Prevention of Ischemic Heart Dz

Question 1

modification of risk factors in order to prevent or delay the onset of CHD

Answer 1

primary prevention

Question 2

Initiation of therapy to reduce recurrent CHD events and decrease cardiac mortality in patients already dx’ed with CHD

Answer 2

Secondary prevention

Question 3

IHD:

Answer 3

ischemic heart disease

Question 4

CHD

Answer 4

coronary heart disease

Question 5

CVD

Answer 5

cardiovascular disease

Question 6

class I recommendation. Should you do it?

Answer 6

YES, benefit waaay better than risk

Question 7

class IIa recommendation: should you do it?

Answer 7

REASONABLE. benefit is greater than risk, which has been proven by random clinical trial

Question 8

Class IIb recommendation, should you do it?

Answer 8

Maybe. benefit is greater than/equal to risk as determined by small/limited studies

Question 9

Class III recommendation, should you do it?

Answer 9

No

Question 10

Fun Fact: Only _______% of women are aware that heart dz is their #1 killa

Answer 10

50%

Question 11

give an example of modifiable risk factors

Answer 11

htn, glucose control, cholesterol mgmt., tobacco, diet, activity level, obesity (you get it)

Question 12

example of non-modifiable risk factors

Answer 12

age, gender, FHx, etc

Question 13

what tool are ya going to use to determine the 10 year risk of having a heart attack?

Answer 13

Framingham risk calculator

Question 14

ABC’s of prevention, what’s A stand for

Answer 14

Antiplatelet therapy, anticoagulant therapy, ACEI’s, ATII blockers

Question 15

ABC’s of prevention, whats the B?

Answer 15

Blood pressure control, BB

Question 16

ABC’s, what’s the C?

Answer 16

cholesterol mgmt., cigarette cessation

Question 17

ABC’s, what’s the D?

Answer 17

diet, DM mgmt

Question 18

ABC’s, what’s the E?

Answer 18

exercise, EF assessment

Question 19

AHA guidelines for the simple 7 of primary prevention goals

Answer 19

get active!, diet, wt loss, stop smoking, cholesterol, BP mgmt., glucose control

Question 20

activity goals: what’s a minimum amt of acceptable activity? What is optimal?

Answer 20

minimum: 30-60 min/day, 5 days/week
optimal: 30-60 min/day, 7 days/week

Question 21

Diet recommendations:

Answer 21

eat food, not too much, mostly plants

Question 22

If you cut back _________ calories per day, you should expect to lose 1 pound a week

Answer 22

500

Question 23

Should you nag patients to quit smoking?

Answer 23

Yes.

Question 24

High triglycerides are a worse risk factor for developing heart disease in which gender?

Answer 24

Female (can double risk with TG>400)

Question 25

what are some medications/drugs that can cause HTN?

Answer 25

NSAIDS, oral contraceptives, steroids, sympathomimetics, ephedra, cocaine, meth, ETOH

Question 26

Medical conditions that can cause secondary HTN:

Answer 26

renal dz, thyroid dz, sleep apnea, etc

Question 27

lifestyle recommendations for BP control:

Answer 27

wt loss, DASH diet, limit sodium, exercise, moderate ETOH (1-2 drinks/day ok)

Question 28

Number one thing that patients can do to reduce mortality rate from heart disease?

Answer 28

stop smoking

Question 29

What is the next most important lifestyle factor (after smoking cessation) to reduce risk for heart disease

Answer 29

diet/exercise

Question 30

following the "effective 7" (ie nonsmoking, 30+min exercise/day, good diet, and BMI<25) reduces overall risk by how much?

Answer 30

83%

Question 31

ASA recommendations, who should definitely get it (recommendation IIa) for primary prevention

Answer 31

at risk women >65, all men

Question 32

ASA recommendation, who should maybe get it for primary prevention?

Answer 32

at risk women <65

Question 33

ASA recommendation, who should not get it for primary prevention?

Answer 33

women with no risk <65

Question 34

ASA recommendation, who should definitely get it for secondary prevention

Answer 34

everybody who's already been dx'ed with CHD

Question 35

Who should be recommended for cardiac rehab?

Answer 35

ALL pts post MI, anyone with recent CABG, chronic angina, or symptomatic PAD

Question 36

Who should be getting Plavix (clopidogrel)?

Answer 36

patients allergic to ASA, or given in addition to ASA following stent placement