Guidelines Flashcards
When you reduce your LDL-C by 1%, how much do you reduce your CVD risk?
1%
What are the 4 groups of patients for statin therapy?
- Adults with clinical ASCVD w/o class II-IV HF or receiving hemodailysis. 2. Adults with LDL-C > 190 mg/dl
- Adults 40-75 y/o with diabetes 4. Adults with > 7.5% estimated 10-year risk of ASCVD
What is the 2013 LDL-C treatment goal for a 50 y/o white nonsmoker with 1 previous of MI?
THERE IS NONE I FOOLED YOU!
What optional additional risk measurement tools can help to refine predicted risk in pts with “intermediate risk”?
- Family history of premature ASCVD 2. hsCRP 3. Coronary artery calcium 4. Ankle brachial indices.
What are the ABCDE treatment recommendations?
A. Aspirin/Antiplatelet therapy B. BP control C. Cholesterol control/cigarette smoking cessation D. Diet and weight management/ diabetes control E. Exercise
Define premature heart disease.
< age 55 for men and <65 for women
Lifestyle recommendations for ALL patients regardless of risk
DASH - like diet, Physical activity, weight management, smoking cessation
Total Cholesterol goals
Optimal - 240
Tryglycerides goal
< 150 mg/dL
What is the treatmnet for high total cholesterol?
Total cholesterol is not a target for therapy.
What is the treatment for high triglycerides?
diet, exercise, weight loss, Fibrates, Niacin, Fish Oil.
HDL Goals
Low - 60
Treatment for low HDL
Exercise, Niacin, Fibrates
Pharmacotherapy for high LDL
Statins, niacin, ezetimibe, bile acid sequestrants
How often should a healthy adult get a fasting lipoprotein profile?
Every 5 years
Which statins should be used for primary prevention?
Pravastatin, lovastatin, atorvastatin, rosuvastatin
Which statins should be used for secondary prevention?
Simvastatin, Pravastatin, Atorvastatin
High intensity statin therapy
Atorvastatin 40-80mg; Rosuvastatin 20-40 mg
Moderate -Intensity statin therapy
Atorvastatin 10-20, Rosuvastatin 5-10, Simvastatin 20-40, Pravastatin 40-80, Lovastatin 40, Fluvastatin XL 80, Fluvastatin 40 mg BID, Pitavastatin 2-4mg
Low- intensity statin
Simvastatin 10, Pravastatin 10-20, Lovastatin 20, Fluvastatin 20-40, Pitavastatin 1 mg
What is the primary goal of managing very high TG concentrations?
Prevent pancreatitis
% statins lower TG
10-30
% Fibrates lower TG
30-50
% IR Niacin lowers TG
20-50
% ER Niacin lowers TG
10-30
% Ezetimibe lowers TG
5-10%
% Omega-3 fatty acids lower TG
20-50
