Download Reducing the risk File

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Topic 1.4, Reducing the
risk of CVD
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Risk Factors of CVD
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High blood pressure

Obesity
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High blood cholesterol
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Smoking
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Genetic inheritance
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Inactivity
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High stress
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High alcohol consumption
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High salt intake
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Low antioxidant intake
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Ways to reduce the risk
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Reduce blood pressure
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Stop smoking
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Reduce salt intake
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Lower cholesterol level, mainly LDL-C
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Reducing intake of fat and saturated fat
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Increase physical activity
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Get to a point where waist to hip ratio is under 0.85/0.9, or
BMI is 20-25
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Alcohol in moderation
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Blood Pressure
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Use pages 49 and 50 in the textbook to complete activity
1.25a in the handout packet
Type of How does it reduce BP?
drug
ACE
inhibitors

Angiotensin converting enzyme
inhibitors
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Reduce conversion of inactive
angiotensin I to angiotensin II

Angiotensin II causes
vasoconstriction

Less angiotensin II = less
vasoconstriction = reduced BP
Inactive Angiotensin I
ACE
inhibitor
Angiotensin II
vasoconstriction
Raised
b.p.
Possible side
effects?
Cough
Dizziness
Abnormal
heart beats
 Reduced
kidney
function



Additional
information
Reduces risk
of kidney
failure for
patients with
kidney
disease.
 Some patients
intolerant:
need
alternative,
which affects
receptors.

Block the Ca+2 ion
channels in the muscle
cells lining the arteries
 Ca cannot enter cells and
muscles cannot contract
 Vessels do not constrict =
lower BP

Calcium
channel
blockers
Headaches
Dizziness
Swollen
ankles (fluid
build-up)
 Abnormal
heart rhythms
 Constipation
 Flushing of
skin
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Not given to
people who
have had a
heart attack:
can make
symptoms of
heart failure
worse or
fatal
Diuretic increase the amount of
urine produced
 (opposite effect to ADH: tubules
become less permeable to H2O,
less is reabsorbed, more lost in
urine)
 decrease in blood volume =
reduced BP

Diuretics



dizziness
nausea
cramps
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Blood Cholesterol
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Read pages 50 and 51 and answer Q1.34 and Q1.35.
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Which drug is used as a treatment?
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How do statins work?
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They inhibit an enzyme which produces LDL-C.
Are the drugs effective and how do we know?
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Statins
Yes, large sample size, 14 trials.
Are there any risks?
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Yes, statins might cause other problems such as intestinal and respiratory
cancers.
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British Heart Foundation Gap Fill
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Fill in the gaps and then we will read through it together.
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Diet
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Use the textbook to complete activity 1.25b
Reduced
cholesterol intake
High levels of cholesterol lead to more build up of
plaque and therefore higher risk of CVD
Reduced salt
intake
High levels of salt in the blood cause the kidneys to
retain water. This increases volume of blood which
raises BP. High BP increases risk of atherosclerosis
Energy balance
If calorie intake exceeds expenditure then weight is gained.
BMI over 25 is a risk factor for CHD: BP + cholesterol level
are often higher
High in
polyunsaturated
fatty acids
Increase the activity of LDL receptor sites thus lowering
level of LDLs in the blood and decreases the risk of
atherosclerosis
Low in saturated
fatty acids
LDL cholesterol is composed of cholesterol, proteins, and
fatty acids from saturated fats. Lower levels of saturated
fats therefore decreases levels of LDL-C
5 portions of
fruit +
vegetables per
day
High in antioxidants which reduce the risk of CVD.
Radicals react with LDL cholesterol and make it more
likely to be taken up into foam cells forming plaques.
Antioxidants lower the amount of radicals
Also contain non-starch polysaccharides
Regular
consumption of
oily fish
Regular consumption of omega 3 fatty acids found in fish
such as salmon, mackerel, trout etc has been shown to
reduce the risk of CVD
(seen in Japan and Greenland)
Increase amount
of non-starch
polysaccharides
Also known as soluble fibre. Has been found to bind
with cholesterol in the digestive system, reducing the
amount absorbed.
Found in fruit, veggies, beans, and grains
Include sterols
and stanols
Naturally produced substances found in plants.
Compete with cholesterol for absorption, therefore
reducing the amount absorbed. Artificially added to
certain foods, like margarines.
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Anticoagulants and platelet
inhibitory drugs
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What do these drugs so?
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Give examples and describe how each work:
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Aspirin
 Prevents platelets sticking together forming platelet plug.
Clopidogrel:
 prevents platelets from sticking together forming platelet plug
Warfarin:
 anticoagulant, affects production of clotting factors.
Are there any risks?
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Platelet inhibitory drugs or anticoagulants reduce blood clotting.
These drugs involve a risk of bleeding. This has to be considered in relation to
risk of CVD.
Q 1.36 and 1.37