🍎Medical Nutrition Therapy I Unit 6 – Cardiovascular Disease: Atherosclerosis & HTN

What's the Deal with Cardiovascular Disease?

• Leading cause of death worldwide responsible for about 31% of all deaths
• Umbrella term encompasses various disorders of the heart and blood vessels
  • Includes coronary artery disease, heart failure, arrhythmias, and more
• Risk factors involve modifiable lifestyle choices (diet, physical activity) and non-modifiable factors (age, genetics)
• Atherosclerosis and hypertension are two key processes contributing to cardiovascular disease development
• Symptoms can include chest pain, shortness of breath, fatigue, and lightheadedness
• Prevention and management involve a combination of lifestyle modifications, medications, and sometimes surgical interventions
• Early detection and treatment are crucial for improving outcomes and quality of life

Atherosclerosis: The Artery Clogger

• Progressive condition characterized by the buildup of plaque in the arterial walls
• Plaque consists of cholesterol, fatty substances, cellular waste products, calcium, and fibrin
• Narrowing and hardening of the arteries reduces blood flow and oxygen delivery to tissues
• Can affect arteries throughout the body, most commonly in the heart, brain, legs, and kidneys
• Endothelial dysfunction is an early step in atherosclerosis development
  • Involves damage to the inner lining of blood vessels
• Inflammatory processes play a central role in plaque formation and progression
• Advanced plaques can rupture, leading to blood clot formation and potentially heart attack or stroke

Hypertension: When Your Blood's Under Pressure

• Persistently elevated blood pressure in the arteries
  • Systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 80 mmHg
• Primary (essential) hypertension has no identifiable cause and accounts for 90-95% of cases
• Secondary hypertension results from an underlying condition (kidney disease, sleep apnea, thyroid disorders)
• Often asymptomatic, earning the nickname "silent killer"
• Uncontrolled hypertension can lead to damage in various organs and increase the risk of heart disease, stroke, and kidney failure
• Lifestyle factors (high sodium intake, obesity, physical inactivity) contribute to hypertension development
• Treatment involves a combination of lifestyle modifications and antihypertensive medications

How Diet Plays a Role

• Dietary choices significantly impact cardiovascular health and disease risk
• High intake of saturated and trans fats raises LDL cholesterol levels, promoting atherosclerosis
• Excessive sodium consumption contributes to hypertension by increasing water retention and blood volume
• Inadequate intake of fruits, vegetables, and whole grains reduces consumption of beneficial nutrients (fiber, antioxidants, potassium)
• Overconsumption of added sugars and refined carbohydrates can lead to obesity, insulin resistance, and inflammation
• Moderate alcohol consumption may have cardioprotective effects, but excessive intake increases disease risk
• Specific dietary patterns (Mediterranean, DASH) have been associated with reduced cardiovascular disease risk
  • Emphasize fruits, vegetables, whole grains, lean proteins, and healthy fats

Nutrition Therapy: Food as Medicine

• Nutrition therapy plays a crucial role in the prevention and management of cardiovascular disease
• Registered dietitians work with patients to develop personalized nutrition plans
• Therapeutic Lifestyle Changes (TLC) diet is often recommended for lowering LDL cholesterol
  • Limits saturated fats to <7% and total fat to 25-35% of total calories
• DASH (Dietary Approaches to Stop Hypertension) diet is effective for blood pressure reduction
  • Emphasizes fruits, vegetables, low-fat dairy, whole grains, and lean proteins
• Nutritional strategies focus on achieving and maintaining a healthy body weight
• Increasing intake of soluble fiber (oats, legumes) can help lower LDL cholesterol
• Incorporating plant-based proteins (soy, nuts) and omega-3 fatty acids (fatty fish) provides cardioprotective benefits

Lifestyle Changes That Make a Difference

• Regular physical activity (150 minutes/week of moderate-intensity exercise) improves cardiovascular health
  • Helps with weight management, blood pressure control, and lipid profile improvements
• Smoking cessation is crucial, as smoking is a major risk factor for cardiovascular disease
• Stress management techniques (meditation, deep breathing) can help reduce blood pressure and improve overall well-being
• Adequate sleep (7-9 hours/night) is essential for maintaining a healthy cardiovascular system
• Limiting alcohol consumption to moderate amounts (1 drink/day for women, 2 drinks/day for men) can reduce disease risk
• Regular monitoring of blood pressure, cholesterol levels, and blood glucose is important for early detection and management
• Making sustainable lifestyle changes often requires support from healthcare professionals, family, and friends

Meds and Other Treatments

• Medications play a crucial role in managing cardiovascular disease risk factors
• Statins are commonly prescribed to lower LDL cholesterol levels by inhibiting HMG-CoA reductase
• Antihypertensive medications (ACE inhibitors, beta-blockers, diuretics) help control blood pressure
• Antiplatelet drugs (aspirin) reduce the risk of blood clot formation and cardiovascular events
• Surgical interventions may be necessary for severe cases or acute events
  • Angioplasty and stenting can open blocked arteries and restore blood flow
  • Coronary artery bypass grafting (CABG) creates new routes for blood to flow around blocked arteries
• Cardiac rehabilitation programs provide comprehensive support for patients recovering from cardiovascular events
• Implantable devices (pacemakers, defibrillators) can help manage arrhythmias and prevent sudden cardiac death

Putting It All Together: Case Studies

• Case 1: 45-year-old male with hypertension and high LDL cholesterol
  • Implement DASH diet, increase physical activity, and start statin therapy
  • Monitor blood pressure and lipid levels regularly
• Case 2: 60-year-old female with a history of myocardial infarction
  • Enroll in cardiac rehabilitation program, focusing on exercise and nutrition education
  • Prescribe beta-blocker, ACE inhibitor, and aspirin for secondary prevention
• Case 3: 55-year-old male with obesity and prediabetes
  • Develop a weight loss plan incorporating a calorie-restricted diet and regular exercise
  • Provide education on portion control and healthy food choices
  • Monitor blood glucose levels and consider metformin if lifestyle changes are insufficient
• Case 4: 70-year-old female with peripheral artery disease and claudication
  • Encourage supervised exercise program to improve walking distance and reduce symptoms
  • Prescribe cilostazol to improve blood flow and manage symptoms
  • Address any additional cardiovascular risk factors (hypertension, dyslipidemia)