Macro- and micronutrients in patients with congestive heart failure, particularly African-Americans

• Published in: Vascular health and risk management Vol. 3; no. 5; pp. 743 - 747
• Main Authors: Newman, Kevin P, Bhattacharya, Syamal K, Munir, Ahmad, Davis, Richard C, Soberman, Judith E, Ramanathan, Kodangudi B
• Format: Journal Article
• Language: English
• Published: New Zealand Taylor & Francis Ltd 2007; Dove Medical Press
• Subjects: African Americans; African Americans - ethnology; Aldosterone - metabolism; Endocrine disorders; Heart failure; Heart Failure - ethnology; Heart Failure - metabolism; Humans; Nutritional Status - ethnology; Oxidative Stress; Review; Vitamin D; Vitamin deficiency; Africa
• ISSN: 1176-6344; 1178-2048; 1178-2048

Not all patients with heart failure, defined as a reduced ejection fraction, will have an activation of the RAAS, salt and water retention, or the congestive heart failure (CHF) syndrome. Beyond this cardiorenal perspective, CHF is accompanied by a systemic illness that includes oxidative stress, a proinflammatory phenotype, and a wasting of soft tissues and bone. A dyshomeostasis of calcium, magnesium, zinc, selenium, and vitamin D contribute to the appearance of oxidative stress and to compromised endogenous defenses that combat it. A propensity for hypovitaminosis D, given that melanin is a natural sunscreen, and for secondary hyperparathyroidism in African-Americans make them more susceptible to these systemic manifestations of CHF-a situation which is further threatened by the calcium and magnesium wasting that accompanies the secondary aldosteronism of CHF and the use of loop diuretics.