Chapter 7: Cardiac and Vascular Risk

Question 1

The term that describes the characteristics found in healthy people that are independently related to the subsequent development of coronary heart disease.

Answer 1

Cardiac risk factor

Question 2

__________ cardiac risk factors include hypertension, hyperlipidemia, low HDL level, diabetes, tobacco use, and obesity.

Answer 2

Modifiable

Question 3

__________ cardiac risk factors include age, gender, and family history of premature coronary heart disease in a first degree relative.

Answer 3

Nonmodifiable

Question 4

Patients with a coronary heart disease risk equivalent have the __________ of coronary heart disease risk but have no yet experienced a coronary heart disease event.

Answer 4

Same level

Question 5

What are the 3 coronary heart disease risk equivalent groups?

Answer 5

1. Patients with 2 or more cardiac risk factors
2. Patients with PVD, AAA, and symptomatic carotid artery disease
3. Patients with type 2 diabetes

Question 6

Study that has provided the richest source of data on predictors of heart and valvular disease. Current emphasis is on biomarkers and genetics as risk factors for heart disease.

Answer 6

The Framingham Heart Study

Question 7

In the general population greater than 60 years, initiate pharmacologic treatment to lower SBP > ______ or diastolic BP > _______.

Answer 7

150; 90

Question 8

In the general population less than 60 years, initiate pharmacologic treatment to lower diastolic BP > _____ and treat to goal of diastolic BP < _______

Answer 8

90; 90

Question 9

In the general population less than 60 years, initiate pharmacologic treatment to lower SBP > _____ and treat to a goal of SBP < _____

Answer 9

140; 140

Question 10

In the population greater than 18 with chronic kidney disease or diabetes, initiate pharmacologic treatment to lower SBP > ____ or diastolic BP > _____ and treat with goal SBP < ______ and diastolic BP < _______

Answer 10

140; 90; 140; 90

Question 11

In the general population, including those with diabetes, initial hypertensive treatment should include one medication from what 4 classes of medications?

Answer 11

1. Thiazide diuretic
2. Calcium channel blocker
3. ACE
4. ARB

Question 12

In the general black population, including those with diabetes, initial hypertensive treatment should include one medication from what 2 classes of medications?

Answer 12

1. Thiazide diuretic

2. Calcium channel blocker

Question 13

In the population greater than 18 years with chronic kidney disease, initial or add on antihypertensive treatment should include a(n) ____ or _____ to improve kidney outcomes. This applies to all chronic kidney diseases with hypertension regardless or race or diabetes status.

Answer 13

ACE or ARB

Question 14

Can you use an ACE and ARB in the same patient?

Answer 14

No

Question 15

If the goal blood pressure is not reached within _____ month(s) of treatment, increase the dose of the initial drug or add a second drug (thiazide diuretic, calcium channel blocker, ACE, or ARB).

Answer 15

One

Question 16

What type of cholesterol is targeted with cholesterol medications?

Answer 16

LDL

Question 17

______ dose statin used for:
Clinical atherosclerotic disease and age 21-75; includes MI, angina syndrome, prior arterial revascularization, CVA, TIA, or PAD

Answer 17

High

Question 18

______ dose statin used for:

Diabetes age 40-75 and if 10 year atherosclerotic cardiovascular disease risk > 7.5%

Answer 18

High

Question 19

______ dose statin used for:

Diabetics age 40-75 and if 10 year atherosclerotic cardiovascular disease < 7.5%

Answer 19

Moderate

Question 20

Does diabetes accelerate artheromatous process that results in increased risk for atherosclerotic disease?

Answer 20

Yes

Question 21

Is left ventricular hypertrophy associated with increased incidences of cardiovascular disease?

Answer 21

Yes

Question 22

What study has developed and updated mathematical health risk appraisal models that relate risk factors to the probability of developing coronary heart disease within the next 10 years?

Answer 22

The Framingham Heart Study

Ex: 24 points = 9% probability of an event within 10 years

Question 23

What are 4 modifiable risk factors for stroke?

Answer 23

1. HTN
2. Diabetes, hyperinsulinemia,and insulin resistance
3. Asymptomatic aortic stenosis
4. Afib

Question 24

Two thirds of people who experience a first stroke have BP higher than _______.

Answer 24

160/95

Question 25

What does CHADS2 stand for in regards to stroke risk factors?

Answer 25

C - Congestive heart failure  (1 point)
H - Hypertension  (1 point)
A - Age > 75  (1 point)
D - Diabetes  (1 point)
S - Stroke or TIA  (2 points)

Question 26

8% of men and 11% of women will have a stroke within ____ years after an MI.

Answer 26

6

Question 27

Post-MI development of Afib is a common source of _________.

Answer 27

Cardiogenic emboli

Question 28

What are 5 risk factors for PVD?

Answer 28

1. Diabetes
2. HTN
3. Hyperlipidemia
4. Increased age
5. Smoking