Normal ranges, targets, BP, cholesterol, glucose, Murtagh pointers Flashcards
Bread and butter GP: preventative medicine, BP and cholesterol targets, waist measurements, risk factors, diabetes, Murtagh's lists and pointers All of the values are taken from therapeutic guidelines.
“What should my total cholesterol be?”
Less than 4.0mmol/L
“What should my good cholesterol be?”
More than 1.0mmol/L
“What should my bad cholesterol be?”
Less than 2.0mmol/L, the same as triglycerides
“What should my triglyceride level be?”
Less than 2.0mmol/L, the same as ‘bad’ cholesterol
“What should my total cholesterol to HDL ratio be?”
Less than 4.5
What waist circumference places a man at ‘increased’ cardiometabolic risk?
94cm
What waist circumference places a woman at ‘increased’ cardiometabolic risk?
80cm
What is the treatment BP target for uncomplicated hypertension?
140/90
What is the treatment BP target for people with hypertension or associated clinical conditions (DM,
130/80
When should anti-HT drugs be started immediately?
- Grade 3 HT (>180/110)
- Associated conditions or end-organ damage
- ‘High’ absolute CVD risk on calculator
- Aboriginal/TI
What are some causes of HT that is STILL high despite max doses of at least 2 drugs?
NON-ADHERENCE
• undiagnosed secondary hypertension
• hypertensive effects of other drugs
• treatment resistance due to sleep apnoea
• undisclosed use of alcohol or recreational drugs
• unrecognised high salt intake
• ‘white coat’ hypertension
• technical factors affecting measurement
• volume overload, especially with chronic kidney disease (CKD).
What are 5 lifestyle changes that can be made to help lower BP?
Exercise (30mins moderate intensity, most if not all days)
No smoking
Weight (BMI <2 SD/day)
Put away your risk calculator! These 7 groups of people AUTOMATICALLY have high CVD risk!
- Diabetics >60yo, or with microalbuminuria
- any cardiovascular disease
- familial hypercholesterolaemia
- total cholesterol >7.5
- Severe (grade 3) HT (>180/110)
- Mod/severe chronic kidney disease (GFR 74yo
These people need to start a statin NOW
Those 7 ‘automatic high risk’ groups + people calculated to be ‘high risk’ using those charts (yellow-red boxes; ie >15% 5yr CVD risk)
These people MIGHT need to start a statin
People who are still ‘moderate’ CVD risk (10-15%) after 3-6mths lifestyle changes, if they have a FHx CVD (ie. CVD in 1st degree relative before 60yo)
