Prevention of Ischemic Heart Dz Flashcards
modification of risk factors in order to prevent or delay the onset of CHD
primary prevention
Initiation of therapy to reduce recurrent CHD events and decrease cardiac mortality in patients already dx’ed with CHD
Secondary prevention
IHD:
ischemic heart disease
CHD
coronary heart disease
CVD
cardiovascular disease
class I recommendation. Should you do it?
YES, benefit waaay better than risk
class IIa recommendation: should you do it?
REASONABLE. benefit is greater than risk, which has been proven by random clinical trial
Class IIb recommendation, should you do it?
Maybe. benefit is greater than/equal to risk as determined by small/limited studies
Class III recommendation, should you do it?
No
Fun Fact: Only _______% of women are aware that heart dz is their #1 killa
50%
give an example of modifiable risk factors
htn, glucose control, cholesterol mgmt., tobacco, diet, activity level, obesity (you get it)
example of non-modifiable risk factors
age, gender, FHx, etc
what tool are ya going to use to determine the 10 year risk of having a heart attack?
Framingham risk calculator
ABC’s of prevention, what’s A stand for
Antiplatelet therapy, anticoagulant therapy, ACEI’s, ATII blockers
ABC’s of prevention, whats the B?
Blood pressure control, BB
ABC’s, what’s the C?
cholesterol mgmt., cigarette cessation
ABC’s, what’s the D?
diet, DM mgmt
ABC’s, what’s the E?
exercise, EF assessment
AHA guidelines for the simple 7 of primary prevention goals
get active!, diet, wt loss, stop smoking, cholesterol, BP mgmt., glucose control
activity goals: what’s a minimum amt of acceptable activity? What is optimal?
minimum: 30-60 min/day, 5 days/week
optimal: 30-60 min/day, 7 days/week
Diet recommendations:
eat food, not too much, mostly plants
If you cut back _________ calories per day, you should expect to lose 1 pound a week
500
Should you nag patients to quit smoking?
Yes.
High triglycerides are a worse risk factor for developing heart disease in which gender?
Female (can double risk with TG>400)
what are some medications/drugs that can cause HTN?
NSAIDS, oral contraceptives, steroids, sympathomimetics, ephedra, cocaine, meth, ETOH
Medical conditions that can cause secondary HTN:
renal dz, thyroid dz, sleep apnea, etc
lifestyle recommendations for BP control:
wt loss, DASH diet, limit sodium, exercise, moderate ETOH (1-2 drinks/day ok)
Number one thing that patients can do to reduce mortality rate from heart disease?
stop smoking
What is the next most important lifestyle factor (after smoking cessation) to reduce risk for heart disease
diet/exercise
following the “effective 7” (ie nonsmoking, 30+min exercise/day, good diet, and BMI<25) reduces overall risk by how much?
83%
ASA recommendations, who should definitely get it (recommendation IIa) for primary prevention
at risk women >65, all men
ASA recommendation, who should maybe get it for primary prevention?
at risk women <65
ASA recommendation, who should not get it for primary prevention?
women with no risk <65
ASA recommendation, who should definitely get it for secondary prevention
everybody who’s already been dx’ed with CHD
Who should be recommended for cardiac rehab?
ALL pts post MI, anyone with recent CABG, chronic angina, or symptomatic PAD
Who should be getting Plavix (clopidogrel)?
patients allergic to ASA, or given in addition to ASA following stent placement
