title: Macro- and micronutrients in patients with congestive heart failure, particularly African-Americans.
abstract: 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.
authors: Division of Cardiovascular Diseases, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA. knewman@utmem.edu
authors: Kevin P
authors: KP
authors: Newman
authors: Syamal K
authors: SK
authors: Bhattacharya
authors: Ahmad
authors: A
authors: Munir
authors: Richard C
authors: RC
authors: Davis
authors: Judith E
authors: JE
authors: Soberman
authors: Kodangudi B
authors: KB
authors: Ramanathan
mesh_terms: D001741:Black or African American / Q000208:ethnology; D000450:Aldosterone / Q000378:metabolism; D006333:Heart Failure / Q000208:ethnology* / Q000378:metabolism*; D006801:Humans; D009752:Nutritional Status / Q000208:ethnology*; D018384:Oxidative Stress
chemical_list: D000450:Aldosterone