Flashcards in Exam #2: Risk Factors for Heart Disease Deck (28):
What is a risk factor?
Characteristic or feature of an individual or population demonstrated to increase the chance of future disease
What is primary prevention?
Strategy to reduce the risk of an initial adverse event
What is secondary prevention?
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.
What are the major risk factors in CAD?
3) Tobacco use
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****
What is the major difference between primary and secondary prevention?
Primary prevention is less cost effective
Describe the multifactorial nature of CHD.
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
What are the non-modifiable risk factors for CHD?
What are the diagnostic and screening tests that help us predict CHD risk?
- EET (exercise tolerance test)
- EBT (electron beam tomography)
What are the modifiable risk factors of CHD?
What are the preventative medications for CHD?
What are the interventions for CHD?
What is the lipid hypothesis?
Elevated serum cholesterol is linked to atherosclerosis
What is the best term for elevated cholesterol? Why?
Dyslipdiemia b/c we are concerned with the ratios of lipids and lipoproteins
What is the "number" for dyslipidemia?
Total cholesterol greater than 240 mg/L
What classification system is used for dyslipidemia today?
What is "optimal" cholesterol?
- LDL less than 100
- Total less than 200
- HDL greater than 40
*****Increased HDL decreased incidence of CHD*****
How should dyslipidemia be managed?
1) Screening= over 20
2) Primary prevention= behavior modification
3) Secondary prevention= behavior AND pharmacologic intervention
What is the basis for the intensity of ASCVD?
Individual risk assessment of lipid levels
What are the highest risk groups for ASCVD?
- Noncoronacy atherosclerotic arterial disease
- Aortic aneurysm
Confer a high 10-year risk of CHD.
How much does smoking increase the risk of an acute MI?
How much does smoking cessation reduce the risk of a cardiac event?
50% in the FIRST YEAR
What should you do with patients in regards to smoking?
1) Always ask
2) Education and counseling by the PHYSICIAN--makes it important
3) Pharmacologic intervention
How much does an increase in 7mmHg diastolic BP increase risk of CHD?
How much does HTN contribute to CVA and CAD?
How should you treat HTN?
- Optimize weight
- Na+ reduction
- Smoking cessation
- Limit alcohol
- Adequate K+ and Ca++
- Lipid lowering
What accounts for 77% of the hospitalization for Diabetics?
How did DM effect the annual CHD mortality in the Framingham study?
Men= doubled mortality