Chronic Complications- Macrovascular Flashcards
ADA blood pressure goals
DM and HTN with low CV risk- <140/90
DM and HTN with high CV risk- <130/80
Pregnancy: 120-160/80-105
ADA treatment for blood pressure
They have no preference (ACEi/ARB, diuretics, CCB) unless the patient has albuminuria- then use an ACEi/ARB
AACE blood pressure goals
<130/80
AACE treatment for blood pressure
ACEi/ARB
ACC/AHA blood pressure goals
<130/80
ACC/AHA treatment for blood pressure
No preference (ACEi/ARB, CCB, thiazide) unless you have CKD, HF, or are African American
ACC/AHA BP treatment in patients with CKD
ACEi
ACC/AHA BP treatment in patients with HF
No preference as long as it’s not a non-DHP CCB
ACC/AHA BP treatment in African American patients
CCB, thiazide diuretics
ADA guidelines for cholesterol management if <40 years old
Depends on ASCVD risk:
If ASCVD risk is <20%: no statin
If ASCVD risk >20%: high-intensity statin
ADA guidelines for cholesterol management >40 years old
Depends on ASCVD risk:
If ASCVD risk <20%: moderate-intensity statin
If ASCVD risk >20%: high-intensity statin
AACE guidelines for cholesterol management
Don’t state what intensity to use, you have to use clinical judgment
AACE “high risk” LDL goal
<100
AACE “very high risk” LDL goal
<70
AACE “extreme” LDL goal
<55
ACC/AHA guidelines for cholesterol management
All diabetes patients get a moderate-intensity statin
ADA guidelines on ASA therapy
Can be considered for primary prevention if the patient has a high CVD risk (>50 years old, smoker, HTN, LDL >100, CKD)
Use in secondary prevention- 81mg
AACE guidelines on ASA therapy
Use in primary prevention if ASCVD risk >10%
Use in secondary prevention- 81mg
ADA recommendations for obesity
Goal is >5% weight loss
Diet, exercise, behavioral therapy
BMI ≥27: consider weight loss medications/therapy
BMI ≥35: consider bariatric surgery
AACE recommendations for obesity
Essentially the same as ADA recommendations
Diet, exercise, behavioral therapy
BMI ≥27: consider weight loss medications/therapy
BMI ≥35: consider bariatric surgery
ADA and AACE guidelines for immunizations
Flu shot: everyone should get it annually
Pneumococcus: PPSV23 and/or PCV13
19-64 years old: PPSV23
>65 years old: PCV13, then PPSV23 at least one year apart
Hep B: all adults should get it
ADA guidelines on smoking
Avoid use of cigarettes, e-cigarettes, and other tobacco products
Counsel on smoking cessation
AACE guidelines on smoking
No specific recommendations, but encourage counseling on smoking cessation
