Chp 12 - CVD Flashcards
Leading cause of death in the US is…..
CVD
AHA - how many deaths each year, e.g 2 of 3, 3 of 5 etc.
1 out of every 3 deaths
CVD - propensity for what areas?
Arteries - coronary, carotid, femoral
Heart, brain and legs
Coronary atherosclerosis - coronary risk factors
Risk factors –> coronary artery blockages progression rate is…
Genetic
Behavioral
Environmental
1.5% reduction in arterial diameter/year
New view on heart disease mgt - final common pathway
Goals of therapy
Inflammation – plaque rupture – thrombosis
plaque stabilization and normalization of artery function
HEALTHY lifestyle scoring system, 4 factors….
INTERMEDIATE includes how many of the 4?
1) no current smoking
2) no obesity (BMI <30)
3) regular physical activity
4) healthy diet
Intermediate = 2
First-line strategy to prevent initial or recurrent cardiac events is to….
favorably modify unhealthy lifestyle practices - including poor dietary habits, smoking, and physical inactivity
the “Big 4” mediations & actions
1) Beta blockers – slow HR and lower BP, affecting nerve impulses
2) ACE inhibitors/Angiotensin II receptor blockers (ARBs) — dilate blood vessels, can lower BP and pressure in the heart
3) Platelet inhibitors — blood thinners, e.g. aspirin – reduce inflammation & clot formation
4) Statins — preventing recurrent heart attacks or strokes – decreasing vascular inflammation
Basic diagnostic tests
Chest x rays
Resting ECG
Ultrasound and PAD screening
Risk factor profiling, e.g. BP, blood glucose, HA1c, BMI, WHR, etc
Intermediate tests
Exercise stress testing
Prognostic indicator – how long pts can exercise and what level they can attain, e.g. METs
Pharmacologic stress testing - meds via IV to simulate exercise
Echocardiography - US waves off heart
Ejection fraction
Advanced test
Coronary angiography, aka cardiac catheterization
Newer screening
a) plaque deposits in the coronary arteries….
b) detect calcium in the coronary arteries…
a) computed tomography angiograms (CTA)
b) CT and electron beam CT
Behavioral choices represent the LEADING factor contributing to premature death, exceeding……(4 things)
1) genetic predisposition
2) social circumstances
3) environmental exposure
4) access to healthcare
AHA Life’s Simple 7
-cigarette smoking
-hypertension
-obesity
-physical activity
-elevated blood glucose
-high LDL
-other dietary risk factors
5 A’s approach to health behaviors - personal behavior change plan
Which two are done most easily by HCP?
1) Assess the risk behavior
2) Advise behavior change
3) Agree - action plan
4) Assist - id barriers, self efficacy, etc.
5) Arrange - self monitoring system, referral base
Assess and Advise
