02.07 Metabolic Syndrome and Coronary Artery Disease Flashcards
Regulate inflammatory response, lipoprotein metabolism, vascular inflammation
Adipokines
Entero-protective
Insulin-sensitizing, anti-inflammatory, lipid regulatory atheroprotective
Adinopectin
Produced by fat cells
Satiety hormone
Leptin
Inc in monocyte and vascular NF kappa beta and ERK 1-dependent inflammatory responses
Resistin
State of chronic low-grade inflammation with the profound system effects
Metabolic syndrome
Primary therapy for metabolic syndrome
Lifestyle changes
Estimates the risk of coronary heart disease
Framingham risk score
Primary prevention of metabolic syndrome
Assess traditional atherosclerotic cardiovascular disease risk factors every 4-6 years in adults 20-79 years of age who are free from ASCVD and estimate 10-year ASCVD risk
Dietary patterns
Secondary prevention of metabolic syndrome
Intensive risk-reduction therapies for patients with established coronary and other atherosclerotic vascular disease
Dietary patterns and exercise
Management for triglyceride levels 150-199 mg/dL
Institute weight reduction and increase physical activity
Carbohydrate-controlled dieting
Management for triglyceride levels 200-499 mg/dL
Reduce non-HDL cholesterol
Statins, fibrates and nicotinic acid
Diabetes prevention
Weight reduction of 5-10%
Sodium intake of <1.5 - 2.4
Metformin
Low glycemic index food Complex unrefined carbohydrates Viscous soluble fibers Protein intake of 10-35% of total calorie intake 25%-35% of calories from fat
DASH diet
High consumption of fruits, vegetables legumes, and grains, moderate alcohol intake, a moderate-to-low consumption of dairy and meat products and a high monounsaturated to saturated fat ratio
Mediterranean diet
Recommendation for lower risk (LDL < 160 mg/dL)
Lifestyle modifications
Pharmacologic intervention if Ldl-C >/= 190 after lifestyle modification
Recommendation for moderate risk (LDL < 130 mg/dl)
Lifestyle modifications
Pharma intervention if LDL-C >/= 160 mg/dL
Recommendation for moderately high risk (LDL < 130 mg/dL)
Lifestyle modification
Pharma therapy if LDL-C >/= 130 or optionally if >/= 100 after LM
Recommendation for high risk (<100 mg/dL)
LM
Pharma if LDL-C >/= 100 or optionally >/= 70
Recommended saturated fat level
Less than 7%
Recommended cholesterol intake
Less than 200 mg a day
Recommended fiber intake
10-25 g/day
Recommended stanols or sterols level
2 grams per day
Omega 3 fatty acid found mainly in fatty fish and some commercially made sources from algae
Docosahexanoic acid
Omega 3 fatty acid found mainly in fatty fish
Eicosapentaneoic acid
Omega 3 fatty acid found in plant sources like flax, canola and soy
Alpha-linolenic acid
Recommendation for omega 3 intake
General population: just eat fish
CAD: 1 g/day
Hypertriglyceridemia/HTN: 1-4 g/day
