Exam #2: Risk Factors for Heart Disease Flashcards Preview

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Flashcards in Exam #2: Risk Factors for Heart Disease Deck (28):
1

What is a risk factor?

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

2

What is primary prevention?

Strategy to reduce the risk of an initial adverse event

3

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.

4

What are the major risk factors in CAD?

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****

5

What is the major difference between primary and secondary prevention?

Primary prevention is less cost effective

6

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

7

What are the non-modifiable risk factors for CHD?

Age
Gender
Family history

8

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

- EET (exercise tolerance test)
- EBT (electron beam tomography)
- ECHO
- CRP

9

What are the modifiable risk factors of CHD?

Smoking
Lipids
BP
DM
Obesity
Alcohol
Diet
Physical Acitivity

10

What are the preventative medications for CHD?

ASA
Beta Blockers
ACE inhibitors

11

What are the interventions for CHD?

PCI
CABG

12

What is the lipid hypothesis?

Elevated serum cholesterol is linked to atherosclerosis

13

What is the best term for elevated cholesterol? Why?

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

14

What is the "number" for dyslipidemia?

Total cholesterol greater than 240 mg/L

15

What classification system is used for dyslipidemia today?

Biochemical

16

What is "optimal" cholesterol?

- LDL less than 100
- Total less than 200
- HDL greater than 40

*****Increased HDL decreased incidence of CHD*****

17

How should dyslipidemia be managed?

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

18

What is the basis for the intensity of ASCVD?

Individual risk assessment of lipid levels

19

What are the highest risk groups for ASCVD?

- DM
- Noncoronacy atherosclerotic arterial disease
- Aortic aneurysm

Confer a high 10-year risk of CHD.

20

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

3x

21

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

50% in the FIRST YEAR

22

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

23

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

27%

24

How much does HTN contribute to CVA and CAD?

CVA= 54%
CAD= 47%

25

How should you treat HTN?

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

Drug therapy

26

What accounts for 77% of the hospitalization for Diabetics?

CVD

27

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

Men= doubled mortality
Women= quadrupled

28

What is synergistic risk?

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