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CDCES > Heart health > Flashcards

Heart health Flashcards

1
Q

What is ASCVD?

A

Peripheral artery dz (PAD)
Cerebrovascular dz
Coronary heart dx (CHD)

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2
Q

What is greatest cause of morbidity and mortality in DM?

A

ASCVD

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3
Q

What are the risk factors for ASCVD?

A 
Overweight/obesity
Smoking
HTN
HLD
CKD
albuminuria
Family hx premature coronary dz
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4
Q

What is the ASCVD risk calculator?

A

10 year risk of 1st CV event
age 40-79
DM is a risk however doesn’t ask about duration or complications from DM

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5
Q

HF hospitalization is how much higher in PWD?

A

2x

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6
Q

Why should we do HTN tx?

A

Reduces HF, microvascular complications, ASCVD events

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7
Q

How should HTN be dx?

A

at every routine visit

3 abnormal values on separate occasions to dx

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8
Q

Treatment of HTN to what BP reduces CV events &microvascular complications?

A

<140/90

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9
Q

Why should PWD monitor BP at home?

A

White coat syndrome
masked HTN
DTR effectiveness of meds

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10
Q

What are HTN goals in adults w/ DM?

A

<140/90 if low CV risk (ASCVD risk <15%) OR if adverse effects to intensive tx
<130/90 if existing ASCVD or 10 year risk >/=15%

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11
Q

BP goal in pregnant women w/ HTN

A

135/85

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12
Q

What are the risk of overtreating HTN?

A

hypotension
falls
acute kidney injury
electrolyte abnormalities

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13
Q

Who is at risk for overtreatment of HTN

A 
CKD
orthostatic HTN
functional limitations
significant comorbidities
polypharmacy
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14
Q

How to treat HTN in pregnancy?

A

Do NOT use- spironolactone, ARB, ACE
Can use- labetolol, methyldopa, long acting nifedipine
May use hydralazine w/ preeclampsia
Diuretic only in late pregnancy for volume control

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15
Q

When to monitor BP after birth?

A

3 days in hospital
7-10 days PP
LT follow-up recommended s/t lifelong increased risk of CV

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16
Q

DASH diet

A

2,300 mg sodium/day
2-3 svgs LF dairy
8-10 svgs F/V combined
avoid excessive etoh

17
Q

How to treat HTN if BP >140/90 but <160/100 AND w/o elevated UACR

A

1 med to start

ACE, ARB, CCB, or Thiazide like diuretic can be used

18
Q

IF HTN + elevated UACR >30 but definitely >300

A

ACE or ARB

19
Q

What if BP is >160/100

A

2 meds

Do NOT combine ARB + ACE

20
Q

What to monitor if on ACE, ARB, or diuretic?

A

EGFR, serum K+, serum creatinine at least annually

21
Q

Why should at least one HTN drug be given at night?

A

Reduces CV events

22
Q

Why should ACE not be given with ARB?

A

Can cause hyperkalemia and/or AKI, which can increase risk of CV event/death

23
Q

What is resistant HTN?

How to treat it?

A

On 3 classes of HTN meds including diuretic and still not meeting goals
Confirm that pt is taking meds as directed
Start mineralcorticoid, which can reduce albuminuria but may increase hyperkalemia risk

24
Q

How does glycemic control effect lipids?

A

Poor glycemic control can raise TG

25
Q

If a PWD is <40 years old, not on a statin, when should lipids be taken?

A

At dx, initial medical evaluation, q 5 years if <40

26
Q

If pt is on a statin, when should lipid panel be taken?

A

@ initiation of statin or other lipid lowering medication
4-12 weeks after starting statin or changing dose
annually after

27
Q

What do do w/ pt 40-75 w/o ASCVD for primary prevention

A

moderate intensity statin

28
Q

What if pt is <40 but has ASCVD risk factors for primary prevention

A

may consider statin+lifestyle changes

29
Q

In pts at higher risk (ASCVD risk factors, age 50-70) for primary prevention

A

use high intensity statin

30
Q

if 10 year ASCVD risk is >20%, what can be added to reduce LDL by 50%

A

ezetimibe

31
Q

what should all PWD w/ confirmed ASCVD get

A

high dose statin

32
Q

If LDL >70 and on maximally tolerated statin w/ confirmed ASCVD

A

ezetimibe or PCSK9 inhibitor

33
Q

Can you use a statin during pregnancy?

A

No

34
Q

How much does a high intensity statin lower LDL compared to moderate?

A

50% versus 30-49%

35
Q

What are the high dose statins?

A

Rosuvastatin

Atorvastatin

36
Q

What can PCSK9 do?

A

Lower LDL 35-60%

37
Q

IMPROVE IT trial

A

Ezetimibe for pts on statin w/ recent acute coronary syndrome
reduced absolute risk 5%, relative risk 14% for major adverse CV events

38
Q

What can be given to pts who need TG lowering but LDL is normal?

A

Icosapent ethyl

TG 175-499

39
Q

what HLD pattern is most common in DM?

A

High TG, low HDL

CDCES (13 decks)

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