CARDIOVASCULAR

DISEASES
CARDIOVASCULAR DISEASES
 General term describing diseases of
the heart and blood vessels

 Include hypertensive disease,

cerebrovascular disease, and
atherosclerotic disease

Source:
https://www.ncbi.nlm.nih.gov
RISK FACTORS FOR CVD
1. Modifiable – smoking, high LDL,
hypertension, physical inactivity,
obesity and DM

2. Non-modifiable – age, genetics, and

gender
1. ATHEROSCLEROSIS
 “hardening of the arteries” due to
accumulation of plaques (vulnerable)
DIET RATIONALE
Calorie, low if obese To attain DBW, reduce
synthesis of fats
Total fat, not more than To correct ratio of HDL, LDL
30% of TER
SFA, approx. 10% of TER To reduce cholesterol
PUFA, approx. 10% of TER formation and deposition in
the arteries
Omega-3 Platelet disaggregators
Omega-6 Arterial dilatations and
cardiac contractility
MUFA To increase HDL level
Cholesterol, 300mg To reduce cholesterol
synthesis
Carbohydrates, controlled In hyperlipidemia
Sodium controlled To control BP
2. CORONARY HEART DISEASE
 Characterized by impaired blood flow
through the coronary arteries, which
may lead to angina, heart attack, or
sudden death.

 Risk: 49% for men; 32 % for women

 STANDARD FOR CHD RISK
ASSESSMENT
CLINICAL DESIRABLE BORDERLI HIGH RISK
MEASURES NE RISK
Total blood <200 200 – 239 > 240
cholesterol
(mg/dL)
LDL (mg/dL) < 100 130 – 159 160 – 189
HDL (mg/dL) > 60 40 – 59 < 40
Triglycerides, < 150 150 – 199 200 – 499
fasting (mg/dL)
BMI 18.5 – 24.9 25 – 29.9 > 30
Blood Pressure <120 / 120 – 139 / > 140 / > 90
<180 80 - 89
REDUCING RISK OF CHD WITH
THERAPEUTIC LIFESTYLE
CHANGES
 DIETARY STRATEGIES:
• Limit saturated fats to less than
7%of total kcal and cholesterol to
less than 200 mg per day.

• Replace saturated fats with

carbohydrates from whole grains,
legumes, fruits, and vegetables or
with unsaturated fats from fish,
vegetable oils, and nuts
 Saturated fats sources:
• Bacon
• Butter
• Chocolate
• Coconut
• Cream cheese
• Lard
 TRANS-FATS
• Fried foods (hydrogenated shortening)
• Margarine (hydrogenated or partially
hydrogenated)
• Non-dairy creamers
• Many fast foods
• Shortening
• Commercial baked goods (doughnuts, cookies,
cakes)
• Many snack food ( microwave popcorn, chips,
crackers)
MUFA OMEGA-6 PUFA OMEGA-3 PUFA
Avocado Margarine Fatty fish (salmon,
(nonhydrogenated tuna, mackerel)
)
Oils (canola, olive, Oils ( corn, Nuts (walnuts)
sesame, peanut cottonseed,
oil) safflower,
soybean)
Nuts (almonds, Nuts (walnuts)
cashews,
hazelnuts,
macadamia,
peanuts,
pistachios)
Olives Mayonnaise
Peanut butter Salad dressing
Sesame seeds Seeds (pumpkin,
REDUCING RISK OFCHD WITH
THERAPEUTIC LIFESTYLE
CHANGES
• Avoid food products that contain
trans-fatty acids.
• Choose food high in fiber, including
oats, barley, beans, and fruit.
• Regularly consume food products
that contain added plant sterols.
• To reduce BP, choose a diet high in
fruits and vegetables, low-fat milk
products, nuts, and whole grains.
REDUCING RISK OFCHD WITH
THERAPEUTIC LIFESTYLE
CHANGES
• Limit sodium intake to 2400 mg per
day
• If alcohol is consumed, it should be
limited to 1 drink daily for women
and 2 drinks daily for men
 1 drink = 12 ounces beer or,
= 5 ounces of wine or,
= 10 ounces of wine cooler or,
= 1 ½ ounces of 80 proof
distilled spirits such as gin, rum,
REDUCING RISK OFCHD WITH
THERAPEUTIC LIFESTYLE
CHANGES
 LIFESTYLE CHOICES:
• Physical activity: At least 30 minutes of
moderate-intensity endurance activity on
most days of the week
• Smoking cessation

 WEIGHT REDUCTION:
• Weight management program may improve
CHD risk factors
2. HYPERTENSION
 High blood pressure

 weakens the heart muscle and

increases the risk of developing heart
arrythmias, heart failure, and even
sudden death
2. HYPERTENSION
SYSTOLIC DIASTOLIC

Desirable BP < 120 < 80

(mmHg)
Prehypertensio 120 – 139 80 – 89
n
Hypertension > 140 > 90
2. HYPERTENSION
 FACTORS THAT CONTRIBUTE:
• Aging – HPN increases with age
• Genetic factors – risk of hypertension
among family members
• Obesity – 60% of people with HPN are obese
• Salt-sensitivity
• Alcohol – 3 or more drinks daily is
associated with HPN
• Dietary factors – intake of potassium,
calcium, and magnesium reduces blood
pressure
 TREATMENT OF HYPERTENSION
Modification Recommendation Expected
Reduction in
Systolic Blood
Pressure
Weight reduction Maintain healthy body 5 – 20 mmHg/ 10
weight (BMI below 25) kgs lost
DASH eating plan Adopt a diet rich in fruits, 8 – 14 mmHg
veg, and low-fat milk
products with reduced
saturated fat intake
Sodium restriction Reduce dietary sodium 2 – 8 mmHg
intake to less than 2400
mg (less than 6g salt per
day)
Physical Activity Perform aerobic exercises 4-9 mmHg
for atleat 30 mins/day
Moderate Alcohol Men: Limit to 2 2 – 4 mmHg
consumption drinks/day
HEART FAILURE
 Also called congestive heart failure

 Characterized by the heart’s inability

to pump adequate blood to meet the
metabolic needs of the body,
resulting in the buildup of fluids in
the veins and tissue
 Causes:
1. Coronary artery disease
2. High blood pressure (hypertension)
3. Congenital Heart Defects
4. Heart Arrhythmias
 HEART FAILURE
 Symptoms:
• Shortness of breath (dyspnea)
• Fatigue and weakness
• Swelling (edema) in your legs, ankles and feet
• Rapid or irregular heartbeat
• Reduced ability to exercise
• Persistent cough or wheezing with white or pink
blood-tinged phlegm
• Increased need to urinate at night
• Swelling of your abdomen (ascites)
• Sudden weight gain from fluid retention
• Lack of appetite and nausea
 The best way to prevent heart failure
is to control conditions that cause
heart failure, such as coronary artery
disease, high blood pressure,
diabetes or obesity.
 Dietary Management:
• Moderate sodium restriction of 2000 mg or
less daily
• Small frequent meal
• Maintain an adequate fiber
• Avoid alcohol
MYOCARDIAL INFARCTION (MI)
 Heart attack, death of a cardiac
cell/tissue due to inadequate blood
supply

 Causes: stress, age

 MYOCARDIAL INFARCTION (MI)
INITIAL PHASE REHABILITATIVE
PHASE
IVF Low fat
Progressive diets Low cholesterol
from liquid to
regular
Low kcal to normal SFF
intake
Low Na Stimulants,
restricted
CEREBROVASCULAR ACCIDENT
(CVA)
 Disruption of blood supply to the
brain due to blockage or rupture
of the blood vessels

 Causes: hypertension, high salt

intake, and atherosclerosis
 Ischemic Stroke
• occurs when a clot or a mass clogs
a blood vessel, cutting off the blood
flow to brain cells.
• underlying condition for this type of
obstruction is the development of
fatty deposits lining the vessel walls
(atherosclerosis)
 Hemorrhagic Stroke 
• results from a weakened vessel that
ruptures and bleeds into the surrounding
brain. 
CEREBROVASCULAR ACCIDENT
 DIETARY MANAGEMENT:
• Adjust the diet based on the ability of the
patient to process food
• If oral diet, follow the same diet as MI