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KIN 429 > 3.1 Risk Factors > Flashcards

3.1 Risk Factors Flashcards

1
Q

What are the modifiable risk factors for CVD?

A

*Smoking
*Dyslipidemia
*Hypertension
*Diabetes (type 2 and pre-diabetes)
*Sedentary lifestyle
*Obesity
*Stress/Depression/Anger/Hostility

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2
Q

How does exercise affect cholesterol?

A

800-1000 kcal/week has effects but requires months, augmented by weight loss

TC moderately decreases
LDL-no change to moderate decrease
HDL increases on avg 10%, may increase linearly with exercise up to 4500 kcal/wk
Trig decrease on avg 20%

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3
Q

When would a person be considered to have metabolic syndrome?

A

3 or more of the following:
Waist circumference ≥ 102 cm in men, ≥ 88 cm in women

Trig ≥ 1.69 mmol/L

HDL-C ≤ 1.04 mmol/L in men, ≤ 1.29 in women

BP ≥ 130/85

BG ≥ 6.1 mmol/L or Glucose intolerance

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4
Q

What are the non-modifiable risk factors for CVD?

A

Family history
Age
Gender

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5
Q

A fasting blood glucose within what range is considered pre-diabetic? A fasting blood glucose above what is considered diabetic?

A

Pre-diabetic: 6.1-6.9
Diabetic: 7.0+

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6
Q

An A1C within what range is considered pre-diabetic?
An A1C above what is considered diabetic?

A

6.1-6.4 = prediabetic
6.5+ = diabetic

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7
Q

Diabetics want their A1C to be below what?

A

7.0

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8
Q

Why are waist circumference and waist to hip ratio a better indicator of increased health risk than BMI?

A

Central obesity (increased visceral body fat) is strongly linked with adverse health outcomes

BMI does not factor body composition (ratio of fat mass to fat free mass)

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9
Q

What is the relative risk for CVD associated with 1,2,3 and 4 risk factors?

A
  • 1 risk factor = 2-3x risk
  • 2 risk factors = 8x risk
  • 3 risk factors = 15x risk
  • 4 risk factors = 30-40x risk
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10
Q

Describe what would classify as a family history of heart disease.

A

1st degree relative
(immediate family - parent or sibling) with a history of CVD, men <55, women before age of 65

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11
Q

At what age does CVD risk increase?

A

Male > 55yrs
Females >65yrs (or premature menopause without hormone-replacement therapy)

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12
Q

What is the biggest modifiable risk factor to change first?

A

Smoking

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13
Q

When is smoking considered a risk factor?

At what point has previous smoking maximized possible risk reduction?

A

current, or quit within 6 months (still considered active)

maximized risk reduction after 3yrs

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14
Q

What are the levels for dyslipidemia as criteria for CVD risk factors?

A

TC > 5.2
LDL > 3.4
HDL <0.9
Triglycerides > 2.3
Risk ratio (tot chol/HDL) >5.8
On medication

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15
Q

At what point is HDL considered a negative risk factor? (takes away a risk factor)

A

HDL >1.6 mmol/L

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16
Q

What is the BP range we want people with diabetes to have?

A

<130mmHg systolic
<80mmHg diastolic

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17
Q

What is the criteria for diagnosis of hypertension risk factor?

A

systolic >140mmHg
diastolic >90mmHg
on medication

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18
Q

When is diabetes considered a risk factor for CVD?

A

type 1 diabetes and >30 yrs old, or for more than 15 yrs

type 2 diabetes and >35 yrs old

if they have impaired fasting glucose

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19
Q

What is considered an impaired fasting glucose affecting insulin resistance?

A

≥5.6 mmol/L

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20
Q

What is the criteria for overweight vs. obesity?

A

Overweight: ≥25 kg/m2

Obese: ≥30 kg/m2
WC ≥88cm female; ≥102 cm male

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21
Q

What is the criteria for sedentary lifestyle to be considered a risk factor for CVD?

A

no regular exercise program
< minimal recommendation from US Surgeon General

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22
Q

What are the psychosocial CVD risk factors?

A

Stress
Depression
Anger
Hostility

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23
Q

What 3 types of factors impact an individual’s risk for CVD?

A

Risk factors
Susceptibility
Exposure

24
Q

What is the difference between absolute risk, accrued risk, and relative risk?

A

absolute risk: individual’s risk of developing CVD over a set period of time, 5-10yrs.

accrued risk: how long? how high?

relative risk: individual’s personal increase in risk - often 2x the risk compared to someone not diagnosed with CVD

25
Q

What are the 4 points of an aggressive risk factor management?

A

role of exercise
role of diet
no smoking
role of medication

26
Q

What does the Framingham Risk Score do?

A

Estimates risk of heart attack in 10 years

27
Q

What is considered optimal BP?

A

110/70

28
Q

What is considered normal BP?

A

130/85

29
Q

What is a high normal BP?

A

130-139/85-89

130/85 to 139/89

30
Q

What is considered mild hypertension?

A

140-159/90-99

140/90 to 159/99

31
Q

What is considered moderate hypertension?

A

160-179/100-109

160/100 to 179/109

32
Q

What important aspects of lifestyle impact blood pressure?

A

Sodium intake
Smoking
Physical activity
Body weight
Alcohol

33
Q

What levels would you want someone with diabetes to have for:
impaired fasting glucose
pre-meal
1-2hrs post meal
A1c level?

A

impaired fasting glucose: 6.1-6.9
pre-meal: 7.0
1-2hrs post meal: 5-10
A1c level: <7

34
Q

What is the risk for CVD for males vs. females with diabetes?

A

Males - increase 2-4 fold
Females - up to 7 fold

35
Q

What are the common complications for diabetics in terms of microvascular and macrovascular disease?

A

Microvascular: retinopathy, neuropathy, nephropathy

Macrovascular: CV disease, cerebrovascular disease, peripheral vascular disease

36
Q

What effect does exercise have on diabetes?

A

improved blood glucose control (esp. type 2)
improved glucose uptake
increases insulin sensitivity
decreased insulin resistance
decreased hyperinsulinemia
reduced risk of diabetic complications due to improved glycemic control

37
Q

Low HDL is a strong predictor of what?

A

CVD

38
Q

Cessation of smoking impacts cholesterol how?

A

increases HDL

39
Q

How does improved diet impact cholesterol?

A

lower LDL, total cholesterol, and triglycerides

40
Q

How does weight loss impact cholesterol?

A

lower LDL, total cholesterol, and triglycerides

41
Q

How does lower alcohol consumption impact cholesterol levels?

A

increases HDL and lowers triglycerides

42
Q

How do you calculate BMI?

A

kg/m2

43
Q

What is an overweight BMI for an asian population?

A

BMI > 23

44
Q

What is the mild, moderate, and severe obesity BMI ranges?

A

mild: BMI>30-34.9
mod: BMI>35-39.9
severe: BMI>40

45
Q

Central obesity results in an increased risk for what?

A

increased risk for hypertension, type 2 diabetes, hyperlipidemia, CAD, premature death

46
Q

What is the range for increased risk for waist to hip ratio?

A

> 0.8 female
0.9 male

47
Q

What are the ranges for increased risk vs obese for waist circumference?

A

increased risk:
>80cm female
>94cm male

obese:
>88cm female
>102cm male

48
Q

Metabolic condition is characterized by what 4 factors?

A

insulin resistance / diabetes
hypertension
dyslipidemia
central obesity

49
Q

What is the key component for reduction of the development of diabetes?

A

exercise

50
Q

What are the 5 treatment goals?

A

reduce body weight by 5% or more
exercise for 30+min/day
reduce fat intake to <30% of tot cal/day
reduce sat. fat to <7-10% of tot cal/day
increase fiber to 15g/1000kcal

51
Q

In the Finnish Diabetes Prevention Study, those who achieved 4+ of the treatment goals had what % prevention of CVD?

A

100% prevention

52
Q

those who follow lifestyle suggestions prevent the development of type 2 diabetes for at least _ years.

A

it was 6, now 10

53
Q

What % of population has 1 or more major modifiable risk factors?
ages 45-74

A

81-94%

54
Q

What % of population has 2 or more major modifiable risk factors?
ages 45-74

A

40-64%

55
Q

What % of people with type 2 diabetes have hypertension?

A

60%

56
Q

How does insulin affect hypertension?

A

increased levels of insulin may cause hypertrophy of the media layer of the artery

insulin is involved in the renal tubular absorption of sodium

KIN 429 (10 decks)

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