Cardiology I Flashcards
What are the serving sizes for 1 alcoholic drink?
-Wine: 5 oz
-Beer: 12 oz
-Distilled Spirits: 1.5 oz
What are contraindications to aspirin?
-Hypersensitivity or allergy
-History of intracranial bleeding or serious GI bleeding
-Severe kidney disease
-Severe hepatic disease
What patient population may benefit from aspirin for primary prevention according to the 2024 ADA guidelines?
-50 years + with at least one additional ASCVD risk factor
-Not at increased risk of bleeding (older age, renal disease, anemia)
-In general, not recommended for patients > 70 years
When should aspirin therapy for primary prevention be avoided or discontinued?
-Low ASCVD risk (< 7.5%)
-Higher bleeding risk
-Shorter duration of aspirin use (< 5 years)
What is the definition of Stage I HTN?
SBP 130-139
or
DBP 80-89
What is the definition of Stage II HTN?
SBP 140+
or
DBP 90+
What is the goal BP for all patients per the ACC/AHA guidelines?
< 130/80
(SBP < 130 for older adults)
What is the goal BP for patients w/ CKD not on dialysis per the KDIGO guidelines?
SBP < 120
How much sodium reduction is recommended for patients with HTN?
Goal of < 1500 mg/dL
(aim for at least a 1000 mg/day reduction)
What type of initial therapy is recommended for patients with Stage II HTN?
Combination therapy, especially if BP is > 20/10 above goal
When is medication therapy indicated for patients with Stage I HTN?
Clinical ASCVD, DM, CKD, or ASCVD risk > 10%
What is first-line HTN treatment for patients with history of renal transplant?
-DHP CCB
-ARB
What is first-line HTN treatment for patients with history of stroke?
-Thiazide
-ACE-I or ARB
What percentage increase in SCr is acceptable after ACE-I/ARB initiation?
< 30%
What class of BP medications can be used for Raynaud syndrome?
DHP CCB
What are contraindications to aldosterone antagonists?
-GFR < 30
-Potassium 5+
What intensity statin is indicated for secondary prevention?
High
(if > 75 and not at high risk, could consider moderate)
When are non-statin therapies considered for patients with established ASCVD but not very high risk?
-<50% reduction in LDL
-LDL 70 or greater on maximally tolerated statin
-Non-HDL 100 or greater on maximally tolerated statin
When are non-statin therapies considered for patients with established ASCVD and very high risk?
-<50% reduction in LDL
-LDL 55 or greater on maximally tolerated statin
-Non-HDL 85 or greater on maximally tolerated statin
What statin intensity is indicated for primary prevention in those 20-75 years old with LDL of 190 or greater?
High
When are non-statin therapies considered for patients with LDL of 190 or greater?
-<50% reduction in LDL
-LDL 100 or greater on maximally tolerated statin
-Non-HDL 130 or greater on maximally tolerated statin
What statin intensity is indicated for primary prevention in those 20-39 years old with diabetes and LDL 70-189?
Moderate, if enhancers present:
-long duration of DM (T2DM > 10 years)
-albuminuria
-eGFR < 60
-retinopathy
-neuropathy
-ABI < 0.9
What statin intensity is indicated for primary prevention in those 40-75 years old with diabetes and LDL 70-189?
If ASCVD risk < 7.5% AND no risk enhancers = Moderate
If ASCVD risk 7.5% or greater OR risk enhancers present = High
What statin intensity is indicated for primary prevention in those 40-75 years old without DM or ASCVD and LDL 70-189?
ASCVD <5% = None
ASCVD 5-<7.5% = Moderate, if risk enhancers present
-family history of premature ASCVD
-persistently elevated LDL 160 or greater
-CKD
-metabolic syndrome
-inflammatory disease
-persistently elevated TG (175 or greater)
ASCVD >7.5-20% = Moderate, if risk enhancers present
ASCVD > 20% = High
