Cardiovascular Risk Reduction Flashcards
What are the modifiable risk factors for CV disease?
HTN, tobacco, ASA, Hyperlipidemia
What is the most common chronic condition treated by family physicians?
HTN
What percentage of patients with Dx of HTN have normal readings out of office?
15-30% (white coat HTN)
What are the routine labs/tests in HTN?
EKG, BMP, glucose, A1c, lipids, UA
What patients should you suspect secondary HTN?
Children, adolescents, rapid acceleration of HTN, resistant HTN (not controlled on 3 drugs)
What are the most common causes of secondary HTN in children?
Renal parenchymal disease and coarctation of the aorta
What effect does estrogen have on blood pressure?
Increases
What OTC meds can raise BP?
COX-2 inh, ibu, naproxen, decongestants
What lifestyle modification has the greatest potential impact on blood pressure?
Weight loss
What is the goal BP for patients 60 years or older?
Less than 150/90
What is the first line antihypertensive therapies in nonblack population?
Thiazide diuretics, CCB, ACEi, ARBs
What is the first line antihypertensive therapy in black population?
Thiazides, CCB
What is the first line antihypertensive therapy in patient >18 yo with CKD?
ACEI or ARB
After starting antihypertensive therapy, in what timeframe should the goal blood pressure be reached?
Within a month
If goal BP is not reached within a month of treatment, what changes can be made in therapy?
Increase dose of initial drug or add a second drug from
If goal BP is not reached with 2 drugs, what is the recommendation for treating these patients?
Add and titrate a third drug
What is the recommendation in initial therapy for patients with BPs >20/10 above goal?
Start two drugs simultaneously
What do the NICE guidelines say in regards to thiazide diuretics?
Chlorthalidone and indapamide are preferred
What is initial hypertension medications for African American patients?
initial treatment is thiazide or a calcium-channel blocker; initial or add-on treatment for patients with chronic kidney disease consists of either an ACEi or ARB.
How much does a ciagarette shorten lifespan?
Each cig shortens lifespan by 11 minutes
What are first line medications for smoking cessation?
Nicotine replacement therapy, buproprion, varenicline
What are the different strengths of nicotine patches and what dose do you start patients on?
21/14/7 mg/day; >10cig/day: start at 21 mg/day; <10 cig/day: start at 14 mg/day
What is the most effective monotherapy for smoking cessation?
Varenicline (Chantix)
What age is aspirin recommended for CVD risk reduction?
50-69; most benefit from 50-59
What are the most potent LDL lowering medications?
PCSK-9 inhibitors
ACC/AHA guidelines/recommendations on statins in patients with diabetes?
ACC/AHA recommends mod intensity statins for all patients with DM aged 40-75 and LDL 70-189 (eg when risk was <7.5%); consider high intensity statin if risk >7.5%
