Exam #2: Risk Factors for Heart Disease Flashcards

1
Q

What is a risk factor?

A

Characteristic or feature of an individual or population demonstrated to increase the chance of future disease

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2
Q

What is primary prevention?

A

Strategy to reduce the risk of an initial adverse event

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3
Q

What is secondary prevention?

A

Strategy to reduce risk of a new adverse event in a patient with a known disease or condition

E.g. a patient with known CAD that are trying to prevent a MI in.

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4
Q

What are the major risk factors in CAD?

A

1) Dyslipidemia
2) HTN
3) Tobacco use
4) DM
5) Chronic renal disease

Note that these are synergistic; account for most of the risk of MI; one risk factor is associated with 90% of adverse cardiac events

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5
Q

What is the major difference between primary and secondary prevention?

A

Primary prevention is less cost effective

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6
Q

Describe the multifactorial nature of CHD.

A

1) Predisposing factors and behavior lead to metabolic abnormalities
2) Metabolic abnormalities lead to quiescent disease markers/ evidence of disease
3) Markers transition to overt disease

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7
Q

What are the non-modifiable risk factors for CHD?

A

Age
Gender
Family history

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8
Q

What are the diagnostic and screening tests that help us predict CHD risk?

A
  • EET (exercise tolerance test)
  • EBT (electron beam tomography)
  • ECHO
  • CRP
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9
Q

What are the modifiable risk factors of CHD?

A
Smoking 
Lipids 
BP 
DM 
Obesity 
Alcohol 
Diet 
Physical Acitivity
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10
Q

What are the preventative medications for CHD?

A

ASA
Beta Blockers
ACE inhibitors

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11
Q

What are the interventions for CHD?

A

PCI

CABG

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12
Q

What is the lipid hypothesis?

A

Elevated serum cholesterol is linked to atherosclerosis

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13
Q

What is the best term for elevated cholesterol? Why?

A

Dyslipdiemia b/c we are concerned with the ratios of lipids and lipoproteins

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14
Q

What is the “number” for dyslipidemia?

A

Total cholesterol greater than 240 mg/L

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15
Q

What classification system is used for dyslipidemia today?

A

Biochemical

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16
Q

What is “optimal” cholesterol?

A
  • LDL less than 100
  • Total less than 200
  • HDL greater than 40

Increased HDL decreased incidence of CHD

17
Q

How should dyslipidemia be managed?

A

1) Screening= over 20
2) Primary prevention= behavior modification
3) Secondary prevention= behavior AND pharmacologic intervention

18
Q

What is the basis for the intensity of ASCVD?

A

Individual risk assessment of lipid levels

19
Q

What are the highest risk groups for ASCVD?

A
  • DM
  • Noncoronacy atherosclerotic arterial disease
  • Aortic aneurysm

Confer a high 10-year risk of CHD.

20
Q

How much does smoking increase the risk of an acute MI?

A

3x

21
Q

How much does smoking cessation reduce the risk of a cardiac event?

A

50% in the FIRST YEAR

22
Q

What should you do with patients in regards to smoking?

A

1) Always ask
2) Education and counseling by the PHYSICIAN–makes it important
3) Pharmacologic intervention

23
Q

How much does an increase in 7mmHg diastolic BP increase risk of CHD?

A

27%

24
Q

How much does HTN contribute to CVA and CAD?

A
CVA= 54% 
CAD= 47%
25
Q

How should you treat HTN?

A

Lifestyle

  • Exercise
  • Optimize weight
  • Na+ reduction
  • Smoking cessation
  • Limit alcohol
  • Adequate K+ and Ca++
  • Lipid lowering

Drug therapy

26
Q

What accounts for 77% of the hospitalization for Diabetics?

A

CVD

27
Q

How did DM effect the annual CHD mortality in the Framingham study?

A
Men= doubled mortality 
Women= quadrupled
28
Q

What is synergistic risk?

A

Additional risk factors amplifies risk to a degree greater than the additive risk