Flashcards in Cardiovascular disease Risk Factors and How to Manage Them Deck (35)
what is the leading cause of death
ASCVD is leading cause of mortality globally
Are ASCVD risk factors assoctiated with other dieases?
Yes, ASCVD risk factors are also associated with a host of other disease states including cancer, depression, and cognitive impairment such as dementia
What is ASCVD? What happens to the arteries? Where is the mismatch
Narrowing of arteries due to accumulated plaque.
Mismatch between the amount of circulation that can flow through the coronary arteries and what is needed for demand.
even a lot of young people have athersclerotic plaques, but its not a problem until a mismatch
What are the 4 consequences of the mismatch between flow circulation thru coronary arteries and what is needed for demand?
Many consequences of this mismatch:
1. Heart failure (weak pump due myocyte death)
2. Angina (stable and unstable, pain due to ischemia but no myocyte death)
3. Acute infarction (ischemia with myocyte death)
4.Sudden cardiac death (SCD) (due to infarct and myocyte necrosis).
What does ACS refer to
Acute Coronary Syndrome (ACS): any of the catastrophic consequences of the mismatch (Unstable angina, MI, SCD).
it has a potential for myocyte death
What is the difference between primary and secondary prevention
Primary-before the disease manifests
Secondary-after the disease manifests...already had an mi dont want them to have another. Already have stable angina, dont want it to progress further.
What do recommendations for prevention depend on: (4)
Recommendations vary depending on
2) level of risk
3) primary or secondary 4) co-morbidities (such as DM)
What is the most important way to prevent atherosclerotic vascular disease heart failure, and atrial fibrillation ?
The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.
Is team based care useful for preventing cardiovascular disease
yes, Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions.
A patient is 40 years old and is being evaluated for cardiovascular disease prevention. What should they undergo?
Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCV) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin
What is a way all adults should help prevent problems
All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages.
For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.
How much exercise should a person engage in ? Moderate and vigerous?
Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.
what 2 lifestyle shuold pts with DMII take
type 2 diabetes mellitus, lifestyle changes, such as:
1. improving dietary habits
2.achieving exercise recommendations are crucial.
What is the first line and second line medication therapy for pts w/ DMII
If medication is indicated:
metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist.
How often should pts be assesed for tobacco use;
All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.
Should pts use aspirin frequently?
No, Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.
What is the first line therapy treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), DMii, and 40-70 w/ elevated risk
Statin therapy is first-line treatment for primary prevention of ASCVD
A person has HTN should they take statins to prevent ASCVD?
No, Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg
Which 4 groups should get statins if indicated
DM II, 40-70 w/ elevated risk , cholesterol >190
Reduction in ASCVD in U.S. over last 2 decades is largely attributed to...
Reduction in ASCVD in U.S. over last 2 decades is largely attributed to reduction tobacco use (and also reduction in second hand and third hand exposure).
Is a person that is exposed to 2nd hand smoke at increased risk
YES! Evidence is clear that ANY tobacco exposure (second and third hand) increases risk.
What kind of lifestyle should be emphasized for all individuals.
A heart-healthy lifestyle should be emphasized for all individuals.
What kind of therapy should be the primary intervention for metabolic syndrome.
Lifestyle therapy should be the primary intervention for metabolic syndrome.
A person is 23 and has a primary LDL-C ≥ 190 mg/dL what should the next step be?
All Adults ≥ 21 years of age with a primary LDL-C ≥ 190 mg/dL should be treated with high-intensity statin therapy unless contraindicated.
An adults b/n 40-75 years of age with an LDL-C 70-189 mg/dL without clinical ASCVD or diabetes and an estimated ten-year ASCVD risk ≥ 7.5% should be treated with :
Adults 40-75 years of age with an LDL-C 70-189 mg/dL without clinical ASCVD or diabetes and an estimated ten-year ASCVD risk ≥ 7.5% should be treated with moderate- to high-intensity statin therapy.
Adults 40-75 years of age with an LDL-C 70-189 mg/dL without clinical ASCVD or diabetes and an estimated ten-year ASCVD risk 5- 7.4% may consider _________________ _______ therapy if there are additional risk factors. The decision to treat should include __________
Adults 40-75 years of age with an LDL-C 70-189 mg/dL without clinical ASCVD or diabetes and an estimated ten-year ASCVD risk 5- 7.4% may consider moderate intensity statin therapy if there are additional risk factors. The decision to treat should include a discussion of the benefits and risks between the patient and clinician.
A person is 55 and have DMII and an LDL-C 70-189 mg/dL what shuld the next steps be
Adults 40-75 years of age with diabetes mellitus and an LDL-C 70-189 mg/dL should be treated with moderate-intensity statin therapy.
An 80 yr old has clinical ASCVD what is the next step
Individuals ≤ 75 years of age who have clinical ASCVD should be treated with high-intensity statin therapy unless contraindicated.
A person has a very high-risk ASCVD what should the next step be?
In adults with very high-risk ASCVD, addition of a nonstatin may be considered at a LDL-C threshold of 70 mg/dL (1.8 mmol/L). Very high-risk includes a history of multiple major ASCVD events or 1 major ASCVD event and multiple high-risk conditions.