD risk and consists of both LDL and HDL. Ratios of __ help to predict risk.
Total cholesterol is a poor indicator of CVD risk and consists of both LDL and HDL. Ratios of __ help to predict risk.
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Which lifestyle factor is NOT listed as a risk factor for hypertension?
Which lifestyle factor is NOT listed as a risk factor for hypertension?
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Match the following lipid levels with the recommended values for individuals at high risk:
Match the following lipid levels with the recommended values for individuals at high risk:
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Salt restrictions may be necessary for individuals with heart failure.
Salt restrictions may be necessary for individuals with heart failure.
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What is the primary role of C-reactive protein (CRP) in the context of cardiovascular disease?
What is the primary role of C-reactive protein (CRP) in the context of cardiovascular disease?
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What are the 5 heart healthy eating principles mentioned in the content?
What are the 5 heart healthy eating principles mentioned in the content?
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______ intake moderately affects blood pressure in the general population.
______ intake moderately affects blood pressure in the general population.
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Match the type of heart failure with its description:
Match the type of heart failure with its description:
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What organ damage can hypertension cause besides the heart?
What organ damage can hypertension cause besides the heart?
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Which lifestyle modification is more effective in lowering blood pressure than salt restriction?
Which lifestyle modification is more effective in lowering blood pressure than salt restriction?
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Heart failure can affect both sides of the heart equally.
Heart failure can affect both sides of the heart equally.
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Study Notes
Cardiovascular Disease
- Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels.
- Three main topics of CVD: high cholesterol, high blood pressure, and heart failure.
Physiology of Arteries
- Arteries carry oxygenated blood from the heart to the body.
- Arteries have three layers: outer layer (connective tissue), middle layer (smooth muscle), and inner layer (endothelial cells).
- Arteries can become blocked, leading to various cardiovascular diseases.
Atherosclerosis
- Atherosclerosis is the accumulation of plaque within the artery wall, leading to narrowing and blockage of arteries.
- Plaque is made up of cholesterol, fatty substances, cellular waste products, calcium, and fibrin.
- Atherosclerosis can lead to restriction of blood flow to organs and tissues, and plaque breaking off and causing blockages elsewhere.
Types of Atherosclerosis
- Coronary arteries: affects the heart, leading to angina or heart attack.
- Cerebral arteries: affects the brain, leading to stroke or transient ischaemic attack (TIA).
- Peripheral arteries: affects arms and legs, leading to intermittent claudication or limb ischaemia.
Risk Factors
- 99% of Australian adults have at least one CVD risk factor.
- Risk factors include:
- Abdominal obesity
- Diabetes
- Smoking
- Inactivity
- Dyslipidaemia
- Hypertension
- Diet quality
- Family history
- Multiple risk factors have a cumulative effect on risk.
Metabolic Syndrome
- Metabolic syndrome is a collection of conditions that increase the risk of heart attack, stroke, and diabetes.
- Conditions include:
- Hypertension
- High blood glucose
- Insulin resistance
- Abdominal obesity
- Dyslipidaemia
Cholesterol
- Cholesterol is a waxy, fat-like substance necessary for hormones, vitamin D, and digestion.
- Total cholesterol is made up of LDL, HDL, triglycerides, and total serum cholesterol concentration.
- LDL cholesterol is atherogenic (promotes fatty deposits), while HDL cholesterol is anti-atherogenic (protects against fatty deposits).
Inflammatory Markers
- 50% of heart attacks occur in individuals with normal serum cholesterol.
- Inflammatory markers include C-reactive protein (CRP) and homocysteine.
- Elevated levels of homocysteine are indicative of cardiovascular disease, but the causal relationship is unclear.
Nutrition Diagnosis
- Excessive mineral intake (sodium)
- Less than optimal intake of fats (saturated fat)
- Excessive fat intake
- Food and nutrition knowledge deficit
Treatment/Management
- Determine the level of risk
- Diet and lifestyle change
- Drug therapy
- Surgery
Australian Guidelines
- National Heart Foundation: Position Statements (2019)
- Dietary Position Statement: Heart Healthy Eating Patterns
- Five heart-healthy eating principles:
- Plenty of vegetables, fruits, and whole grains
- A variety of healthy protein sources
- Unflavoured milk, yoghurt, and cheese
- Healthy fats
- Herbs and spices to flavour foods instead of salt### Cardiac Rehabilitation
- Implemented to assist in recovery following a cardiac event
- Plays an important role in recovery and secondary prevention of CVD
- Exercise, education sessions, and nutrition education programs
- The Heart Foundation strongly recommends that all Australians who experience a heart event are referred to and attend a cardiac rehabilitation program
Hypertension
- Chronic high blood pressure
- Can lead to CHD, stroke, heart failure, kidney failure, and other health problems
- Often has little to no symptoms, but can cause damage to organs such as the heart, brain, kidneys, and eyes
- Risk factors include age, genetics, ethnicity, overweight/obesity, chronic conditions, sedentary lifestyle, diet quality, medications, excessive alcohol intake, and smoking
Treatment of Hypertension
- Diet modification, including reducing sodium intake
- Weight loss
- Physical activity
- Medication
- Treating underlying disorders
- Stress management
Heart Functions
- The heart has four chambers: two upper chambers (atria) and two lower chambers (ventricles)
- The heart pumps blood through a sequence of highly organized contractions
- The heart receives oxygen-depleted blood and sends it to the lungs to become oxygenated, then pumps oxygen-rich blood to the rest of the body
Heart Failure
- Chronic, progressive condition where the heart is unable to pump enough blood to meet the body's needs
- Can involve either or both sides of the heart, but usually affects the left side first
- Classified as systolic failure (heart cannot pump or eject blood efficiently) or diastolic failure (heart cannot fill with blood as it should)
Symptoms of Heart Failure
- Typical symptoms: dyspnoea (difficulty breathing), fatigue, orthopnoea (shortness of breath when lying down), paroxysmal nocturnal dyspnoea (shortness of breath during sleep)
- Less typical symptoms: nocturnal cough, wheeze, abdominal bloating, anorexia, confusion, depression, palpitations, dizziness, syncope (feeling faint), bendopnoea (leaning forward)
Causes of Heart Failure
- Most common causes: heart attack and coronary heart disease
- Other causes: aging, chronic conditions, damage to the heart muscle, faulty heart valves, heart rhythm problems, genetic heart conditions, inflammation of the heart muscle, pregnancy
Arrhythmias
- Irregular heart rhythms
- Tachycardia: heart rate over 100 beats per minute
- Bradycardia: heart rate less than 60 beats per minute
- Atrial fibrillation: irregular, rapid heart rhythm that can lead to blood clots in the heart
Classification of Heart Failure
- Ejection fraction measures the amount of blood the heart pumps out with each beat
- Heart failure classified as reduced ejection fraction (HFrEF/systolic HF) or preserved ejection fraction (HFpEF/diastolic HF)
CoQ10
- Present in food, but quantities are thought to be insufficient to affect HF incidence or progression
- CoQ10 deficiency correlates with the severity of HF symptoms and the degree of LV dysfunction and is associated with mortality in HF
- Evidence for CoQ10 supplementation is stronger than that for other supplements, but the level of evidence is still moderate due to the relatively small size of the study
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Description
This quiz covers three main topics related to cardiovascular disease, including high cholesterol, high blood pressure, and heart failure. It is part of Clinical Nutrition 1, course NUDI3220.
