Macro- and micronutrients in African-Americans with heart failure

Syamal K. Bhattacharya, Robert A. Ahokas, Laura D Carbone, Kevin P. Newman, Ivan C. Gerling, Yao Sun, Karl T. Weber

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

An emerging body of evidence suggests secondary hyperparathyroidism (SHPT) may be an important covariant of congestive heart failure (CHF), especially in African-Americans (AA) where hypovitaminosis D is prevalent given that melanin, a natural sunscreen, mandates prolonged exposure of skin to sunlight and where a housebound lifestyle imposed by symptomatic CHF limits outdoor activities and hence sunlight exposure. In addition to the role of hypovitaminosis D in contributing to SHPT is the increased urinary and fecal losses of macronutrients Ca2+ and Mg2+ associated with the aldosteronism of CHF and their heightened urinary losses with furosemide treatment of CHF. Thus, a precarious Ca2+ balance seen with reduced serum 25(OH)D is further compromised when AA develop CHF with circulating RAAS activation and are then treated with a loop diuretic. SHPT accounts for a paradoxical Ca2+ overloading of diverse tissues and the induction of oxidative stress at these sites which spills over to the systemic circulation. In addition to SHPT, hypozincemia and hyposelenemia have been found in AA with compensated and decompensated heart failure and where an insufficiency of these micronutrients may have its origins in inadequate dietary intake, altered rates of absorption or excretion and/or tissue redistribution, and treatment with an ACE inhibitor or AT1 receptor antagonist. Zn and Se deficiencies, which compromise the activity of several endogenous antioxidant defenses, could prove contributory to the severity of heart failure and its progressive nature. These findings call into question the need for nutriceutical treatment of heart failure and which is complementary to today's pharmaceuticals, especially in AA.

Original languageEnglish (US)
Pages (from-to)45-55
Number of pages11
JournalHeart Failure Reviews
Volume11
Issue number1
DOIs
StatePublished - Mar 1 2006
Externally publishedYes

Fingerprint

Micronutrients
African Americans
Heart Failure
Secondary Hyperparathyroidism
Sunlight
Sodium Potassium Chloride Symporter Inhibitors
Sunscreening Agents
Hyperaldosteronism
Melanins
Furosemide
Dietary Supplements
Treatment Failure
Angiotensin-Converting Enzyme Inhibitors
Life Style
Oxidative Stress
Antioxidants
Skin
Therapeutics
Serum
Pharmaceutical Preparations

Keywords

  • Calcium
  • Hypovitaminosis D
  • Magnesium
  • Secondary hyperparathyroidism
  • Selenium
  • Zinc

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bhattacharya, S. K., Ahokas, R. A., Carbone, L. D., Newman, K. P., Gerling, I. C., Sun, Y., & Weber, K. T. (2006). Macro- and micronutrients in African-Americans with heart failure. Heart Failure Reviews, 11(1), 45-55. https://doi.org/10.1007/s10741-006-9192-6

Macro- and micronutrients in African-Americans with heart failure. / Bhattacharya, Syamal K.; Ahokas, Robert A.; Carbone, Laura D; Newman, Kevin P.; Gerling, Ivan C.; Sun, Yao; Weber, Karl T.

In: Heart Failure Reviews, Vol. 11, No. 1, 01.03.2006, p. 45-55.

Research output: Contribution to journalArticle

Bhattacharya, SK, Ahokas, RA, Carbone, LD, Newman, KP, Gerling, IC, Sun, Y & Weber, KT 2006, 'Macro- and micronutrients in African-Americans with heart failure', Heart Failure Reviews, vol. 11, no. 1, pp. 45-55. https://doi.org/10.1007/s10741-006-9192-6
Bhattacharya, Syamal K. ; Ahokas, Robert A. ; Carbone, Laura D ; Newman, Kevin P. ; Gerling, Ivan C. ; Sun, Yao ; Weber, Karl T. / Macro- and micronutrients in African-Americans with heart failure. In: Heart Failure Reviews. 2006 ; Vol. 11, No. 1. pp. 45-55.
@article{0a75ed3362a743fb884105e56ba25534,
title = "Macro- and micronutrients in African-Americans with heart failure",
abstract = "An emerging body of evidence suggests secondary hyperparathyroidism (SHPT) may be an important covariant of congestive heart failure (CHF), especially in African-Americans (AA) where hypovitaminosis D is prevalent given that melanin, a natural sunscreen, mandates prolonged exposure of skin to sunlight and where a housebound lifestyle imposed by symptomatic CHF limits outdoor activities and hence sunlight exposure. In addition to the role of hypovitaminosis D in contributing to SHPT is the increased urinary and fecal losses of macronutrients Ca2+ and Mg2+ associated with the aldosteronism of CHF and their heightened urinary losses with furosemide treatment of CHF. Thus, a precarious Ca2+ balance seen with reduced serum 25(OH)D is further compromised when AA develop CHF with circulating RAAS activation and are then treated with a loop diuretic. SHPT accounts for a paradoxical Ca2+ overloading of diverse tissues and the induction of oxidative stress at these sites which spills over to the systemic circulation. In addition to SHPT, hypozincemia and hyposelenemia have been found in AA with compensated and decompensated heart failure and where an insufficiency of these micronutrients may have its origins in inadequate dietary intake, altered rates of absorption or excretion and/or tissue redistribution, and treatment with an ACE inhibitor or AT1 receptor antagonist. Zn and Se deficiencies, which compromise the activity of several endogenous antioxidant defenses, could prove contributory to the severity of heart failure and its progressive nature. These findings call into question the need for nutriceutical treatment of heart failure and which is complementary to today's pharmaceuticals, especially in AA.",
keywords = "Calcium, Hypovitaminosis D, Magnesium, Secondary hyperparathyroidism, Selenium, Zinc",
author = "Bhattacharya, {Syamal K.} and Ahokas, {Robert A.} and Carbone, {Laura D} and Newman, {Kevin P.} and Gerling, {Ivan C.} and Yao Sun and Weber, {Karl T.}",
year = "2006",
month = "3",
day = "1",
doi = "10.1007/s10741-006-9192-6",
language = "English (US)",
volume = "11",
pages = "45--55",
journal = "Heart Failure Reviews",
issn = "1382-4147",
publisher = "Springer Netherlands",
number = "1",

}

TY - JOUR

T1 - Macro- and micronutrients in African-Americans with heart failure

AU - Bhattacharya, Syamal K.

AU - Ahokas, Robert A.

AU - Carbone, Laura D

AU - Newman, Kevin P.

AU - Gerling, Ivan C.

AU - Sun, Yao

AU - Weber, Karl T.

PY - 2006/3/1

Y1 - 2006/3/1

N2 - An emerging body of evidence suggests secondary hyperparathyroidism (SHPT) may be an important covariant of congestive heart failure (CHF), especially in African-Americans (AA) where hypovitaminosis D is prevalent given that melanin, a natural sunscreen, mandates prolonged exposure of skin to sunlight and where a housebound lifestyle imposed by symptomatic CHF limits outdoor activities and hence sunlight exposure. In addition to the role of hypovitaminosis D in contributing to SHPT is the increased urinary and fecal losses of macronutrients Ca2+ and Mg2+ associated with the aldosteronism of CHF and their heightened urinary losses with furosemide treatment of CHF. Thus, a precarious Ca2+ balance seen with reduced serum 25(OH)D is further compromised when AA develop CHF with circulating RAAS activation and are then treated with a loop diuretic. SHPT accounts for a paradoxical Ca2+ overloading of diverse tissues and the induction of oxidative stress at these sites which spills over to the systemic circulation. In addition to SHPT, hypozincemia and hyposelenemia have been found in AA with compensated and decompensated heart failure and where an insufficiency of these micronutrients may have its origins in inadequate dietary intake, altered rates of absorption or excretion and/or tissue redistribution, and treatment with an ACE inhibitor or AT1 receptor antagonist. Zn and Se deficiencies, which compromise the activity of several endogenous antioxidant defenses, could prove contributory to the severity of heart failure and its progressive nature. These findings call into question the need for nutriceutical treatment of heart failure and which is complementary to today's pharmaceuticals, especially in AA.

AB - An emerging body of evidence suggests secondary hyperparathyroidism (SHPT) may be an important covariant of congestive heart failure (CHF), especially in African-Americans (AA) where hypovitaminosis D is prevalent given that melanin, a natural sunscreen, mandates prolonged exposure of skin to sunlight and where a housebound lifestyle imposed by symptomatic CHF limits outdoor activities and hence sunlight exposure. In addition to the role of hypovitaminosis D in contributing to SHPT is the increased urinary and fecal losses of macronutrients Ca2+ and Mg2+ associated with the aldosteronism of CHF and their heightened urinary losses with furosemide treatment of CHF. Thus, a precarious Ca2+ balance seen with reduced serum 25(OH)D is further compromised when AA develop CHF with circulating RAAS activation and are then treated with a loop diuretic. SHPT accounts for a paradoxical Ca2+ overloading of diverse tissues and the induction of oxidative stress at these sites which spills over to the systemic circulation. In addition to SHPT, hypozincemia and hyposelenemia have been found in AA with compensated and decompensated heart failure and where an insufficiency of these micronutrients may have its origins in inadequate dietary intake, altered rates of absorption or excretion and/or tissue redistribution, and treatment with an ACE inhibitor or AT1 receptor antagonist. Zn and Se deficiencies, which compromise the activity of several endogenous antioxidant defenses, could prove contributory to the severity of heart failure and its progressive nature. These findings call into question the need for nutriceutical treatment of heart failure and which is complementary to today's pharmaceuticals, especially in AA.

KW - Calcium

KW - Hypovitaminosis D

KW - Magnesium

KW - Secondary hyperparathyroidism

KW - Selenium

KW - Zinc

UR - http://www.scopus.com/inward/record.url?scp=33745617699&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745617699&partnerID=8YFLogxK

U2 - 10.1007/s10741-006-9192-6

DO - 10.1007/s10741-006-9192-6

M3 - Article

C2 - 16819577

AN - SCOPUS:33745617699

VL - 11

SP - 45

EP - 55

JO - Heart Failure Reviews

JF - Heart Failure Reviews

SN - 1382-4147

IS - 1

ER -