LECTURE\POWERPOINT

[TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS

20% of cardiac output goes to the most important organ in our
OUTLINE body which is our brain, then the rest will be distributed in the
I Terminology different system of the body.
A Coronary Artery Disease & Acute Coronary Syndrome
i Development of Collateral Circulation Table No.1 Cardiovascular Terminologies
ii Risk Factors for CAD TERM DESCRIPTION
B Hypertension
i Blood Pressure Blood Flow Cardiac • Amount of blood ejected by the heart (left
ii Nitric Oxide Output ventricle) in a minute
iii Classification of Hypertension • 5-8 L/m normal CO for adults
iv Medical Management • Stroke Volume x Cardiac Rate = CO
v Complication of Hypertension • Low CO: Irritability, restlessness, agitation,
vi Lifestyle Modification deterioration of LOC
vii Cardiovascular Disease
Stroke • Amount of the blood ejected by the heart
viii Compliance
Volume per contraction (S1-Lub and S2-Dub)
• 70 cc normal blood ejected per contraction
TERMINOLOGY Preload • Amount of blood returned to the right side of
• Right and Left Coronary Artery – artery that supplies the heart the heart (ventricle)
with oxygenated blood, right is bigger than left; • If the atrium and contracting and filling the
o Atherosclerosis – the artery is blocked with lipids/fats ventricle with blood
▪ Commonly the left coronary artery is affected
Afterload • Pressure that the left ventricle has to pump
since it is smaller than the right
against (the resistance it must overcome to
circulate blood)
Diastole • The right and left atrium is contracting – the
atrioventricular valves (tricuspid and
bicuspid/mitral valve) are open, at the same
time, the semilunar valves (pulmonic and
aortic valve) are close, so that it will prevent
the flow of blood.
• As the atrium are contracting, it is giving
blood to your ventricle – it is increasing your
preload
• Relaxation phase of the heart
• Atrioventricular valve should open for 0.5
second, more or less – 120 cc must go the
ventricle
• S2 sound is produced (Dub) by the closure of
semilunar valves and the opening of
atrioventricular valves
• REMEMBER: Sound is produced by the closure
and not the opening of the valves
Systole • S1 sound is produced (Lub) by the closure of
atrioventricular valves and opening of
semilunar valves
• Both ventricles are contracting, right ventricle
once it reaches its highest pressure it will push
the deoxygenated blood against pulmonic
valve and it will open – the blood will go to
the pulmonary trunk and pulmonary artery
going to the lungs for oxygenation
• At the same time, the left ventricle is also
CIRCULATION OF BLOOD IN THE HEART contracting but this time is carrying the
oxygenated blood because of the high
Deoxygenated blood coming from the head will enter the pressure it will open the aortic valve and
superior vena cava; deoxygenated blood coming from the pushes that oxygenated blood to the
lower extremities and abdominal organs will pass the inferior ascending aorta to be give to the brain (20%)
vena cava. It will now enter the right atrium, passes the and descending aorta to the different system
tricuspid valve and enters into the right ventricle. From the right
ventricle, the pressure increases and it will open the pulmonic • Heart disease continues to be the no. 1 in the country,
valve. Now, the deoxygenated blood will enter the pulmonary accounting for almost 25% of all deaths
trunk to the pulmonary arteries, going to the lungs for • 9 Filipinos die of heart disease every hour
oxygenation. Once the blood has been oxygenated by the • 1 out of 4 Pinoys is HYPERTENSIVE while 1 out of 5 Pinoys have
lungs, it will now enter the 4 pulmonary veins (wherein we have PRE-HYPERTENSION or are at risk of developing high blood
2 on the left and 2 on the right), it will pass the left atrium, enters pressure
the bicuspid/mitral valve, it will go to the left ventricle, and the
pressure increases again that open the aortic valve. From the CORONARY ARTERY DISEASE AND ACUTE CORONARY
aortic valve it goes to the ascending aorta and immediately
SYNDROME
supplies the brain with blood.
• A type of blood vessel disorder that is included in the genera;
category of ATHEROSCLEROSIS

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 [TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS
o Begins as soft deposits of fat that harden with age
o Referred to as “hardening of arteries”
o Can occur in any artery in the body
o Atheromas (fatty deposits)
o Preference for the coronary arteries

ETIOLOGY AND PATHOPHYSIOLOGY

• Atherosclerosis is the major cause of CAD
o Characterized by a focal deposit of cholesterol and
lipid, primarily within the intimal wall of the artery
o Endothelial lining altered as a result of inflammation
and injury
• Common artery that is affected: (a) Open, functioning coronary artery, (b) Partial coronary artery
o Left and Right Carotid Artery – artery that supplies closure with collateral circulation being established, & (c) Total
blood to the brain coronary artery occlusion with collateral circulation bypassing
o Left and Right Coronary Artery – artery that supplies the occlusion to supply blood to the myocardium
blood in the heart
• Low-Density Lipoproteins – this is the lipids that obstruct the • Due to the obstruction, the body compensate by developing
artery, also known as the bad cholesterol a collateral circulation
o Since there is a partial obstruction, there will be a
WHY DOES IT DESTROY THE INTIMAL LAYER OF THE ARTERY? new group of blood vessels so that is where the
blood will flow, but since is new – it is fragile and it
Since there are lipids that causes a partial obstruction, and can immediately rupture
when there is a partial obstruction – it will make the pressure in o When there is complete obstruction, then there will
the artery high. Due to the high pressure, it will destroy the be collateral circulation
intimal layer of the artery. There is nitric oxide or NO that is being
produced by the intimal layer of the artery which dilate the RISK FACTORS FOR CAD
artery (e.g., when exercising there will be a gush of blood to
that artery because of the dilation due to the nitric oxide in Table No.2 Risk Factors
order to accommodate the massive amount of blood going to RISK FACTORS EXAMPLES
the lower extremity since we are walking or jogging) Nonmodifiable • Age – as we age, blood pressure
increases because the artery is not
• Risk Factors for elastic anymore; as we grow older (30,
Atherosclerosis: 60 and above) about 85% of nitric oxide
o Obese becomes low level
o Sedentary Lifestyle – • Gender – more male clients are dying
no outside activities from CAD and women usually have this
like walking or at later age (menopausal age: 45 and
jogging above),
• Since the lipids are o since estrogen which helps
starting to obstruct the accelerated the good cholesterol
artery, there will be a (high-density lipoproteins - *removes
high blood pressure the bad cholesterol in the body).
• If there is an increase o Male gender is known as
pressure, (1) it will destroy breadwinner of the family which
the intimal layer of the equates to more stressors and when
artery and (2) there will they encounter those stressors they
be no production of smoke and drink liquor.
nitric oxide o Also, male gender are trained not to
show their emotions and not
• It can also obstruct the allowed to cry when they’re angry
artery in the legs – since when they were still children
peripheral arterial parents usually say that “You’re a
disease boy you are not supposed to cry
• If the carotid artery is and show your anger” which is
blocked with lipids, there wrong – this the reason why they
will be less blood going in can’t bring it out this leads to severe
the brain and that will kill headache, high blood pressure,
the neurons; this can chest pain
lead to CVA (Cerebrovascular Accident), or apoplexy, or • Ethnicity – African-American and
brain attack or stroke. Koreans and Filipinos, high rate of
• If the coronary artery is blocked with lipids, this will kill a part hypertensive people and due to high
of the heart which leads to heart attack or medical term is salt intake
Myocardial Infarction • Family History – hypertension is a familial
disease
DEVELOPMENT OF COLLATERAL CIRCULATION • Genetic predisposition
• When occlusion of the coronary arteries occurs slowly over a Modifiable • Elevated serum lipids – lipids,
long period, there is a greater chance of adequate collateral Risk Factors triglycerides and cholesterol are high
circulation developing due to diet
o Do not eat red meat (rich in lipids)

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 [TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS
• Hypertension – it runs in the family; it is a substance that dilates the artery (view page 2: WHY DOES IT
consistently high blood pressure of at DESTROY THE INTIMAL LAYER OF THE ARTERY?)
least 140/90 mmHg • If the artery is obstructed, with bad cholesterol (LDL) – the
• Diabetes – since there is no insulin, the pressure will be high – this destroys the intimal layer of the
glucose cannot enter the cell – then the artery. This leads to less production of NO. RBC, thrombocytes
glucose will stay in the blood. If the and lipids will be attracted in the injure sites – and it will
blood is filled with glucose, the blood accumulate in the injured site – and once the accumulation
becomes viscous then the circulation is gigantic in size then it will narrow the lumen and the blood
will be sluggish which increase the blood will have a hard time flowing
pressure • Bigger and medium arteries are those commonly affected in
o High glucose levels may irritate the atherosclerosis:
endothelial layer of the blood o Carotid artery – supplies the brain with adequate
vessel, leading to atherosclerosis amount of blood
o Coronary artery – carrying oxygenated blood going
HYPERTENSION to the heart for the heart to pump well, so that there
will be plenty of oxygenated blood that will be sent
Table No.3 Hypertension and its Causes to the diff. system of the body, however if that artery
TYPES CAUSES is partially blocked then that narrows
Essential / • Excess salt ▪ If it’s narrow, there will be less blood that will be
Primary / • Abnormal arteries sent to the heart, and the heart will not
Idiopathic • Increased blood volume contract well (decrease contractility due to
Hypertension • Genetic disorders (it runs in the family) insufficient blood flowing)
• Stressful life
Secondary • Health condition NITRIC OXIDE
Hypertension • Certain medicines • Endothelium – they form a one-cell thick, intimal layer of the
• Recreational drugs artery that produces NO
• Pregnancy o Once the NO is destroyed due to persistent high
• Hormonal therapy pressure in the artery, that injury will be attractive to
• e.g., when kidney is destroyed, the blood lipids to accumulate as well as the thrombocyte
pressure will be high. If the kidney is and RBC which can cause partial obstruction
treated, the BP will be normal
• e.g., hyperthyroidism – thyroid gland
releases so much thyroxine and
triiodothyronine, and this will definitely
increase the metabolism of the body, as
well as the BP
• e.g., pregnancy – it can also give you high
BP, and once the mother delivers the
baby the BP becomes normal

Table No.4 Hypertension Category

BLOOD PRESSURE, mmHg
CATEGORY
SYSTOLIC DIASTOLIC
Optimal < 120 • and < 80
Normal < 130 • and < 85
High Normal 130 – 139 or 85 – 89
Hypertension
Stage 1 140 – 159 or 90 – 99
Stage 2 160 – 179 or 100 –
Stage 3 > / = 180 or 109 > / = 110

TONGUE
• In the folds of our tongue there is a bacterium that whenever
we take in nitrates in the form of vegetables or meat – it is
going to convert that nitrate to NO

• Somewhere in our life, usually in our 40s or so, we stop being

able to easily synthesize NO
• This decreases endothelial NO, results in endothelial
dysfunction
o Due to high BP, that is caused by the many stressors
in life – this going to stimulate the SNS which will alert
• Hypertension – the lumen of the artery is narrow, the adrenal medulla which releases
• Pre-hypertension – some of young adults are already in this catecholamines specifically norepinephrine which
stage, but there are no symptoms yet since their artery is causes vasoconstriction which leads to high BP
elastic • As we age, we lose 85% of our ability to make NO
• Endothelial dysfunction is a prerequisite and precedes the
BLOOD PRESSURE BLOOD FLOW development of atherosclerosis, heart attack and stroke
• If the lumen of artery is narrow, pressure in the artery is
accelerated – this destroys the intimal layer of the artery FOODS HIGH IN NO
which is the one who produces nitric oxide which is a • Arugula
• Red beets

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 [TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS
• Garlic RBC, thrombocyte and the lipids will be attracted to the injured
• Cilantro – Coriander site and this will be accumulated, and once the accumulation
• Lettuce is bigger, then it will narrow the lumen of the artery and it will
• Basil be hard for the blood to flow – causing a high blood pressure
• Citrus Fruits
• Watermelon SECONDARY HYPERTENSION
• Dark Chocolate • A direct result of another problem or condition
• Conditions that result to hypertension are the following:
EXPLAIN HOW HIGH BLOOD PRESSURE IS THE ORIGIN OF LEFT pheochromocytoma, hyperthyroidism, neurologic disorders
VENTRICULAR HYPERTROPHY that increase ICP, high dose estrogen use, renal artery
stenosis
(1) When there is a high blood pressure, the afterload is high. If
the systemic BP is high (e.g., 150/90 mmHg) – this will increase 5 MOST COMMON CAUSES OF HIGH BLOOD PRESSURE (VIDEO)
the workload of the left ventricle which will generate a pressure 1. Excessive Salt – more than 3g per day is excessive; eat less
greater than 150/90 mmHg ranging from 160 – 180 systolic in processed food
order to push the blood to the different system. If the 2. Alcohol Intake – 2 drinks per day for male and 1 drink per
generated pressure is below, for example: 130 – the left day for female is considered excessive
ventricle cannot push that blood to the systemic circulation. 3. Inactive (Sedentary) Lifestyle – keep moving and stay
Thus, once there is an increase workload, the compensatory activity
mechanism of the left ventricle is that the muscle will enlarge 4. Obesity – major risk factor
in order to push the blood stronger to keep the blood flow to 5. Smoking – smoking is the leading cause of preventable
the different system of the body – this is called left ventricular heart disease
hypertrophy.
NOSE BLEEDING
(2) When the heart is enlarged – it needs more blood because
1. Help the patient to sit, leaning forward, with the head tilted
in the blood we have the O2 which is needed for the survival
forwards
of the cells, and the food in the form of glucose. So, if the
o Rationale: This position keeps the blood from
muscles enlarge, it needs more blood but the coronary artery
dripping down the throat or being aspirated into
will not increase the blood supply, it will only supply the same
the lungs
amount of blood. Thus, the contractility of the heart will be less.
2. Apply direct pressure for at least 15 minutes by pinching the
Stroke volume and cardiac output will be less.
nostrils together
o Rationale: Once you apply pressure, thrombocytes
To know that there is a left ventricular hypertrophy – the PMI /
will be attracted to that area and it will close the
apical pulse will not be seen any more on the 5th intercostals
wounds, so that blood will stop oozing out of your
space left mid-clavicular line, but this time it can reach the 6th
nose. If it is pinched less than 15 minutes there is a
intercostal space on the left anterior axillary line.
possibility that the blood will not clot, and it will
rebleed
CLASSIFICATION OF HYPERTENSION 3. Apply cold compress to the bridge of the nose
PRIMARY / ESSENTIAL / IDIOPATHIC HYPERTENSION o Rationale: It is going to cause vasoconstriction and
• This the most common type of hypertension it will lessen the amount of blood oozing out
• Affects 90% of people with hypertension 4. Keep the patient CALM and QUIET especially if he has high
BP
CAUSES OF PRIMARY HYPERTENSION o Rationale: Because it is possible that the oozing of
the blood, patient will be anxious. Anxiety can
• Hyperactivity of the sympathetic nervous system stimulate the SNS, norepinephrine will be release –
SNS is stimulated when excited, filled of stressors, depressed, the higher will be the blood pressure
embarrassed or when exercising, this will alert the adrenal
medulla wherein it will produce the two catecholamines: MEDICAL MANAGEMENT
epinephrine and norepinephrine (a vasoconstrictor) – this
• The BP should be brought down to 120/70 mmHg to less than
makes the BP also high then that will destroy the intimal layer
140/80 mmHg
of artery
Table No.5 Drug Management for Hypertension
• Hyperactivity of the renin-angiotensin system
CLASSIFICATION DESCRIPTION
The SNS stimulation (e.g., stressors in life) will trigger the kidneys
ACE Inhibitors • Suffix: -pril
to release a hormone called renin. This renin will go to the liver
• Generic Name: Enalapril, Lisinopril,
wherein it will mix with an enzyme called Angiotensinogen and
Captopril
this will produce to Angiotensin I. This Angiotensin I will travel the
o Enalapril – Renitec & Hypace
lungs and will be converted to Angiotensin II which has two
o Imidapril – Norten & Vascor
effects: (1) potent vasoconstrictor – this will make the patient’s
o Cilazapril – Vascase
BP high which will lead to the destroying of the intimal layer of
o Ramipril – Ramipro & Tritace; more
the artery, and (2) it will stimulate adrenal cortex to release a
effective if taken at bed time and
hormone called aldosterone – wherein it will order the kidney
also been show to reduce
tubules to reabsorb Na, ‘where sodium are, water follows’
ventricular hypertrophy
therefore, this will increase blood volume – thus it will increase
• Goof for pt. with weak heart, heart
the blood pressure.
failure, cardiomegaly, and high blood
pressure (150 – 160 systolic)
• Endothelial dysfunction
• Side effect: Persistent dry, irritating,
The intimal layer of the artery, endothelium, produces nitric
non-productive cough
oxide – this helps the artery to dilate. However, if the artery is
• Adverse effect: Infrequent but
obstructed by the bad cholesterol, it will destroy the intimal
dangerous – agranulocytosis,
layer of the artery which will cause injury to the site. There will
proteinuria, acute kidney failure,
be less production of NO due to this situation. Moreover, the
glomerulonephritis

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 [TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS
• This medication causes orthostatic
hypotension, and the client should be Calcium • Suffix: -ipine, -zem
instructed to rise slowly from lying to Channel • Generic Name: Nifedipine,
sitting to standing position to prevent Blocker Nicardipine, Amlodipine
falls and injury o Diltiazem – Dlizem & Filazem
• Prevent the conversion of angiotensin I o Verapamil – Isoptin
to angiotensin II o Amlodipine – Amlodine &
• Angiotensin II: (1) potent Amlocor
vasoconstrictor which will definitely o Nifedipine – Adalat & Calcibloc
increase BP, and (2) will stimulate the o Amlodipine besylate – Norvasc
adrenal cortex to release aldosterone ▪ Dilate the peripheral vessels
– this will order the kidney tubules to to lower BP
reabsorb sodium, then water will be ▪ Used primarily in pt. with
attracted hypertension
• Hyperkalemia – as sodium is • High effect for high blood pressure
reabsorbed, the lumen becomes more • Side effect: Edema
electronegative and provides a • Never be given for pt. with heart failure
favorable environment for potassium • In pt. aged over 55 or in those of
secretion African-American of any age. CCB are
• Choice for the initial tx. of HPN in the first drugs of choice
people aged under 55 years should be • This is because lower levels of
an ACE Inhibitor circulating renin in pt. of
Angiotensin- • Suffix: -sartan African/Caribbean origin are thought
Receptor • Generic Name: Losartan, Valsartan, to make ACE inhibitors less effective in
Blocker Irbesartan lowering BP than in Caucasians
(ARBs) o Losartan – Cozaar, Lifezar • It depresses myocardial contractility
o Telmisartan – Pritor • Relaxes and dilates arteries causing a
• Good for high blood pressure, weak fall in BP and decrease venous return
heart • Slow excitability of the SA node,
• Low effect for high blood pressure decrease conduction through AV
(Adrenergic • Suffix: -olol node, and reduce myocardial
Blockers) • Generic Name: Propranolol, Atenolol, contractility
Beta Blockers & Metoprolol, Timolol, Esmolol • Slowing heart rate and decreasing
Alpha Blockers • Goof for pt. with high blood pressure, contractility reduce myocardial O2
nervous, thyroid problems demands to help manage angina or
(hyperthyroidism); it has low effect for myocardial ischemia
high blood pressure
• Side effect: Slow cardiac rate NURSING MANAGEMENT
• Common Adverse Effect: Dizziness, • Instruct patient to report dizziness
bradycardia, hypotension, fatigue and irregular heart rate
• Avoid grapefruit juice because it
BETA BLOCKERS ALPHA inhibits the hepatic metabolism of
BLOCKERS CCB may lead to pharmacologic
Decrease heart rate Causes effects
and contractility vasodilation • All CCBs should be used cautiously
Because they of the in pt. with heart failure
decrease the work of peripheral • It is essential to avoid excessive falls
the heart, it protect it vessels and in blood pressure, which can
from ischemia and reduced BP precipitate:
hypertrophy o Cerebral ischemia
Atenolol – Cardioten & Doxazocin – o Renal Ischemia
Tenormin Alfadil XL o Coronary Ischemia
Metoprolol – Betaloc & • Antihypertensive medications can
Neobloc cause a drop in the blood pressure
*Not given if the pt. PR when the client changes positions
is less than 60 bpm from a sitting or lying position to an
It is a negative Given for upright position because of gravity
inotropic and negative patient with and relaxed blood vessels
chronotropic drug high cardiac
• Inotropic – affects rate
contractility; Diuretics • Suffix: -ide
negative • Generic Name: Hydrochlorothiazide,
inotropic: Furosemide
decrease o Hydrochlorothiazide – for blood
contractility pressure, Betazide & Diuzid
• Chronotropic – o Furosemide – for edema, Lasix &
affects heart rate; Pharmix
negative • First-line therapy for hypertension
chronotropic: • Eliminating excess salt and water from
decrease heart the body
rate • Given during morning since patient will
urinate often, if given in night – patient
will wake up often

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 [TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS
• Caution pt. to stand up slowly to • Limit your Sodium Intake – eating no more than 2,400mg a
minimize the risk of dizziness from day of sodium brings down your systolic pressure by 2-8 pts
orthostatic hypotension o Sodium is a component of table salt
• Gradual change of position o 1 tsp of salt is 40% Na and 60% Cl, has 2,300 mg of
Na
PATIENTS FAIL TO ADHERE TO PRESCRIBED MEDICATION THERAPY o Na is also a major component of:
FOR SEVERAL REASONS: ▪ Monosodium glutamate (MSG)
1. Adverse reactions to medications ▪ Baking Soda
2. Drug regimens that are complicated ▪ Sodium Benzoate
3. A lack of knowledge about hypertension management ▪ Sodium Nitrate
4. A symptomless nature of hypertension o High Na diet contributes to high BP, a major cause
5. Patients forgetting to take their medications was a major of heart attack and stroke
reason for non-adherence
• Following a DASH Diet (Dietary Approaches to Stop
COMPLICATIONS OF HYPERTENSION Hypertension)
o Low fat diet, rich in vegetables, fruits and low-fat
• Cerebrovascular Accident (CVA) – you can have an
dairy foods lower your SBP by 8-14 pts
aneurysm in any of your arteries in your brain because your
blood pressure is always high, and one day that aneurysm will
• Stop Smoking
just rupture and blood will start to ooze, and you are now a
o Tobacco use is the leading risk factor for CAD and
case of CVA
a potent vasoconstrictor leading to hypertension
• Renal Damage – due to chronic hypertension, because there
o Nicotine increases the release of epinephrine and
is less blood going to kidneys and that will destroy it
norepinephrine which results in peripheral
• Blindness – because of the high pressure, you are dilating the
vasoconstriction, elevated BP and HR, greater O2
blood vessels in your eyes. Possible it can also rupture, and
consumption and increased risk of dysrhythmia
blood will start to ooze and can result to blindness; once
you’re blind there is no treatment or cure
• Limit your alcohol intake – no more than 2 drinks a day for
• Heart Problems – * read left ventricular hypertrophy
men, one for women
pathophysiology
o The liver is activated to process alcohol, it is less able
to process FATS
LIFESTYLE MODIFICATION ▪ Elevated cholesterol and triglyceride
• Losing Excess Weight – for every 20lbs you lose, you drop your o Depressed myocardial contractility – low CO which
systolic BP by 5-10 pts stimulate the SNS and releasing the norepinephrine
o The relationship bet. obesity and blood pressure has then will cause high BP
been clearly established from numerous studies o Interfere with kidneys ability to metabolize
o For many people with hypertension whose body hormones like renin and angiotensin
weight is more than 10% over ideal, weight o After drinking it causes vasodilation which leads to
reduction of as little as 10lbs can lower BP low BP
o Also, weight loss may improve the response to ▪ These changes can impair the body’s ability to
medication pump fresh blood to the brain, the person feels
o While all the measures are important for health LIGHTHEADED
promotion, weight reduction measures will have the
most immediate impact CARDIOVASCULAR DISEASE
• Exercise Regularly – brisk walking for 30mins drops your
• Some individuals do not develop hypertension even if they
systolic BP by 4-9 pts: Regulates BP, Lower body fat levels,
ingest a lot of salt because their kidneys can handle it
Protection from arthritis, Lowers stress levels & Weight loss
o They simply get rid of the excess salt through urine
o Exercise helps make BV more flexible and increases
o They are called salt-resistant
their diameter by increasing nitric oxide levels
• Others, however, have no such innate capability, and the
o 45 mins of moderate-intensity exercise will raise HDL
excess Na gets stored in the body and attracts water
cholesterol lvl.
causing:
o Increases an enzyme that breaks down
o Edema
triglycerides so it can be processed by the liver
o Weight Gain
o Regular exercise has an anti-clotting effect similar to
o Elevated blood pressure
aspirin therapy
o Heart failure
o Exercise can reduce visceral fat
▪ These are the salt-sensitive individuals
Table No.6 Subcutaneous Fat vs Visceral Fat
• The greatest amount of salt we ingest does not come from
FAT DESCRIPTION
the condiments we use.
Subcutaneous • Easy to remove if you have active
o The biggest source is processed foods, which
lifestyle
include:
• Fat that is directly under the skin which ▪ Canned goods
locally known as “bilbil” ▪ Salty snacks
Visceral Fat • Hard to remove and need medicines to ▪ Frozen meals
be remove ▪ Instant Noodles
• Fat that is located deep inside the ▪ Margarine
abdominal cavity surrounding the ▪ Ketchup
internal organs ▪ Dried Fruits
• Visceral fat cells can release o Salt reduction in all processed foods is doable &
inflammatory molecules that damage can have a tremendous impact on hypertension
BV control, since around 80% of salt intake really
• Visceral fat can release fatty acids even comes from them
when the body does not need them for • Too much salt retained in the body may lead to:
energy so it remains in the blood o High BP
o Heart failure

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 [TRANS] LESSON 3: CARDIOVASCULAR PROBLEMS
o Stroke
o Premature death
• CVD and stroke have remained the top 2 killers in the country
for the last 30 yrs
• Around 200,000 Filipinos dying yearly
• Increased salt intake is particularly related to the risk of
developing stroke

COMPLIANCE
• Long-term compliance and adherence has emerged as the
most essential element in reducing morbidity and mortality
associated with hypertension
o Take medication consistently and as directed by
your doctor

REFERENCES

Notes from the discussion by Prof. Linda V. Subido, MAN

Manila Doctors Colleges of Nursing PowerPoint Presentation

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