NUTRITION of The

CARDIOVASCULER
SYSTEM
SYARIF HUSIN
BLOK 15

INTRODUCTION
In United States; 37,3% cause of death,
1 in every 2,7 deaths.
Atherosclerosis, ischemic heart disease
and hypertension is a risk factor for all
others cardiovasculer disease.
Determined cardiovasculer disease:
hereditary, environmental and lifestyle.
Lifestyle: Prevention and treatment of
cardiovasculer disase.

A. HYPERTENSION
Goal treatment:
1. Reduction risk of cardiovascular
and renal disease.
2. Reduction BP to < 140/80 mmHg (
or to 130/80 mmHg with diabetes
and cronic renal disease)
Plan treatment: weight reduction,
physical activity, nutrition therapy,
pharmacological intervention.

NUTRITION THERAPY
Lifestyle modification and
nutrition therapy.
Increased physical activity
Smoking cessation
Weight loss
Reduction of sodium and alcohol

NUTRITION
INTERVENTIONS
Decrease sodium, saturated fat
and alcohol.
Increase calsium, potassium and
fiber : efectife lowering of BP.
Sodium restriction reduce
incidence Cardiovascular Disease,
Renal Disease and Stroke.

INCREASED PHYSICAL
ACTIVITY

DASH : Recommended 3060 min of aerobic

minimum four days per
week

SMOKING CESSATION
To achieve success, the
smoker should also be
able to identify his or her
reasons for quitting

WEIGHT LOSS
Weight loss of greater than 5 kg
reduced both diastolic and systolic.
An approximate 20 lb weight loss
will result in lowered systolic.
Waist circumference: independent
predictor of hypertension risk.
BMI > 35 risk factor.

REDUCTION SODIUM
The Dietary Guidelines for Americans
recommend an intake of less than 2300 mg
of sodium, equivalent 6 g sodium chloride.
Terapy hypertension:
Mild : 1,5 2,5 g Na (3,75 6,25 gNaCl)
Moderate : 0,5-1,5 g Na (1,25 - 3,75g
NaCl)
Severe : < 0,5 g Na ( < 1,25 g NaCl)

EFFECTS of LIFESTYLE MODIFICATION to

MANAGE HYPERTENSION
RECOMMENDATION
Weight reduction (BMI
18,5-24,9).
Diet rich fruits,
vegetables and low fat.
Intake sodium 2,4 g ( 6
g sodium chloride)
Aerobic (walking) 30
min/day.

AVERAGE
SYSTOLIC
REDUCTION
5 20 mmHg/10 Kg
8 14 mm Hg
2 - 8 mmHg
4 9 mm Hg

B. ATHEROSCLEROSIS
Thickening of the blood
vessel walls specifically
caused by the presence of
plaque.

RISK FACTORS
Family
history
Age
Sex
Obesity
Dyslipidemia

Hypertension
Diabetes
Physical
inactivity
Smoking

ALTERABLE RISK
FACTORS

Obesity
Dyslipidemia
Hypertension
Physical inactivity
Atherogenic diet
Smoking

OBESITY
Risk factor of atherosclerosis
Waist circumference : Men >102 cm
Women > 88 cm.
Abdominal fat and insulin resistance
Hypothyroidism leading to obesity :
risk of atherosclerosis
Poorly managed hypothyroidism :
greater progression of coronary
atherosclerosis

INCREASING PHYSICAL
ACTIVITY
Lowering blood pressure and
triglycerides.
Increasing HDL
Improving endothelial fucntion
Decreasing platelet aggregation

ATHEROGENIC DIET
Westernized diet : high
saturated fat and low fiber.

Indonesian diet ?

SMOKERS
Higher levels of serum cholesterol,
triglycerides and LDL cholesterol.
Lower HDL cholesterol
Endothelial dysfucntion, inflammation
and modification of lipids
Nitric oxide : endothelial relaxasion.
Inflammatory : increased leukocyte
count and proinflammatory cytokines

C. ISCHEMIC HEART
DISEASE
Nurition Implications
Immediate medical care after MI
strives to reduce pain, stabilize
cardiac function and when
appropriate, begin the
rehabilitation post MI. Nutrition
therapy after MI will be consistent
with these medical goal.

ISCHEMIC HEART
DISEASE

Nutrition interventions
Many institutions treatment protocols
limit initial oral intake to clear liquids
with out caffeine in order to prevent
arrytmias and to decrease risk of
vomiting or aspiration.
Oral diets usually progress from
liquids to soft, easily chewed foods
with smaller, more frequent meals.
Therapy lifestyle.

D. HEART FAILURE
Nutrition implications
Nutritional care during CHF is difficult.
Nutritional therapy that restricts both
sodium and fluid is crucial to control
acute symptoms and may assist with
reducing with the overall work of the
heart.
Difficulty eating and cardiac cachexia.

CACHEXIA in HF

Cachexua in HF include myocardial

nutrient deficiencies of:
L-carnitine
Coenzyme Q10
Creatine
Thiamine
Taurine

Nurition interventions
Restrictions sodium and fluid.
Correction of nutrient deficiencies.
Nutrition education for increasing
nutrient density and making food choice
that enhance oral intake.
Sodium 2000 mg (Standard initial
recommendation).
Fluid requirement 1 ml/kcal or 35 ml/Kg
BB.

E. STROKE and
ANEURYSM
Enteral nutrition support will be
necessary if an oral diet cannot
meet nutritional needs.
Evidence support early initiation
of nutritional support to prevent
complications, reduce hospital
stay and promote rehabilition.