28. 1 preface

Cardiovascular disease is a serious disease endangering human health. This is one of the main causes of death. There are many kinds of the disease, and the causes are complicated. Some of these diseases. Such as atherosclerosis, coronary heart disease, hypertension and heart failure are closely related to nutritional factors, and a reasonable diet has become one of the important measures to prevent and treat these diseases. In order to discuss these problems better, some basic situations of cardiovascular nutrition are briefly introduced at first.

28. 1. 1 history and present situation

The occurrence and prevalence of many cardiovascular diseases, in a sense, are related to the development of human history. In ancient times, people lived a social life of gathering and hunting. They eat unprocessed natural food with relatively balanced nutrients. With the development of production, the division of class and the change of environment (including diet), the phenomenon of unbalanced nutrition gradually appears. A few people may be overnourished, while more people are malnourished. These two extremes, together with other factors, will lead to various cardiovascular diseases. According to historical records, the aristocrats in ancient Rome lived in luxury, and their diet composition was very close to that of western countries today. These people have records of angina pectoris and sudden death. Obvious atherosclerosis was also found in the mummies of Egyptian nobles. The female corpse of the Western Han Dynasty Palace unearthed in Mawangdui, Changsha, China more than 2000 years ago was confirmed by modern pathology to have pathological changes of atherosclerosis and myocardial infarction. Nevertheless, this disease was rare in ancient times.

In modern times, especially in western countries, people's lifestyle and diet structure have changed more and more. According to the latest data, the average American consumes more than 65,438+000 g of fat every day, and it is mainly animal fat. Food cholesterol is 400 ~ 700 mg, with an average of 560 mg. The intake of coarse grains is small, but the consumption of refined sugar is large (100g or more). In addition, the consumption of alcohol and salt is also great. Excessive intake of total calories and imbalance among various nutrients may be one of the main reasons for the widespread prevalence of cardiovascular diseases, especially coronary heart disease. When Bahous pointed out the change of western diet and its harm, he quoted a sentence: "People are digging their own graves with their own teeth." This situation has attracted the attention of cardiologists, nutritionists, the public and relevant social departments. At present, sixteen expert committees on "Dietary Fat and Coronary Heart Disease" have put forward a series of dietary reform measures. 1977, the US Congress put forward the "dietary goal", which advocated people to eat more grains, so that the intake of complex carbohydrate increased from 28% to 48% of the total calories, and the intake of fat decreased from 40% to 30% of the total calories, and the ratio of animal fat to plant pigment was properly controlled, vegetables and fruits were increased, and cholesterol, sucrose and salt were restricted.

In fact, China's first medical classic, Huangdi Neijing Su Wen, more than 2,000 years ago, fully embodies the contents of the diet reform in the world today. It is pointed out that the reasonable diet of human beings should be "five grains for nourishment, five livestock for benefit, five fruits for help and five vegetables for supplement". This view only correctly expounds various nutrients necessary for human diet and dialectically points out the primary and secondary relationship between them (that is, nourishment, benefit, help and supplement). It has laid the excellent dietary characteristics of our nation and has far-reaching guiding significance for safeguarding people's health and preventing diseases, especially coronary heart disease.

This correct view has been constantly supplemented and developed in many dietotherapy monographs in past dynasties. For example, in the book "Shou Shi Bao Yuan" written by Gong Tingxian in Ming Dynasty, the importance of diet control is quite incisive: "Those who are good at keeping in good health will keep it inside, those who are not good at keeping in good health will keep it outside, and those who keep in good health will have internal organs and blood vessels, so it is generally popular and neutral, and those who are not sick will indulge their appetite, which is extremely delicious and poor in diet. Although the body is full, the color is pleasing and the cheese is strong. " This discussion is still of great significance to the prevention and treatment of obesity, hyperlipidemia, hypertension and coronary heart disease today, and to the health and longevity of middle-aged and elderly people.

The knowledge and contribution of China ancient medicine to nutrition, health and diseases (including cardiovascular diseases) came from people's rich practice and also guided people's practice. Because of this, it has a broad and profound mass base that no other nation in the world can match. For thousands of years, the working people in our country have used various foods for health care and disease prevention, and many foods have become customs because they have been passed down from generation to generation. However, the situation in other countries is quite different. For example, Doc wrote in the book Nutrition and Cardiovascular Diseases: "More than 2,000 years ago, in the era of Hippocrates, a famous ancient Greek doctor, although doctors advised people to prevent and control diseases by changing their eating habits, most patients would rather take medicine or endure pain than take dietary measures." Working people in ancient China have long known that vegetarianism can prolong life. Modern science has proved that many components in vegetarian diet, such as vegetable oil, contain a lot of polyunsaturated fatty acids and vitamin E, while mushrooms and auricularia can not only reduce blood fat, but also improve blood coagulation function, which is conducive to preventing hyperlipidemia and coronary heart disease.

Looking at the history and present situation, it is not difficult to see that there is a very close relationship between nutrition and cardiovascular diseases.

28. 1.2 Relationship between nutrition and cardiovascular weight and disease amount

(1) The importance of nutrition to the cardiovascular system is of great significance for maintaining the structure and function of the cardiovascular system.

Nutrition is an important source of energy: any mechanical work needs energy, and the heart shoulders extremely heavy and complicated tasks. Therefore, it must convert chemical energy in food into mechanical energy. Free fatty acid (FFA) (about 67%), glucose and lactic acid (about 65,438 0.7% each), amino acids, ketone bodies and pyruvate are the main nutrients taken by normal myocardial cells from blood. According to body weight, a normal heart needs about 18g fatty acid, 1 1g glucose, 10g lactic acid and 0.6g pyruvate every day. It can be seen that its intake of nutrients is considerable.

The uptake and utilization of nutrients by myocardial cells are influenced and regulated by many factors. The most important thing is the absolute concentration of nutrients in the blood. The higher the concentration, the greater the intake. For example, when fasting, blood sugar and insulin levels are low, and adipose tissue releases a large amount of FFA, which leads to an increase in blood concentration. Therefore, the uptake and utilization of FFA by myocardial cells on an empty stomach also increased significantly. On the contrary, the blood glucose and insulin levels increase and FFA content decreases after meals, so the myocardium mainly absorbs and utilizes glucose. On the other hand, during strenuous exercise, the content of lactic acid in blood increases obviously and becomes the main energy supply substance at this time. It can be seen that normal myocardial cells have strong adaptability to the intake and utilization of various nutrients. However, under pathological conditions, such as acute myocardial infarction, the adaptability of ischemic myocardial cells to nutrients is obviously weakened. At this time, FFA is harmful to it, and glucose becomes a good substrate. Therefore, in acute myocardial infarction, it is beneficial to drip glucose and polarized liquid (glucose plus insulin and potassium).

Like myocardial tissue, arterial wall also needs to obtain various nutrients from blood, including protein, sugar, fat and cholesterol. Among them, cholesterol (including some triglycerides and phospholipids) enters the arterial wall in the form of lipoprotein (mainly LDL), and then enters the cell through the receptor pathway on the cell surface as a structural component of the cell. This may also be one of the ways in which food cholesterol is removed.

② Nutrients participate in some important physiological and biochemical processes of cardiovascular system: apart from certain energy, myocardial relaxation and contraction also require the participation of certain metal ions, such as potassium, sodium and calcium. In addition, some vitamins and trace elements in food are auxiliary groups of several important enzyme systems in myocardial tissue and arterial wall metabolism.

(2) Harm of nutrient deficiency or excess to cardiovascular system Both nutrient deficiency and excess can damage the normal structure and function of cardiovascular system, thus leading to cardiovascular diseases.

Malnutrition, such as beriberi and heart disease caused by vitamin B 1 deficiency, has long been well known. In recent years, some animal experiments show that the lack of potassium, magnesium and chlorine in diet can increase the susceptibility of myocardial cells to pathogenic factors, thus inducing primary necrotizing cardiomyopathy. Keshan disease in some areas of China is a cardiomyopathy with unknown causes, which may be related to the lack of certain trace elements in diet, such as selenium, magnesium and molybdenum. Magnesium deficiency can cause abnormal electrocardiogram, promote selective calcification of myocardium, and induce fatal myocardial spasm and rapid arrhythmia. Vitamin B6 and C deficiency will affect the structural integrity of arterial wall. Dietary fiber deficiency is closely related to the increase of cardiovascular disease, diabetes and tumor incidence.

Overnutrition is more serious and common to cardiovascular system than undernutrition. Excessive intake of total calories, saturated fatty acids, cholesterol and refined sucrose can easily induce obesity, hyperlipidemia and atherosclerosis, as mentioned above. Excessive sodium intake is related to the pathogenesis of hypertension. In addition, in recent years, it has been found that some special food ingredients, such as excessive erucic acid (22-carboxylic acid), can cause myocardial damage in animals. Some toxic substances in individual vegetable oils can inhibit the activity of cholesterol ester hydrolase in arterial wall, thus inducing atherosclerosis.

All these advances provide a favorable basis for understanding the pathogenesis and prevention of cardiovascular diseases at the cellular and molecular levels.

Common sense: Understand the common sense of health care and treatment of diseases, and make clear the name and type of diseases.

, classification, staging and other related information, master the first aid methods and precautions in acute attack.

Diet: Cardiovascular diseases advocate a low-salt low-fat high-fiber diet and eat more fresh vegetables.

Diabetic patients should strictly follow the diabetic diet. People like to eat pickles, Aral Sea products and so on. , high salt content, should be

Restrict or prohibit eating.

Work and life arrangement: after the acute and severe illness gets better, it is appropriate to be safe according to the age, physical strength and specific conditions of illness.

Put an end to exercise and daily life, avoid excessive mental stress and physical activity, and ensure adequate sleep and rest time.

The combination of work and rest is beneficial to nerve and blood circulation function, improves exercise tolerance, and obese people can lose weight. But the heart

Uncontrolled people such as colic, acute myocardial infarction, severe hypertension and arrhythmia should be restricted in their activities.

Blood pressure monitoring: Blood pressure monitoring of cardiovascular diseases is very important, especially for patients with hypertension, at least.

Measure once a week. Pay attention to the circadian rhythm and physiological changes of blood pressure, try to measure it regularly and learn to be correct.

Accurate measurement methods and judgment of measurement results, and make records of blood pressure and corresponding disease changes.

Quit smoking and drinking: Smoking and drinking are common bad habits, which are related to hypertension, coronary heart disease, arrhythmia and heart disease.

Fatigue and other diseases, especially sudden death of coronary heart disease, are closely related, and the risk of onset is significantly reduced after abstinence.

Mental health care: Cardiovascular diseases are mostly chronic diseases with a long course, which can cause various complications and have a negative impact on the quality of life.

Quantity has different degrees of influence. We should correctly understand the disease, establish an optimistic outlook on life, and avoid anxiety, tension and sadness.

View, enhance the determination and confidence to fight the disease.

Insist on taking medicine according to the doctor's advice: Most cardiovascular diseases, such as coronary heart disease, hypertension and heart failure, need long-term consolidation.

Taking medicine and treatment after discharge is an important part of the whole disease treatment scheme, especially for patients with hypertension, hematuria and urine.

After the pressure control is normal, we should stick to medication. Sudden withdrawal of drugs will lead to withdrawal syndrome and aggravate the condition.

Is very dangerous. In addition, it is more noteworthy that you should never take drugs with unreliable quality, and do your best.

Regular pharmacies, regular hospitals and medical institutions with high reputation buy medicines.

Regular follow-up: Regular follow-up of cardiovascular diseases is very important, and the doctor will take medicine according to your situation.

The dosage and type of drugs should be adjusted accordingly. Because the use of drugs for cardiovascular diseases is complicated and professional,

So I suggest you go to a cardiovascular hospital, a hospital with a cardiovascular clinic for a follow-up visit.