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    Cardiovascular disease is the leading cause of death globally, accounting for nearly 30% of deaths. Hypertension is a major risk factor for CVD and its prevalence in Malaysia has increased from 32.9% to 40.5% in those over 30 years old from 1996 to 2004. Lifestyle modifications like following the DASH diet, reducing sodium intake, increasing physical activity, and avoiding smoking can help prevent and control hypertension. Treatment involves making dietary changes and potentially using medications like beta-blockers or ACE inhibitors.

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    Cardiovascular Disease

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    CVD

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    Cardiovascular disease is the leading cause of death globally, accounting for nearly 30% of deaths. Hypertension is a major risk factor for CVD and its prevalence in Malaysia has increased from 32.9% to 40.5% in those over 30 years old from 1996 to 2004. Lifestyle modifications like following the DASH diet, reducing sodium intake, increasing physical activity, and avoiding smoking can help prevent and control hypertension. Treatment involves making dietary changes and potentially using medications like beta-blockers or ACE inhibitors.

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    33 views35 pages

    Cardiovascular Disease

    Uploaded by

    sang
    Cardiovascular disease is the leading cause of death globally, accounting for nearly 30% of deaths. Hypertension is a major risk factor for CVD and its prevalence in Malaysia has increased from 32.9% to 40.5% in those over 30 years old from 1996 to 2004. Lifestyle modifications like following the DASH diet, reducing sodium intake, increasing physical activity, and avoiding smoking can help prevent and control hypertension. Treatment involves making dietary changes and potentially using medications like beta-blockers or ACE inhibitors.

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    © All Rights Reserved
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    of 35

    Cardiovascular Disease

    • CVD has been the leading cause of death in the


    world
    • CVD now accounts for nearly 30% of deaths
    globally.
    • CVD kills almost as many people yearly as the
    next seven causes of death combined.
    • For the last 10 years, CVD has been the leading
    cause of death in Malaysia
    Prevalence of Hypt in Malaysia
    • ≥30 years old has increased from 32.9% in 1996
    to 40.5% in 2004.
    • Prevalence > in males than females
    • Treatment, control and prevention is low
    NHMS 2015
    • Overall % = 30.3% (done among 16,017 adults in
    Malaysia)
    • Rises with age (highest at 75.4% among 74-75
    yrs old)
    • Rural (33.5%) higher than Urban (29.3%)
    Hypertension
    • Persistently high arterial blood pressure, defined
    as systolic blood pressure above 140 mm Hg
    and/or diastolic blood pressure above 90 mm
    Hg

    • Hypertension is an independent risk factor for


    both CHD and stroke

    • Hypertension frequently coexists with other


    cardiovascular risk factors, including obesity,
    dyslipidemia, insulin resistance ,and glucose
    intolerance.
    Classification Pressure for Adults Ages
    18 Years and Older of Blood
    Risk Factors for Developing
    Hypertension

    • Aging
    • Genetics (Family history)
    • Obesity
    • Ethnicity – African American, South Asians
    • Salt intake
    • High alcohol consumption
    Treatment of Hypertension
    • Diet and lifestyle changes should be the first
    line of therapy for hypertension. (JNC 7 report,
    2003)

    • Medication : Beta-Blockers, ACE inhibitors –


    interferes with conversion of angiotensin I to II,
    Diuretics – blood volume
    Lifestyle modification
    DASH Diet
    • Works within 14 days
    • Lowers BP quite well
    • Includes more potassium, calcium,
    other nutrients
    DASH Diet

    • Pattern
    —7-8 whole grains
    —4-5 vegetables
    —4-5 fruits
    —2-3 low-fat or fat-free dairy products
    —6 oz or less meat/poultry/fish
    —4-5 servings nuts, beans, or legumes/week
    —2-3 servings fat (total kcal = 27% fat)
    Salt Content & Substitutes
    • Composition: KCl, CaCl, Al-Cl
    • KCl can provide extra potassium for those taking
    diuretics
    • KCl can be harmful if patient has renal insufficiency
    • “Lite” salt contains sodium
    • Some spices and herbs are low in sodium
    • Foods that contribute the most sodium to the diet
    are canned, smoked, and processed foods, including
    frozen and prepared dinners, deli meats, and fast
    food
    Reduction of Sodium
    • Avoid fast foods
    • High sodium = pickled, cured, soy sauce, broth
    • Fresh, unprocessed foods
    • Avoid snack foods, processed meat, processed
    fish, tomato based products, canned soups,
    cheese, bakery products, sauces
    • Use more spices and herbs
    Lifestyle Modifications for Prevention
    of Hypertension
    Risk Factors for Atherosclerosis
    • Etiology - risk factors; additive effect
    ▫ Family history
    ▫ Age and sex
    ▫ Obesity
    ▫ Dyslipidemia
    ▫ Hypertension
    • Etiology - risk factors cont.
    ▫ Physical inactivity
    ▫ Atherogenic diet (↑ SF, ↓ fiber)
    ▫ Diabetes mellitus
    ▫ Impaired fasting glucose/ metabolic syndrome
    ▫ Cigarette smoke
    Blood lipid levels
    Easy memory tips:
    Process
    • Pathophysiology
    ▫ Inflammatory response
    ▫ Injury to endothelial lining
    ▫ Attracts platelets
    ▫ Form small clots – thrombi
    ▫ Continued migration of cells to the area
    ▫ Proliferation of the plaque
    DIETARY FACTORS
    Treatment
    • Nutrition Therapy
    ▫ Therapeutic Lifestyle Changes (TLC) developed
    as component of ATP-III
     Modifications in fat, cholesterol
     Rich in fruits, vegetables, grains, fiber (↓ LDL)
     Limit sodium to 2400 mg
     Include plant stanols - natural components of
    plants which compete with dietary and biliary
    cholesterol for absorption in the intestinal
    lumen. Recommendation: 2g/day to significantly
    reduce LDL levels.
    • Nutrition Therapy - Fat Modifications

    ▫ Total fat 25-35% of calories


    ▫ Very-low-fat diets
    ▫ Saturated fat < 7% of calories
    ▫ Avoid trans fats
    ▫ Increase intake of monounsaturated fats &
    Polyunsaturated omega-6 fatty acids
    ▫ Increase intake of omega-3 essential fatty acids
    ▫ Limit dietary cholesterol < 200 mg daily
    Management of CVD diseases is optimal with
    changes in the diet and lifestyle habits.

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