Assignment 1 (Evidence-Based Practice Paper Reflection)

Running head: COMPLEMENTARY THERAPY FOR HEART DISEASE 1

COMPLEMENTARY THERAPY FOR HEART DISEASE 11

Complementary Therapy for Heart Disease

Deborah. J

Peer Review Evidence Based Practice Paper

 Heart or cardiovascular diseases involves all the conditions that affect the heart structure and functions, blood vessels, and blood clots. Specific cardiovascular diseases include coronary artery disease, congenital heart defects, myocardial infarction, heart failure, stroke, hypertension, and arrhythmias (Eilat-Adar, Sinai, Yosefy & Henkin, 2013). Heart disease is the leading cause of death globally. The cause of death usually results from direct and indirect factors of heart disease. It is responsible for about 17.9 million deaths globally (Cardiovascular diseases, 2019). This represents 31% of all deaths in the world. It is also the leading cause of hospitalization among individuals aged 65 years and above. There are also cases of heart disease in people below 65 years old, but the incidence rate is not the same.

Heart diseases are considered a lifestyle disease since it arises from human practices and behaviors. The behaviors are not the direct causes of heart disease but act to contribute to its incidence. One of the risk factors of heart disease is nutritional practice. Heart diseases occur due to structural changes in the body resulting from the accumulation of some nutrients such as fats and sugars in the body (Cardiovascular diseases, 2019). The structural changes result in altered physiological processes in the cardiovascular system, causing the heart to develop problems when pumping blood out to the other system. Close to a poor diet is a lack of physical activity. Physical activity is considered a booster for a healthy heart. Lack of exercise contributes to the accumulation of fats and sugars in the body hence increasing the risk of heart diseases (Cardiovascular diseases, 2017).

The aim of treating heart disease is to eliminate symptoms through curing the underlying cause, preventing complications, and promoting quality living. Heart disease is usually treated with a range of drugs that target the altered systems or organs in the body to restore normal cardiac functions. Other therapeutic approaches for treating cardiovascular diseases include nutritional practice and physical therapy (Lindquist, Tracy & Snyder, 2018). These two are considered as complementary or alternative therapies for heart disease patients. Complementary or alternative therapies are approaches with scientific basement to improve the health of the patients. They are meant to complement the drug therapy that the patients are subjected to (Synder, Niska & Lindquits, 2014). Other complementary therapies for heart disease include yoga, relaxation therapy, and meditation. They are used to introduce a relaxed mood for the patients to reduce and prevent blood pressure from rising.

In this paper, the chosen complementary therapy for heart diseases in this paper, therefore, is nutrition or diet therapy. Nutrition can either promote or affect cardiovascular health. Poor nutrition is one of the leading factors that contribute to heart disease among patients in the world. It is known to cause and or worsen cases of the heart of disease among patients (Cardiovascular diseases, 2017). Therefore, diet therapy works both as a preventive and rehabilitative therapeutic approach for heart disease. This was established after patients with heart disease demonstrated poor health outcomes following initiation of drug therapy. A great milestone was made on the treatment of disease when nutritional modification for patients with heart disease was done. The components of the diet that nutritional therapy targets are fats, sugars, and sodium. These three nutrients are the leading causes of physiological alteration resulting in heart disease. This therapy, therefore, focuses on reducing the levels of the nutrients in the body through dietary restrictions. The subsequent paragraphs will discuss the physiological process of the interaction of these nutrients to cause heart disease. 

Nutritional or diet therapy treats heart disease in several ways. Understanding how the three nutrients cause heart disease is essential to recognize the role of nutrition therapy for heart disease. Accumulation of fats in the body usually results in their deposition in the blood vessels. As a result of this phenomenon, there is going to be resistance to blood flow due to partial or complete blockage of the arterial and venous lumen (Cardiovascular diseases, 2017). This will result in the heart muscles to increase in the rate and strength of contraction to pump blood against the increased central and peripheral resistance. As a result of continued overstretching of the heart muscles to pump blood, there is hypertrophy of the ventricles of the heart. Hypertrophy of heart ventricles usually predisposes the heart to sudden stopping, causing heart failure and subsequent stroke (Hinkle & Cheever, 2013). All these changes are attributed to the fats distributed along the lumen of the blood vessels resulting from excess dietary consumption of fats.

On the other hand, excessive intake of sugars predisposes individuals to cardiac disease through increased levels of serum glucose. Increased serum glucose results in the reduction of albumin, which are proteins found in the blood to regulate blood pressure. The presence of excessive sugars in the blood increases the blood pressure for individuals (Hinkle & Cheever, 2013). Persistently raised blood pressure usually resulted in hypertrophy of cardiac muscles. With time, the hypertrophied muscles collapse, resulting in the heart's inability to pump blood to other vital organs and tissues in the body (Cardiovascular diseases, 2017). The impaired supply of blood to the brain and heart muscles, ischemic stroke, and a heart attack occur, increasing the risk of disability and death for the patient. The primary cause of increased serum glucose is high dietary consumption and lack of proper metabolism due to excessive accumulation (Hinkle & Cheever, 2013).

As a nutrient in the body, sodium is responsible for the control of fluid volume in the body. The roles of sodium are usually to promote the reabsorption of water in the kidney tubules. Having excessive dietary intake of sodium, therefore, increase the volume of fluid in the body. Bloody pressure in the body is usually the product of cardiac output and stroke volume. Stroke volume tends to increase when the overall fluid volume is high (Hinkle & Cheever, 2013). Increased fluid volume, coupled with increased peripheral resistance to blood flow, usually causes severe hypertension. Stroke and heart attack are the major complications of hypertension among adults. 

With the information on the role of sodium, fats, and sugars on cardiac health, using dietary practice as a method for managing heart disease is easy. Patients suffering from heart disease need to consume little or no fats for better health outcomes. Avoidance of fats in the diet ensures that there are no excessive fats deposited on the blood vessels. As a result, there is no obstruction to blood flow within the body. Lowering the levels of fats in the body system also reduces the chances of diabetes. Diabetes is known to occur due to reduced cellular sensitivity to the actions of insulin produced in the pancreases. Having diabetes increases the risk of kidney damage due to the excessive amounts of sugars that destroy the capillary network in the nephrons (Hinkle & Cheever, 2013). Damaged kidney, therefore, means that checking of the fluid volume in the body is impaired. There is an increased level of fluid of retention since there is no urine production. This causes blood pressure and heart failure due to increased preload and afterload in the heart.

Reducing the dietary intake of sodium is almost similar to the effects of reduced-fat consumption. Avoiding food reach in sodium ensures that the fluid retained by the kidney is the required amount (Cardiovascular diseases, 2017). As a result, the heart will be pumping blood without much straining. This helps in the maintenance of the heart muscles and small capillaries in the kidney and the brain. Increased blood pressure usually results in the bursting of the small blood vessels in the brain and the kidneys, respectively, causing stroke and kidney disease. Stroke due to this phenomenon is considered a hemorrhagic stroke, which has complex treatment. Such is only preventable through proper management of the blood pressure with dietary modification (Hinkle & Cheever, 2013).

Nutritional therapy also includes a reduction in the amount of sugars consumed by the patients. Increased levels of sugars in the body result in forcing out of the albumin component of the blood in the kidneys. Albumin, as stated before, act to regulate the blood pressure. Without albumin, the blood pressure increases result in the destruction of small blood vessels in the body. The effects of the phenomena are similar to the outcomes of high levels of sodium in the body (Hinkle & Cheever, 2013). Modification of the diets of patients is an appropriate therapeutic approach towards the complementation of pharmacological management of heart disease. Therefore, minimizing dietary consumption of sugars helps to prevent incidences of hypertension and subsequent complications such as stroke and myocardial infarction.

Using nutritional therapy as the alternative for treating the cardiac disease usually considered the best because of several reasons. One of the reasons for this approach is the effectiveness. Limiting the levels of sugars, fats, and sodium in the diet of patients with heart disease has proven to be very effective. With fewer sugars and fats in the body, the physiological process of the cardiovascular system is working normally even when the patients do not use the drugs used to manage cardiac conditions such as hypertension (Hinkle & Cheever, 2013). Limiting sodium in the diet specifically helps in preventing fluid in the body. Without excessive fluid, the heart can pump blood normally. Evidence from research suggests that patients with a history of heart disease and sodium-restricted diet are free of signs of hypertension, such as headaches, dizziness, and palpitations (Harsha & Bray, 2017). Those who avoid fats have few or no history of complications such as stroke and heart failure. This differs from those individuals who are using drugs alone to manage their conditions. 

Another reason for using nutritional therapy as an alternative treatment for heart disease is because of safety. The use of medications to manage the disease, including heart disease, is known to cause adverse effects on the health of the patient. Some drugs used to treat hypertension, such as nifedipine and digoxin, may result in hypotension in patients. Some diuretic agents, such as hydrochlorothiazide, may result in constipation and dehydration among some patients if not monitored closely (Cardiovascular diseases, 2017). This is different from diet therapy. It is safe to use and can achieve the same objectives as using drugs to treat conditions such as hypertension (Esselstyn, 2017). Diet therapy can be self-administered by the patient without necessarily requiring the healthcare provider to be present.

Diet therapy is considered the best also as it is affordable. Some of the drugs used to manage heart disease are expensive as compared to nutritional products considered safe for consumption as far as heart disease is concerned (Cardiovascular diseases, 2017). Individuals only need to use their daily diet to manage their condition at home. Evidence suggests that using nutritional therapy to manage heart conditions is preferred by many individuals since some of the prescribed food products are already in their diet (Harsha & Bray, 2017). There are no issues of changing the diet to treat the condition. This therapeutic approach is, therefore, considered as the best solution to individuals with heart disease.

Application into Practice.

Diet therapy has scientific proof to be used in the field of nursing practice. As a complementary therapy, dietary practice for the management of heart disease is widely used to improve the health outcomes and quality of life for patients and society. Healthcare providers are currently focusing on promoting the health of the people in addition to treating. Health promotion is achieved through health education for individuals and communities. Among the components of health education is the proper nutritional practice for better health. Health promotion aims to increase the capacity and knowledge of the people for self-care (Hinkle & Cheever, 2013). Heart disease is always considered a chronic condition that can be prevented through lifestyle modification. One of the methods of achieving is through having a proper diet towards heart health. Patients who have been admitted to care facilities to receive cardiac treatment using drugs are also on dietary management to improve their health outcomes. Depending on the severity of the condition, the patient is usually subjected to varying dietary restrictions. Some individuals are allowed to a small number of fats, while others are prohibited. 

Individuals suffering from severe hypertension are restricted from using both enteral and parenteral feeds or fluids that contain sodium. This is usually done to ensure that the blood pressure is minimized and maintained as much as possible. There are cases whereby individuals are not responding to medications and diet therapy. One way of improving the health of such people is to review the medication regime. It is not usual to change the dietary intake, but changing the drugs taken by the patient is usually possible. Diet therapy is, therefore, preferred as the best alternative to the pharmacological management of heart disease.

Achieving the best results for patients with cardiac disease is not possible without the patient's involvement in dietary therapy. Patients need to be educated on the importance of nutritional therapy on their health. Using a specific model such as the Health Belief Model to educate the people will result in the process's better uptake. Patients need to understand both benefits and the other outcomes of engaging in specific health-related issues. They need to learn that diet practice is not for heart disease alone but also act to prevent other conditions such as cancers from arising. 

Healthcare practice also needs to actively engage other stakeholders in the community when designing the diet therapy for the patients who have heart disease. When designing the therapy, it is important to determine the availability of substitutes for the nutrients which have been restricted in the diet. They should be available to ensure that the patients' nutritional needs are met even with the restrictions imposed on the diet (Cardiovascular diseases, 2017). For instance, table salt, rich in sodium, should be replaced with potassium-rich table salt. This ensures that the patients are adhering to the new dietary practices without many complexities.

The cost of dietary products safe for heart disease will have to be considered. Patients with heart disease and diabetes are usually advised to avoid fast foods rich in sugars and fats. They are advised to feed on fresh farm products sold in the groceries and supermarkets. The majority of groceries are usually expensive; hence some people cannot be able to afford them. Therefore, the healthcare providers' role is to provide the best alternative for the patients to achieve similar health outcomes. Those who can afford these nutritional products are encouraged to go for them. 

Another essential of diet therapy is adherence to drug therapy, which is the mainline for the management of the disease. Patients need to adhere to the prescription provided by healthcare providers for better health outcomes. Evidence suggests that some patients have stopped using medications used to treat specific heart diseases with claims that diet therapy is enough. It is the role of the healthcare providers to ensure that these patients are adhering to the guidelines for using both drug and diet therapy for the management of heart disease (Hinkle & Cheever, 2013).

Cultural Considerations for Diet Therapy.

Cultural beliefs usually play a significant role in the health and treatment of people. Cultural lifestyles are identified through feeding habits where specific food is associated with special importance. Diet therapy involves the restriction of some nutritional intake. Some of the food prohibited or restricted due to heart disease are the primary food in some cultures. As a result, some health messages such as avoidance of sugar, fats, and salt or sodium in food may not go well with some cultural beliefs. There is a likelihood that conflict may arise between healthcare providers and members of some communities. Therefore, there is a need for healthcare teams to come up with interventions that are culturally acceptable to the people. Culture, in this case, entails both traditional, social, and economical way of life. 

Some individuals will view food without much sugar and fats as of low social and economic class. The majority of people prefer buying their food in supermarkets. This considered the social culture of some individuals in society. The food which they purchase is mainly made of sugars and fats. Hence restricting from these foods is considered a cultural violation. It is, therefore, important for healthcare providers to assess others' social class before advising them on what to consume and what to avoid. Without proper education on the importance of dietary change, some individuals will against healthcare advice hence increasing the complications of heart diseases. 

Some traditional cultures, such as Spanish, have more fats in their traditional diets. Therefore, restricting them from feeding in such food is not a welcomed idea for them. It needs the care provider to take them through extensive health education for them to understanding. Food is considered an element of identity for their culture. Hence, restricting them will not be easy. As a nurse or a clinician, one is always expected to demonstrate a high level of cultural competence when dealing with patients from a diverse background. Hispanics have significant numbers of people with heart disease and diabetes in America. This phenomenon has been attributed to poor dietary practices by the majority of the people. Therefore, it is the role of care providers to come up with an extensive health education program for them to embrace the required diet therapy even if it may go against their traditional culture of feeding.

Conclusion.

Heart disease is a chronic condition that occurs due to many factors that interact to cause altered physiological processes in the cardiovascular system. One of the factors contributing to heart disease is poor nutritional practices. Feeding on high amounts of fats, sugars, and sodium is known to indirectly trigger the events leading to heart disease among people. Treating heart disease involves many approaches, the primary being use of drugs. Complementary therapies for heart disease include diet therapy, yoga, and physiotherapy. Diet therapy is considered as one of the best alternative or complementary to pharmacological therapy since it is affordable, available, and safe for the patients. Appropriate application of diet therapy in nursing practice leads to improved patient outcomes. It is also important for care providers to consider the cultural implications of diet therapy on the majority of the people in their bid to manage heart disease appropriately. 

References

Cardiovascular diseases. (2019, June 11). Retrieved from https://www.who.int/health-topics/cardiovascular-diseases/

Cardiovascular diseases (CVDs). (2017, May 17). Retrieved from https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Eilat-Adar, S., Sinai, T., Yosefy, C., & Henkin, Y. (2013). Nutritional recommendations for cardiovascular disease prevention. Nutrients, 5(9), 3646-3683.

Esselstyn, C. B. (2017). A plant-based diet and coronary artery disease: a mandate for effective therapy. Journal of geriatric cardiology: JGC, 14(5), 317.

Harsha, D. W., & Bray, G. A. (2017). Diet and Blood Pressure: The High and Low of it. In Nutrition Guide for Physicians and Related Healthcare Professionals (pp. 123-128). Humana Press, Cham.

Hinkle, J. L., & Cheever, K. H. (2013). Clinical handbook for Brunner & Suddarth's textbook of medical-surgical nursing. Lippincott Williams & Wilkins.

Lindquist, R., Tracy, M. F., & Snyder, M. (Eds.). (2018). Complementary and alternative therapies in nursing. Springer Publishing Company.

Synder, M., Niska, K. A. T. H. L. E. E. N., & Lindquits, R. (2014). Evolution and use of complementary and alternative therapies. Complementary & alternative therapies in nursing, 3-16.