Objectives
 Identify factors that contribute to heart
disease
 Explain why cholesterol and saturated fats
are limited in...
Cardiovascular Disease
Affects heart and blood vessels.
Leading cause of death and permanent disability
in many countries....
Congestive heart failure occurs when the heart
cannot maintain blood circulation to all body
tissues.
The heart muscle (my...
Arteriosclerosis: arteries become thick and hard
making the passage of blood difficult and
sometimes impossible.
Atheroscl...
Plaque may cause a reduced blood flow beyond the
obstruction; ischemia occurs.
Ischemia may cause pain.
Angina pectoris: C...
Coronary artery bypass graft (CABG): procedure
to bypass circulation around a clogged artery.
Cerebrovascular accident (CV...
* Major:
Hyperlipidemia: (Cholesterol; high LDL, low HDL)
Hypertension
Smoking
* Contributory factors:
Obesity
Diabetes me...
Primary treatment for hyperlipidemia.
Involves reducing the quantity and types of fats
and often kcal in the diet.
America...
American Heart Association recommendations for
prevention:
*Adult diets contain less than 200 mg of
cholesterol per day
*N...
It takes 2 to 3 months to adjust to a low-fat diet.
Change should be made gradually if physician
allows.
Provide client wi...
If appropriate blood lipid levels cannot be attained
within 3 to 6 months by use of fat-restricted diet
alone, the physici...
Caused by blockage of a coronary artery
supplying blood to heart.
Heart tissue beyond blockage dies.
Causes: atheroscleros...
After the attack, the client is in shock.
Fluid shift occurs, and client may be thirsty.
Client should be NPO (nothing by ...
Injury to the heart muscle occurs from
atherosclerosis, high BP, rheumatic fever.
When damage is extreme and the heart can...
• Sodium builds up, and more fluid is retained,
resulting in edema.
• Heart beats faster and enlarges to compensate.
• Dea...
• Diuretics can cause excessive loss of potassium.
• Blood potassium levels should be carefully watched
to prevent hypokal...
Chronically high blood pressure.
Essential, or primary hypertension: 90% of cases;
cause is unknown.
Secondary hypertensio...
• Contributes to heart attack, stroke, heart failure, and
kidney failure.
• “Silent disease” because sufferers can be
asym...
• Sodium and fluid collect in body tissue, causing
edema, extra pressure is placed on the blood vessels.
• Sodium-restrict...
Weight loss
Sodium-restricted diet
Diuretics
When diuretics are given together with a sodium-
restricted diet, the client ...
Impossible to have a diet totally free of sodium.
Meats, fish, poultry, dairy products, and eggs all contain
substantial a...
Most people are accustomed to salt in their food
and transition to sodium-restricted diet may be
difficult.
It will help t...
Most of the cardiac clients will be told they must
reduce the fats, sodium, and sometimes, the
amount of kcal in their die...
Cardiovascular disease represents the
leading cause of death in many countries.
May be acute, as in myocardial infarction,...
L4 diet and cardiovasr disease
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L4 diet and cardiovasr disease

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L4 diet and cardiovasr disease

  1. 1. Objectives  Identify factors that contribute to heart disease  Explain why cholesterol and saturated fats are limited in some cardiovascular conditions  Identify foods to avoid or limit in a cholesterol-controlled diet  Explain why sodium is limited in some cardiovascular conditions  Identify foods that are limited or prohibited in sodium-controlled diets
  2. 2. Cardiovascular Disease Affects heart and blood vessels. Leading cause of death and permanent disability in many countries. Can be acute (sudden) or chronic. Acute: myocardial infarction (MI, heart attack) Chronic: develops over time, loss of heart function Heart may or may not maintain circulation. Heart may beat faster and enlarge to compensate.
  3. 3. Congestive heart failure occurs when the heart cannot maintain blood circulation to all body tissues. The heart muscle (myocardium), the valves, the lining (endocardium), the outer covering (pericardium), or the blood vessels may be affected by heart disease.
  4. 4. Arteriosclerosis: arteries become thick and hard making the passage of blood difficult and sometimes impossible. Atherosclerosis: affects inner lining of arteries where deposits of cholesterol, fats, and other substances accumulate over time, thickening and weakening artery walls. Deposits are called plaque.
  5. 5. Plaque may cause a reduced blood flow beyond the obstruction; ischemia occurs. Ischemia may cause pain. Angina pectoris: Chest pain; may radiate down left arm. If lumen of vessel narrows completely in a coronary artery, a heart attack occurs.
  6. 6. Coronary artery bypass graft (CABG): procedure to bypass circulation around a clogged artery. Cerebrovascular accident (CVA): blood flow to brain is blocked or blood vessel bursts (stroke). Peripheral vascular disease: vessels in extremities affected. Atherosclerosis
  7. 7. * Major: Hyperlipidemia: (Cholesterol; high LDL, low HDL) Hypertension Smoking * Contributory factors: Obesity Diabetes mellitus Male sex Heredity Personality type (ability to handle stress) Age (risk increases with age) Sedentary lifestyle
  8. 8. Primary treatment for hyperlipidemia. Involves reducing the quantity and types of fats and often kcal in the diet. American Heart Association guidelines: blood cholesterol 200 mg/dl or less is desirable 200 to 239 mg/dl is borderline high 240 mg/dl and greater is high
  9. 9. American Heart Association recommendations for prevention: *Adult diets contain less than 200 mg of cholesterol per day *No more than 30% of kcal from fat; maximum of 7% from saturated fats, 8% from polyunsaturated fats, 15% from monounsaturated fats *Proteins 12 to 20% of kcal, and carbohydrates 50 to 55% of kcal
  10. 10. It takes 2 to 3 months to adjust to a low-fat diet. Change should be made gradually if physician allows. Provide client with information about the fat content of foods and methods to prepare it. Encourage client to select whole, fresh foods and to prepare them without addition of fat. Lean meat should be selected and all visible fat removed. Use fat-free milk and fat-free skim cheeses. Gradually introduce 25-35 grams of fiber. Discuss challenges with a dietitian and the M.D.
  11. 11. If appropriate blood lipid levels cannot be attained within 3 to 6 months by use of fat-restricted diet alone, the physician can prescribe a cholesterol- lowering drug. Example: simvastatin (Zocor) Client teaching: Zocor interacts with grapefruit and its juice; total avoidance is necessary.
  12. 12. Caused by blockage of a coronary artery supplying blood to heart. Heart tissue beyond blockage dies. Causes: atherosclerosis, hypertension, abnormal blood clotting, infection such as that caused by rheumatic fever (damages heart valves).
  13. 13. After the attack, the client is in shock. Fluid shift occurs, and client may be thirsty. Client should be NPO (nothing by mouth). IV fluids may be given. After several hours, client may begin to eat. Liquid diet usually recommended first 24 hours. Then, a low-cholesterol, low-sodium diet. Foods should not be extremely hot or cold. Food that is easy to chew and digest prescribed. Percentage of energy nutrients will be based on particular needs of the client. Sodium limited to prevent fluid overload. Restriction on caffeine the first few days after an
  14. 14. Injury to the heart muscle occurs from atherosclerosis, high BP, rheumatic fever. When damage is extreme and the heart cannot provide adequate circulation, the amount of oxygen taken in is insufficient for body needs. Shortness of breath is common and chest pain can occur on exertion. Tissues retain fluid that would normally be carried off by the blood.
  15. 15. • Sodium builds up, and more fluid is retained, resulting in edema. • Heart beats faster and enlarges to compensate. • Death can occur in severe cases. • Body tissues do not receive sufficient amounts of nutrients. • Edema may mask the problems of malnutrition and underweight. • Fluid restriction may be ordered. • Diuretics aid in the excretion of water and sodium, and a sodium-restricted diet typically prescribed.
  16. 16. • Diuretics can cause excessive loss of potassium. • Blood potassium levels should be carefully watched to prevent hypokalemia which can upset the heartbeat. • Fruits, especially oranges, bananas, and prunes are excellent sources of potassium.
  17. 17. Chronically high blood pressure. Essential, or primary hypertension: 90% of cases; cause is unknown. Secondary hypertension: 10% of cases; caused by another condition. Causes of secondary hypertension include kidney disease, problems of the adrenal glands, use of oral contraceptives.
  18. 18. • Contributes to heart attack, stroke, heart failure, and kidney failure. • “Silent disease” because sufferers can be asymptomatic. • Frequency increases with age and is more prevalent among African Americans. • Heredity and obesity. • Smoking and stress. • Weight loss usually lowers blood pressure and, consequently, clients are often placed on weight- reduction diets.
  19. 19. • Sodium and fluid collect in body tissue, causing edema, extra pressure is placed on the blood vessels. • Sodium-restricted diet, often accompanied by diuretics, can be prescribed to alleviate this condition. • Increasing fruits and vegetables to 6 to 10 servings per day helps to lower blood pressure.
  20. 20. Weight loss Sodium-restricted diet Diuretics When diuretics are given together with a sodium- restricted diet, the client may lose potassium via the urine. So, amount of potassium-rich foods in the diet should be increased. Daily intake of sodium be limited to no more than 2,400 mg to avoid edema and hypertension. Food and Nutrition Board recommends . Board set a safe minimum at 500 mg/day for adults.
  21. 21. Impossible to have a diet totally free of sodium. Meats, fish, poultry, dairy products, and eggs all contain substantial amounts of sodium naturally. Cereals, vegetables, fruits, and fats contain small amounts of sodium naturally. Water contains varying amounts of sodium. Many products contain sodium. Some over-the-counter medicines contain sodium. Physician’s permission should be obtained before using any medication or salt substitute.
  22. 22. Most people are accustomed to salt in their food and transition to sodium-restricted diet may be difficult. It will help the client if the reduction in sodium can be gradual. Remind the client of the numerous herbs, spices, and flavorings allowed.
  23. 23. Most of the cardiac clients will be told they must reduce the fats, sodium, and sometimes, the amount of kcal in their diets. Help the cardiac client want to learn how to help himself or herself via nutrition.
  24. 24. Cardiovascular disease represents the leading cause of death in many countries. May be acute, as in myocardial infarction, or chronic, as in hypertension and atherosclerosis. Hypertension may be a symptom of another disease.
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