Adams: Cardiovascular Disease Flashcards
What is the leading cause of death in the US?
CVD 42%
What are the major modifiable risk factors that contribute to CVD?
Hypertension
dyslipidemia
cigarette smoking
impaired glucose tolerance
What are the major risk factors for CVD?
- Age: M>45, F >55
- FH of MI or sudden death: F < 55, M < 65
- Hypertension (systolic more than diastolic)
When do initiate TLC in someone with CHD risk (10 yr graeter than 20%)?
LDL > 100 mg/dL
When do you initiate TLC in someone with 2 or more risk factors and a 10 year risk greater than 20%?
LDL >130 mg/dl
When do you initiate TLC in someone with 0-1 risk factors?
LDL > 160 mg/dl
When do you deal with triglycerides?
if they’re GREATER than 150 after LDL is managed
When do you deal with HDL cholesterol?
<50 in women, after LDL is managed
Why is dyslpidemia a big deal in the us?
> 50% have a total cholesterol >20 mg/dl
20% have a total cholesterol > 240
**CAD DOUBLES for every 50 mg/dl increase over 200 mg/dl
What is the treatment for dyslipidemia?
- Mediterranean diet
2. Statins- Lower cholesterol levels, best meds b/c REDUCE CVD
What is the only non-surgical treatment for cholesterol reduction that reduces mortality?
Statins
What si the 4A smoking cessation program?
Ask, Advise, Assist, Arrange follow up
What medications can help someone to quit smoking?
Routes: patches, gum, nasal spray, inhaler (used 8-12 wks)
Cost: $70-250/month
What is varenicline (chantix)?
Med to help you quit smoking.
Binds w/ high affinity and selectivity at α4β2 neuronal nicotinic acetylcholine receptors
$120
What is bupropion?
Helps to reduce the urge to smoke through its effect on NE and DA systems
Inhibits hte uptake of NE, 5HT and DA
What is an impaired glucose tolerance?
110-125
What glucose level is considered diabetes?
> 125 mg/dl
What is metabolic syndrome?
Insulin resistance HTN dyslipidemia elevated CRP central obesity (>35 in women, >40 in men) BMI > 30
Why are the benefits of physical activity?
Increases HDL 5%
Improves insulin utilization
Upgrades number of insulin receptors
Why do higher amounts of ETOH increase CVD risk?
- high calories > obesity
- elevated triglycerides
- cardiomyopathy (direct effect)
- hypertension
- a. fib
What is CRP?
Synthesized in liver in response to IL-6 which is released by areas of inflammation
Why is high CRP significant?
- risk factor for future CV disease
2. indicator of likelyhood of diabetes
What are considered to be HIGH levels of CRP?
> 3 mg/L
What is a no risk primary prevention of CV?
- Eating more fruits and veggies
- More physical activity
- smoking cessation
Aspirin in low risk people
