Cardiac Risk Factors

Question 1

What are the 3 broad categories of risk factors for cardiovascular disease?

Answer 1

1. medical conditions - DM, hypercholesterolemia, hypertension
2. lifestyle choices- smoking, poor diet, lack of exercise, obesity
3. genetic factors

Question 2

Since 1980 there has been a decrease in US deaths for coronary disease. Half this change has been attributed to reductions in what 3 risk factors?

Answer 2

1. decreased cholesterol
2. reduced hypertension/BP
3. reduced smoking prevalence

Question 3

What are the Major Independent risk factors for coronary artery disease?

Answer 3

1. hypertension
2. DM
3. smoking
4. high cholesterol (LDL >200)
5. Advanced age
6. family history
7. AHA: Obesity and physical inactivity

Question 4

What is the definition of a “low risk state”?

Answer 4

1. non-smoker
2. no DM
3. BP < 120/80
4. LDL btw 100-130
5. HDL >55 for women >45 for men
6. total cholesterol <200

Question 5

The effects of elevated serum cholesterol concentration are limited to __________ of which coronary heart disease is the major variety.

Answer 5

atherosclerotic diseases

Question 6

Diabetes affects multiple organ systems, but what is the major effect of treated diabetes?

Answer 6

advances atherosclerosis–> coronary heart disease

Question 7

What is the relationship between LDL-c, total cholesterol and HDL-c levels with increased risk of coronary heart disease?

Quantify the relationship.

Answer 7

there is a consistent direct relationship between LDL and total cholesterol with increased risk of coronary heart disease.
there is an inverse relationship between HDL cholesterol levels and risk of coronary heart disease

1% increase change in serum cholesterol corresponds to a 2% change in incidence of CAD.

Question 8

What ratio of Total: HDL cholesterol is considered normal?

Answer 8

<3.5 is ideal and over 4.5 is considered adverse.

Question 9

What factors modify LDL goals?

Answer 9

1. smoking
2. hypertension
3. Low HDL
4. family history of early CAD (males <65)
5. Age
6. Diabetes (risk equivalent to CAD)

Question 10

Who have most large-scale clinical trials on the effects of cholesterol on CAD followed

Answer 10

Middle age hypercholesterolemic males

Question 11

What is primary prevention? What did primary prevention trials demonstrate in terms of cholesterol control?

Answer 11

Primary prevention trials examined the effects of LDL lowering in middle age men and women WITHOUT clinically evident CAD. 
Studies suggested statins:
1. decreased mortality
2. decreased MI, angina, stroke
3. need for revascularization