CV Disease Epidemiology Flashcards
What percentage of deaths in the US does CV disease cause?
42%
Major CV risk factors:
- Males over 45 yrs
- Females over 55 yrs
- Family history - Father
Order of dealing with Dylipidemia:
- First LDL
- Then TG (>150)
- Then bringing HDL up (
Normals: Cholesterol HDL LDL TG
200
>60
1-129
TG -
Dyslipidemia risk factor:
CAD doubles for every 50 mg/dl increase over 200mg/dl
Statins
HMG-CoA reductase inhibitors to lower cholesterol levels are considered the best medication due to positive effectiveness on reducing CVD.
-Statins are only non-surgical treatment for cholesterol that reduces mortality
Varenicline (Chantix)
-Binds with high affinity and selectivity at alpha4beta2 neuronal nicotinic acetylcholine receptors
(competitive agonist with nicotine)
-For every nine highly motivated patients who use varenicline instead of placebo, one will not be smoking one year later
-Equal to or a tad better than bupropion
Bupropion
- Inhibits uptake of NE, serotonin, and DA
- Mechanism by which bupropion enhances ability of patients to abstain from smoking is unknown
- Drug believes to reduce urge to smoke through its effect on the NE and DA neurotransmitter systems
- Equally effective as nicotine replacements
- Synergistic effects when used with nicotine replacements
What is likely to be ineffective or harmful in preventing CV disease?
Beta-carotene
Vitamin E - inc. death from subarachnoid hemorrhage
What should you use in people who have had an MI/ischemic event to prevent another?
Beta blocker!
At what cardiovascular risk do you start a statin?
Above 5%!