Download Summary of Chapter 21 – Nutrition and Disorders of the

Summary of Chapter 21 – Nutrition and Disorders of the Heart and Blood Vessels
Atherosclerosis is characterized by a buildup of plaque on an artery’s wall. Rupture of plaque can lead to thrombosis and obstruction of
blood flow. Atherosclerosis can lead to complications such as angina pectoris, heart attack, stroke, pain while walking, kidney disease,
and aneurysms. Plaque is initiated by factors that damage the artery wall and advanced by rupture of the plaque and blood coagulation.
Factors that cause plaque formation and progression include inflammation, hypertension, smoking, hyperlipidemias, and diabetes.
Long-term CHD management emphasizes risk reduction. Modifiable risk factors include elevated LDL and triglyceride levels, high
blood pressure, cigarette smoking, diabetes, obesity, sedentary lifestyle, and an atherogenic diet. The Therapeutic Lifestyle Changes
(TLC) approach includes dietary and lifestyle modifications that can help to reduce LDL levels and eliminate other risk factors. Dietary
recommendations are to reduce saturated fat, trans fats, and cholesterol; increase soluble fiber; and incorporate plant sterols and stanols
into the diet. Treatment recommendations for mild hypertriglyceridemia emphasize weight control, regular physical activity, smoking
cessation, avoiding a high carbohydrate intake, and restricting alcohol. Severe hypertriglyceridemia may require drug therapies and
dietary fat restriction. Medications given after a heart attack suppress blood clotting and regulate heart rhythm, and patients are initially
offered heart-healthy, soft foods. To reduce the risk of a future heart attack, patients must learn strategies similar to the TLC approach.
Nearly one in three persons in the United States has hypertension, which increases the risk of developing heart disease, heart failure,
stroke, and kidney failure. Blood pressure is elevated by factors that increase blood volume, heart rate, and resistance to blood flow.
Although the underlying cause of most cases of hypertension is unknown, major risk factors include aging, family history, ethnicity,
obesity, and certain dietary choices. Treatment usually includes a combination of lifestyle modifications and drug therapies..
In congestive heart failure, the heart is unable to pump adequate blood to tissues. Consequences may include congestion in the veins,
lungs, and other organs and impaired organ function. CHF is usually a chronic, progressive heart condition that results from other
cardiovascular illnesses. Treatment of CHF includes drug therapies that reduce congestion and strengthen heart function. The main
dietary recommendation is moderate sodium restriction.
The two major types of strokes, ischemic and hemorrhagic stroke, may be a consequence of atherosclerosis, hypertension, or both.
Transient ischemic attacks are short-lived “mini-strokes” and are a warning sign that a more severe stroke may occur. Strokes are largely
preventable by reversing modifiable risk factors, which include hypertension, cigarette smoking, diabetes mellitus, and elevated LDL
cholesterol. Treatment includes the use of anticlotting drugs such as aspirin, antiplatelet drugs, and anticoagulants. A patient who has had
a major stroke may have problems eating normally due to lack of coordination and difficulty swallowing.