CARDIO: Prevention of CVD Flashcards
What are ‘life’s simple 7’ for preventing CVD?
Life’s Simple 7 include: tobacco avoidance, regular exercise, normal BMI, healthy diet,
ideal lipids, ideal glucose, and blood pressure.
What are primordial, primary, and secondary prvention of CVD?
Primordial prevention involves the early establishment of habits and lifestyle choices
that prevent the development of CVD risk factors. Ideally primordial prevention starts
in utero, continues through infancy, childhood, adolescence, and into young adulthood through tobacco avoidance, daily activity, healthy diet, and weight management.
Primary prevention is the prevention of CVD before the onset of any clinical manifestations of disease. Primary prevention assesses individualized risk for disease and targets preventive efforts to reduce clinical events.
Secondary prevention is the prevention of recurrent disease after an initial clinical event. Secondary prevention optimizes risk factors and aims to reverse existing CVD.
What risk calculators can you use to help calculate CVD risk>
American College of Cardiology (ACC)/American Heart Association (AHA) Pooled
Cohort Risk Assessment (United States; http://www.cvriskcalculator.com/), the
National Vascular Disease Prevention Alliance (Australia; http://www.cvdcheck.
org.au), and the QRISK2-2016 score (United Kingdom; https://qrisk.org/2016/)
What pharmacotherapy can you consider for pt’s expressing interest in smoking cessation and have great difficulty if patches or lozenges have failed?
- Bupropion
- Varenicline
Bupropion improves smoking cessation rates in some patients compared with placebo and is
used with the patch-plus method for additional benefit.20 Varenicline is another option.
Recent data suggest an increased risk of coronary events with varenicline; hence
bupropion is recommended if there is concern for CVD
What tools are available to patients to help optimize nutrition/weight?
An individualized approach to weight management may include the US Department
of Agriculture’s Daily Food Plans and Super Tracker (www.choosemyplate.gov),
MyFitnessPal, Lose It, or applications for use on smart phones
In terms of physical activity, what should most adults aim for?
150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous intensity aerobic activity every week.
Forty minutes of moderate to vigorous activity 3 to 4 days per week are recommended
to improve blood pressure control and blood cholesterol levels.
What 3 diets might you recommend for heart health/overall health?
Mediterranean diet, the Dietary Approaches to
Stop Hypertension (DASH) diet, and the AHA heart-healthy eating pattern.
MED DIET SCORE: A patient’s adherence and understanding of the Mediterranean diet is assessed through the Med Diet Score (http://
oldwayspt.org/traditional-diets/mediterranean-diet).
How can patients assess whether they are adhering to the med diet?
A patient’s adherence and understanding of the Mediterranean diet is assessed through the Med Diet Score (http://
oldwayspt.org/traditional-diets/mediterranean-diet).
When is statin therapy warranted?
- Pt’s w/current clinical CVD
- Pts’ w/ LDL-C > 190 mg/dL
- pts 40-75 w/ diabetes
- Pts w/ 10 yr calc risk > or + to 7.5
What is considered prehypertensive?
Patients with a systolic blood pressure
(SBP) of 120 to 130 mm Hg or a diastolic blood pressure (DBP) of 80 to 89 mm
Hg are considered prehypertensive and should be counseled on health-promoting
lifestyle modifications to prevent CVD
For the general population, therapy for htn is indicated when?
Age 60 and below: 140 SBP or 90 DBP
Above 60: 150 SBP or 90 DBP**unless hx of stroke, tia, or high CVD risk
For the general population younger than 60 years
of age, pharmacologic therapy should be initiated at a SBP greater than or equal
to 140 mm Hg and/or DPB greater than or equal to 90 mm Hg and titrated to a
goal DBP less than 90 mm Hg and less than 140 mm Hg. For patients older than
the age of 60, pharmacologic therapy is recommended for an SBP greater than
or equal to 150 mm Hg or DBP greater than or equal to 90 mm Hg. Physicians guideline recommends that lower SBP threshold (140 mm Hg) for initiating or intensifying pharmacologic therapy in adults aged 60 years or older with
a history of stroke, transient ischemic attack, or at high cardiovascular risk
What are the recommendations for aspirin use in CVD reduction?
No aspirin under 50 yo
50-59 w/ 10% or greater risk–> baby aspirin
See table for specifics
USPSTF recommendation for AAA screening?
men 65-75 who have a hx of smoking
Strongest modifiable risk factor for CAD
Smoking
Framingham Heart Study
