Cardiology I Flashcards
What does ASCVD Risk Calculator calculate
Risk of FIRST EVENT
What are the components of the ASCVD Risk Calculator
Age, Race, Gender, Tot Chol, HDL, SBP, On BP Meds?, Diabetes, Smoking status
ASA Primary Prevention < 50 years old
Not recommended
ASA Primary Prevention 50-59 years old
Recommended if:
10-year ASCVD risk > or = 10% AND Life Expectancy is > or = 10 years
ASA Primary Prevention 60-69 years old
Recommended if:
10-year ASCVD risk > or = 10%
ASA Prevention > 70 years old
Not Recommended
Elevated BP Category
120-129 / < 80
Non-pharm Only
Reassess 3-6 months
HTN Stage 1
130-139 / 80-89 + Hx ASCVD, Diabetes, CKD, or 10 yr ASCVD > or = 10
MONO-therapy + Non-Pharm
Reassess 1 month
IF No Risk Factors listed above
Non-Pharm ONLY
Reassess 3-6 months
HTN Stage 2
140-149 / 90-99
DUAL Therapy + Non-Pharm
Reassess 1 month
General BP goal for all populations
< 130/80
Possible reason for Chlorthalidone over HCTZ
POTENTIAL CV benefits
Long Half-Life
When is an ACE/ARB preferred in Diabetes + HTN
IF Albuminuria
Avoid Alpha-antagonists (Doxazosin, Prazosin, etc) in:
ASCVD/HF ==> Can lead to exacerbations due to increased stress on heart
Hydralazine Reduces
Nitrate Intolerance
Hypertensive Crisis
> 180 / > 120 ==> End Organ damage
Lipid Panel Conditions
May be done Fasting or Non-Fasting
Inaccurate if TG > 400 mg/dL
Expected LDL Reductions
High: > or = 50%
Medium: 30-49%
Low: < 30%
Secondary ASCVD Prevention + Age < or = 75 y/o
High-Intensity Therapy
IF < 50% LDL Reduction on High-Intensity Therapy ==>
Add Ezetimibe or PCSK9 mAb
ASCVD + > 75 y/o
Moderate-Intensity Therapy
Primary Prevention
LDL > or = 190 mg/dL + 20-75 y/o ==> High-Intensity Therapy
If LDL Reduction < 50%
Add Ezetimibe or PCSK9 mAb
Diabetes patient on Moderate-Intensity therapy
Age 40-75 y/o
LDL < 190 mg/dL
Diabetes patient on High-Intensity therapy (No ASCVD)
Age 40-75 y/o
LDL < 190 mg/dL
+
ASCVD > or = 7.5% + Risk Enhancers
