Term
|
Definition
Men over 45
women over 55
hypertension 140/90
hyerlipdemia
diabetes
low HDL 40 |
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Term
|
Definition
|
|
Term
| 4 favorable health behaviors |
|
Definition
Non ssmoking less than 25 bmi
Physical activity at goal level
Diet |
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|
Term
|
Definition
Fasting Bg <100
bp 120/80
Cholesterol 200 |
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|
Term
| When does disease risk increase for men and women |
|
Definition
At 102 cm waist, 88cm w/h
>25 , w- h, men- at risk
>30 w-VH, men high
>35 w-VH, men VH
>40 w-ex m-ex |
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Term
| how does visceral fat occur A |
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Definition
| A. Insulin resistance- portal circulation, altered FFA metabolism creates hyperinsulmia hypertriglyerides, glucose intolerance |
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Term
| Visceral fat creation is b |
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Definition
| Release of inflammatory cytokines- insulin resistance, pro inflammatory, pro thrombosis, pro hypersensitive |
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Term
|
Definition
| Lack of dysfunctional subcutaneous fat- ecototopic fat |
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Term
| What are some of the things that affect the artery wall: endothelial dysfunction and leads to atheroschlerosis to which leads to CVD |
|
Definition
| hypertension, hypercholesterolemia, obesity>> (systemic oxidative stress, liver inflammation), diabetes, smoking, liver inflammation>systemic inflammation, |
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Term
| what are some cytokines that are secreted by the adipose tissue and macrophage |
|
Definition
| Il-1, Il-6, TNF-a, Resistan, Prostoglandins, Angiotensiongen, Endothelin, PA-1, CRP |
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Term
|
Definition
| inflammation, obesity, and hypertension |
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Term
| how does water and salt rentention effect renin-angiotension-aldosterone system |
|
Definition
| with increase volume renal perfusion decreases. there is then less renin outupr and angiotensinogen can't be converted to angiotensin 1 which then can't be converted to angiotensin 2 by ace: which has an affect on sympathetic ns, tublular secretion of NA+ Cl reabsorption and K- excretion water retneion inhibits Aldosterone secretion and ADh by the pituitary gland, |
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Term
|
Definition
normal <120/80mmHg
pre hypertension 120-139s/80-89diastolic
stage 1: >140/90
stage 2: 160/100
3: 180/110 |
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Term
| risk factors for untreated risk factors |
|
Definition
| heart disease, stroke, renal disease |
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|
Term
| diagnostic workshop of hypertension |
|
Definition
| assess risk factors and comorbidiits, reveal identifiable causes of hypertension, assess presence of target organ damage, conduct history and physical examination, obtain lab tests, electrocardiogram |
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Term
|
Definition
| blood glucose, urine, hematocritm lipid panal, K, creatine, calcium. albumin/ creatine ratio |
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|
Term
| CVD risk factors with hypertension |
|
Definition
hypertension
obesity
dylipidemia
diabetes, cigerettes, physical inactivity, microalbuminuria, age, family hostoryof CVD |
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Term
| Identifiable cause of hypertension |
|
Definition
| sleep apnea, drug induced, chrnoic kidney disease, primary aldosernism, renovascular disease, cushing syndrom or steroid therapy, thyriod parathyroid |
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|
Term
| mean Arterial blood pressure |
|
Definition
| cardiac output x total peripheral resistance |
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Term
|
Definition
heart rate and stroke volume
symp and spara symp activiy
venous return
blood volume |
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|
Term
| totoal peripheral resistance |
|
Definition
arteriolar radius
blood viscosity |
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|
Term
| without treatment what are some consequences |
|
Definition
| stroke, Blood vessel damage, heart attack or heart failure, kidney failure |
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|
Term
| what can weight loss do for hypertension |
|
Definition
| lowers sympathetic ns activity, stiffness of large conduit arteries, renal sodium excretion, improves small resistnce vessels and periheral resistance,abdominal fat |
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|
Term
| lifestyle modification for cvd and hypertension |
|
Definition
decrease weight, decrease smoking limit alcohol and decrease sodium intake to less that 2.3g/d
maintain intake of potassium, calcium, magnesium
aerobic exercise |
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|
Term
potassium
calcium
magnesium
intake req |
|
Definition
3.5-4.6g
.8-1.2g
.28-.35g |
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|
Term
| average systolic Bp recommendation |
|
Definition
| 5-20mmhg/10kg at BMI 18.5-24.9 |
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|
Term
|
Definition
| dietary approoach to stop hypertension 27% fat 9.6serv f/v, 1.6 serv meats, 2serv low fat dairy, .7 serv nuts |
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|
Term
| what is the results of f/v diet and dash diet |
|
Definition
| dash has an effect on bp and there are intermediate results on f/v diet |
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|
Term
what are the biggest contributers to salt intake
recommemdations |
|
Definition
processed foods, snack items, and table salt
no salt ar table, minimal salt in cooking, avoid highly processed foods, use more fersh foods and foods cooked ar home from scratch |
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|
Term
| how much does meat and meat alternative contribute to sodium, what about mixed dishes? |
|
Definition
|
|
Term
| strategies to lower sodium |
|
Definition
downsize portions: more calories in a meal equals more sodium, skip jump sizing, share a dish when dining out
- fill half your plate with f/v
- nutrition facts
- nutrition information when eating out
- retrain your taste buds
compare products
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|
Term
| what is salt hypertension |
|
Definition
|
|
Term
| what kind of an affect does K have on hypertension |
|
Definition
| higher intake lowers hypertension |
|
|
Term
|
Definition
hyperlipdiemia
decrease blood volume |
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|
Term
|
Definition
reduce peripheral resistance by interferring with the production of angiotensin 11
"pril"
leads to hypertension... |
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|
Term
|
Definition
decrease heart rate and cardiac output
"prolol" |
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|
Term
|
Definition
blocks vascular muscle response, reduces stroke volume
"osin" |
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|
Term
|
Definition
movement of calcium, reduces vasoconstriction
"pine" |
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|
Term
|
Definition
| increases water and sodium excretion |
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|
Term
| Atherolerosis risk factors |
|
Definition
| smoking, diabetes, hypertension, dyslipidemia which causes NO2 to occur |
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Term
|
Definition
| biochemical factors and functional changes, atherosclerotic lesion |
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|
Term
| how does atherosclerosis lesions occur |
|
Definition
| oxLDL causes macrophages to be converted into lipid laden foam cells where they produce a extracellular matrix |
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|
Term
| how do we evalulate plasma lipids and lipoprotiens |
|
Definition
| cholesterol, chol esters, triglyercides, apolipoprotiens, lipid panel ( total chol, HDL TG and LDL) |
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|
Term
| does genes affect hyperlipidemia |
|
Definition
| apoB, LDL recpetor, apo E , apoA, Lp(a) |
|
|
Term
| lipoprotien metabolism cascade |
|
Definition
| dietary lipids> sm I, packages into chylomicrons> cap(LPL)> liver as Chylo remnant> VLVL into cap (LPL) and into IDL back to LDL or Liver or into extrahepatic cell |
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Term
|
Definition
optimal: <100
borderline : 130-159
high: 160-189
very high: 190 |
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|
Term
|
Definition
<200 desireable
200-239 borderline
>240 High |
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|
Term
|
Definition
|
|
Term
|
Definition
<150 normal
150-199 borderline high
200-499 high
500 very high |
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|
Term
| Summary of ATP guidelines |
|
Definition
1.determine lipoprotien levels, 2.idenitfy presence of clinical atherosclerosis disease
3. major risk factors:smoking, hypertension, family history...
4. assess 10 yr plan if 2+ risk factors
step 5: determine risk category: implement plans |
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Term
|
Definition
primary: reduction of LDL cholestorl level
Secondary: diagnosis and reduction of underlying causes of the metabolic syndrom : abdominal obesity, TG, HDL, Insulin, HTN |
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|
Term
| how are treament goals achieved |
|
Definition
1.medical nutrition managment
2.drug therapy |
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|
Term
If a patients had CHD what is the LDL goal and drug therapy req.
when >2 CHD risk factors
when < 2 CHD risk |
|
Definition
<100
initiate drug therapy LDL chol >130
<130mg
drug @ LDL >160
<160mgLDL chol
LDL chol >190
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|
Term
| Major class of anti hyperlipidemic medications |
|
Definition
Bile acid sequestrants(cholestyramine)
Nicotinic acid
HMg reductase inhibitors
Fibirc Acid derivitives
Cholesterol Absorption inhibitors (zetia) |
|
|
Term
| what do bole acid sequenstrants do to metabolism |
|
Definition
| binds BA and Gi complaints |
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Term
|
Definition
| low VLDL and then flushing, ^ uric acid , hyperglycemia |
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|
Term
| HMG coA reductase inhibitors |
|
Definition
| hepatic dysfunction, GI upset |
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Term
|
Definition
lowers VLDl prodcution by the liver and highers LPl synthesis.
Gi upset, hepatic dysfunction |
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|
Term
| Cholestorl Absorption inhbitors ( Zetia) |
|
Definition
| Selectivity hinhibits choletorol absroption from gut |
|
|
Term
| what are the three different diets for hyperlipidemia? |
|
Definition
|
|
Term
| what can increase the production of less inflammatory products and decrease pro inflammatory |
|
Definition
|
|
Term
| what can soluble fiber mechanism of action |
|
Definition
binds bile salts in GI
cholesterol removed from serum for bile synthesis n an effort to resotre bile acid pool
promotes synthesis of short chain fatty acids via fermentiaon in thecolin
lower fat diets usually |
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|
Term
| soluble fiber recommendations |
|
Definition
| legumes beans peas oatmeal cereal grains and fuits |
|
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Term
|
Definition
| lower absorption of cholestorol from gut , dietary choleserol and bilary cholesterol |
|
|
Term
| what are some food recommendations for CVD? |
|
Definition
limit sat fats, consume fish twice a week, f/v, little salt, minimize sofas
less than 200mg daily- cholestrol
less than 7% st fat
moderatly increase mono and poly unsaturated fat
avoud trans fats
DASH
Mediterranean diet
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|
|
Term
|
Definition
6-8 serv bread,
4-5 serv v/f
milk- low fat 2-3
lean meats, fish and poultry 6 or less
nuts seeds and legumes 4-5 wk
fats and oils 2-3serv
sweets and added sugars 5 or less |
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|
Term
mediterranean diet
does what |
|
Definition
decrease in cellular and circulating inflammatory biomarkers
apolipo protiens
reduced diabetes |
|
|
Term
|
Definition
| creatine phosphokinase enzyme released from damaged/ necrotic cells |
|
|
Term
|
Definition
limit caffiene
liquid diet in some cases
low cholesterol
sodium levels |
|
|
Term
| surgeries fro Coronary arteries |
|
Definition
coronoary artery bypass graft
angioplasty |
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|
Term
congestive heart failure
symptoms |
|
Definition
long term complication os MI, blood cannot be pumped efficiently due to damage cardiac muscle
low kidney >renin>>Na/fluid reabsorption can result in edema. cannot return blood to the heart from lungs
weakness, cough, SOB, arrythmias |
|
|
Term
|
Definition
Na restriction 1-2g/d- fluid restriction
diuretic and digitalis, may need more K |
|
|
Term
| what is the typical rehab program |
|
Definition
| diet-TLC, exercise, stress management, medical supervision, 4 month program |
|
|
Term
| cornoary reversal program |
|
Definition
diet: strict TLC, vegetarian with non-fat dairy egg white low fat and cholesterol
exercise with stress management
medical superviosn
2yr |
|
|
Term
| metabolic dysregulation is from |
|
Definition
| over-nutrition, genetics, inactivity |
|
|
Term
| what does metabolic dysregulation lead to |
|
Definition
insulin resistance inflammation,
diabetes, hypertension, certain cancers, ASCVD, Dyslipidemia, alzhimers |
|
|
Term
|
Definition
lifestyle change - weeight reduction, increased pa
drug therapy: statin for dyslipidemia, hypoglycemic agents to bring hb A1c to guildline target and medications to reduce hypertension |
|
|
Term
|
Definition
0-12mo 2,000
Childern and adults 2500L
51-70 3000UL
>70 4000UL |
|
|
Term
|
Definition
Fatty fish
eggs fortified milk, endogenous |
|
|
Term
| what is the pathway of Vit D |
|
Definition
intake> 25 (OH)D via 25 hydroxylase
> 1 ,25 diOH D via 1a-hydroxylase |
|
|
Term
| what is the effects of 1,25 Oh D attaching to VDR |
|
Definition
| causes transcription ffactors fro calcitropis effects, immunomodulatory effects, antiproliferative effect and pregnancy related effects |
|
|
Term
| what are some effects of active Vit D |
|
Definition
| calcium, phosphorus hometostasis, neuromusclar effects, immunomodulatory , cardiovascular, growth and regualtion |
|
|
Term
| what is low levels of active vit D associated with |
|
Definition
| increased risk of diabetes, obesity, hypertension, CVD MI or stroke, bacterial diseases, cancer-colon |
|
|
Term
| evidence for obesity/diabetes |
|
Definition
| observational studies- in vitro- animal models |
|
|
Term
|
Definition
no sig difference in weight loss
increase in insulin sensitivity |
|
|
Term
|
Definition
observational study- equator study
decrease in serum 25 : increase in hypertension
Animal studies: Vit D > thrombogenesis
VitD supp> improved glucose tolerance, reduced inflammatory components
RTC - no sig
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|
|
Term
| what does Vit D do to renin and angiotensinogen and what is the ultimate effect |
|
Definition
| inhibits renin and angiotensin and therefore no vasocontriction and so bp can remain low |
|
|
Term
|
Definition
helps with tuberculosis and psoriasis
helps drive the VDR to increase T-cell profliferatio by lowering the Th1 response |
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