NUR 631 Topic 8 DQ 1

Sample Answer for NUR 631 Topic 8 DQ 1 Included After Question

Answer all of the following questions for your discussion response. Use the format displayed in the “Discussion Forum Sample.”

  1. Describe coronary artery disease. How does it develop? What is the pathophysiological basis of how the various risk factors can lead to this disorder?
  2. Numerous hormones have an impact on cardiac function. List two to three of these hormones and address how they affect the heart or the cardiovascular system.
  3. Diet and lifestyle play an important role in cardiovascular health. What is the impact of a poor diet and lifestyle on the cardiovascular system?

A Sample Answer For the Assignment: NUR 631 Topic 8 DQ 1

Title: NUR 631 Topic 8 DQ 1

Describe coronary artery disease. How does it develop? What is the pathophysiological basis of how the various risk factors can lead to this disorder?

Coronary artery disease (CAD) is an umbrella term for various cardiovascular disorders such as dyslipidemia, atherosclerosis, and hypertension. Atherosclerosis is the thickening of blood vessels caused by prolonged trauma and lipid buildup along the coronary wall (McCance et.al, 2019). CAD is not a singular disease because it can affect all the vascular systems of the body and can lead to myocardial infarctions, ischemia, and sudden death if not treated promptly or early enough. The layers of the artery starting from inside out include the endothelium, tunica intima, tunica media, and the adventitia (McCance et.al, 2019). CAD is developed from damaged endothelial walls that can arise from various risk factors such as hypertension, smoking, diabetes, and aging.

The damage to the endothelial walls of the arteries leads to fatty streak and lipid core formations, platelets attach to the endothelium, lipids accumulate, and eventually, fibrous tissue is capped over the lipid pool, with these lesions, a thrombus can attach to plaque wall, ultimately leading to infarction, stroke, or blocked artery (McCance et.al, 2019).  Any blockage in the artery can decrease oxygenation and perfusion. Chronic smokers cause damage to the endothelial walls because it causes inflammation and weakness. High blood pressure damages the walls because of turbulent blood flow to the walls.

Hyperlipidemia is another risk factor that contributes to the development of CAD, meaning higher levels of low-density lipoproteins because they easily penetrate the subintima layer of the arterial walls (McCance et.al, 2019). Modifiable risk factors such as weight, smoking, diet, lifestyle, and activity levels can decrease the risk of developing CAD. Non-modifiable risk factors include age, family history, and ethnicity. Management of CAD includes managing risk factors either by lifestyle changes or medication management with agents that reduce cholesterol and high blood pressure. 

Numerous hormones have an impact on cardiac function. List two to three of these hormones and address how they affect the heart or the cardiovascular system.

Numerous hormones have an impact on the cardiovascular system. While there are many hormones that play a factor in heart function, it is important to note the three responsibilities of hormones. These include contractility and the increase or decrease in blood flow as needed for the body, the redistribution of blood volume during hemorrhage or shock, and the regulation of heat loss (McCance et.al, 2019). Two hormones we will discuss are epinephrine and adrenomedullin (ADM). Epinephrine is a catecholamine hormone that is released from the adrenal medulla and plays a part in the vasoconstriction of the vascular beds (McCance et.al, 2019).

Epinephrine does not affect coronary, liver, or skeletal muscle beds (McCance et.al, 2019). Adrenomedullin (ADM) is a vasodilating peptide responsible for cardiovascular, pulmonary, and renal function (McCance et.al, 2019). According to an article from Hypertension Research, ADM is prominently increased during inflammatory episodes and is associated with sepsis, it is a clinical marker in the therapeutic management of inflammation (2022). ADM can also be used in the treatment of heart failure and other cardiovascular diseases (2022).

Diet and lifestyle play an important role in cardiovascular health. What is the impact of a poor diet and lifestyle on the cardiovascular system?

The International Journal of molecular sciences warms that cardiovascular disease is the leading cause of death in Western countries by as much as 30% worldwide (2018). Diet and lifestyle changes are important in overall cardiovascular health and healthy living habits. Diet modification is the most recommended treatment for the management of coronary artery disease. Diets that are high in trans fats, saturated fats, sodium, sugar, and carbohydrates all affect cardiac health. A high-fat diet contributes to the development of atherosclerosis. High sodium diets affect blood pressure and can exacerbate heart failure. The Mediterranean diet is recommended for individuals with cardiac issues, in a period of over 5 years, it reduced the risk of cardiovascular disease by 29% (McCance et.al, 2019).

The management of diet can positively impact oxidative stress and inflammation on the endothelial walls (2018). The impact of a poor diet and lifestyle on the cardiovascular system is massive, it can affect proinflammatory cytokines and plaque formation on arterial walls. Healthy eating habits such as consuming foods high in fiber, antioxidants, minerals, vitamins, and monounsaturated, and polyunsaturated fatty acids can contribute to low inflammation and healthy fats that are required for cardiovascular health (2018). A poor diet and sedentary lifestyle can also contribute to high blood pressure, high cholesterol (LDLs), obesity, increased fasting glucose, inflammation, and oxidative stress.

References:

Casas, R., Castro-Barquero, S., Estruch, R., & Sacanella, E. (2018). Nutrition and Cardiovascular Health. International journal of molecular sciences19(12), 3988. https://doi.org/10.3390/ijms19123988

Kita, T., Kitamura, K. Translational studies of adrenomedullin and related peptides regarding cardiovascular diseases. Hypertens Res 45, 389–400 (2022). https://doi.org/10.1038/s41440-021-00806-y

McCance, K. L., Huether, S. E., Brashers, V. L., Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children (Eighth ed.). Elsevier.

A Sample Answer 2 For the Assignment: NUR 631 Topic 8 DQ 1

Title: NUR 631 Topic 8 DQ 1

Describe coronary artery disease. How does it develop? What is the pathophysiological basis of how the various risk factors can lead to this disorder?

Coronary artery disease (CAD) is a cardiovascular disorder characterized by the narrowing or blockage of the coronary arteries, the blood vessels that supply oxygen-rich blood to the heart muscle. It is the leading cause of death worldwide and is primarily caused by atherosclerosis, a process involving the accumulation of fatty deposits, cholesterol, cellular debris, and calcium within the arterial walls, forming plaques.

The development of CAD begins with endothelial dysfunction, which occurs due to various risk factors such as smoking, hypertension, high blood cholesterol levels, diabetes, obesity, sedentary lifestyle, and genetic predisposition (Malakar et al., 2019). Endothelial dysfunction leads to inflammation and oxidative stress, triggering the accumulation of lipids, particularly low-density lipoproteins (LDL), within the arterial wall. Over time, these lipids undergo oxidation and are engulfed by immune cells, primarily macrophages, forming foam cells (Sharifi-Rad et al., 2020).

This process initiates the formation of fatty streaks, the earliest visible lesions in atherosclerosis. As the plaque matures, smooth muscle cells proliferate and migrate to the site, producing collagen and creating a fibrous cap over the lipid core. The plaques may continue to grow and eventually restrict blood flow through the coronary arteries, leading to reduced oxygen supply to the heart muscle. The plaques can also become unstable, prone to rupture or erosion, exposing the underlying contents to the bloodstream. This triggers the formation of blood clots, which can further block the arteries, resulting in a sudden and complete occlusion.

The consequences of CAD can range from angina (chest pain) and myocardial infarction (heart attack) to heart failure and life-threatening arrhythmias. The pathophysiological basis of CAD involves a complex interplay of risk factors, endothelial dysfunction, lipid accumulation, inflammation, oxidative stress, immune response, plaque formation, and potential plaque rupture, ultimately leading to compromised blood flow and cardiac events. Managing risk factors and adopting a heart-healthy lifestyle are essential in preventing and managing coronary artery disease.

Numerous hormones have an impact on cardiac function. List two to three of these hormones and address how they affect the heart or the cardiovascular system.

There are several hormones that play a significant role in modulating cardiac function and influencing the cardiovascular system. One of the notable hormones in this regard includes adrenaline (epinephrine). Adrenaline is released by the adrenal glands in response to stress or excitement. When adrenaline binds to beta-adrenergic receptors on cardiac muscle cells, it triggers a cascade of events that result in increased heart rate and contractility (Khan et al., 2020). These effects enhance cardiac output, ensuring a sufficient blood supply to meet the body’s demands during periods of increased activity or stress.

The second hormone is Angiotensin II is, a hormone produced by the renin-angiotensin-aldosterone system. It exerts its effects by binding to specific receptors in the blood vessels and the heart. Angiotensin II causes vasoconstriction, narrowing the blood vessels, which leads to an increase in peripheral resistance (Khan et al., 2020). This, in turn, raises blood pressure and increases the workload on the heart. Angiotensin II also stimulates the release of aldosterone, a hormone that promotes sodium and water retention, further contributing to an increase in blood pressure.

The above hormones have significant effects on cardiac function and the cardiovascular system. Adrenaline enhances heart rate and contractility, while angiotensin II increases peripheral resistance and blood pressure. Understanding the influence of these hormones is crucial in managing conditions such as heart failure, hypertension, and other cardiovascular disorders.

Diet and lifestyle play an important role in cardiovascular health. What is the impact of a poor diet and lifestyle on the cardiovascular system

A poor diet and lifestyle can have detrimental effects on the cardiovascular system, leading to a range of health problems. Firstly, a diet high in saturated fats, cholesterol, and sodium can contribute to the development of atherosclerosis, a condition characterized by the build-up of plaque in the arteries (Jain, Jain & Markande, 2022). The plaque narrows the arteries and restricts blood flow, increasing the risk of heart disease, heart attacks, and strokes.

It is also important to note that an unhealthy diet often lacks essential nutrients like fiber, antioxidants, and omega-3 fatty acids, which are crucial for maintaining cardiovascular health. Insufficient intake of these nutrients can result in elevated cholesterol levels, high blood pressure, and inflammation, all of which strain the heart and blood vessels. Furthermore, a sedentary lifestyle devoid of regular exercise further compounds the negative impact on the cardiovascular system. Lack of physical activity contributes to weight gain, obesity, and weakened cardiovascular function. It also lowers HDL (good) cholesterol and raises LDL (bad) cholesterol levels, promoting the development of cardiovascular diseases.

References

Jain, A., Jain, P., & Markande, G. B. (2022). Etiopathological and diagnostic study of Margavaranajanya Hridroga wsr to Coronary Artery Disease-An Observational Study. Journal of Ayurveda and Integrated Medical Sciences7(7), 47-57.

Khan, R., Sikanderkhel, S., Gui, J., Adeniyi, A. R., O’Dell, K., Erickson, M., … & Patel, D. (2020). Thyroid and cardiovascular disease: a focused review on the impact of hyperthyroidism in heart failure. Cardiology research11(2), 68.

Malakar, A. K., Choudhury, D., Halder, B., Paul, P., Uddin, A., & Chakraborty, S. (2019). A review on coronary artery disease, its risk factors, and therapeutics. Journal of cellular physiology234(10), 16812-16823.

Sharifi-Rad, J., Rodrigues, C. F., Sharopov, F., Docea, A. O., Can Karaca, A., Sharifi-Rad, M., … & Calina, D. (2020). Diet, lifestyle and cardiovascular diseases: linking pathophysiology to cardioprotective effects of natural bioactive compounds. International journal of environmental research and public health17(7), 2326.