Primary Prevention Of ASCVD Flashcards
List “Life’s Simple 7”
- BP
- Cholesterol
- Blood glucose
- Get active
5, Eat better - Lose weight
- stop smoking
Leading cause of Cardiovascular disease death?
Coronary heart disease
Deaths due to cardiovascular disease in 2020 (globally)?
19.1 million
Guidelines on primary prevention of cardiovascular disease?
2019 acc/aha Guideline on the primary prevention of Cardiovascular Disease
ASCVD Risk factors? (8)
- Age/race/ethnicity
- Family history
- Hypertension
- Hyperlipidemia
5, DM - Tobacco use
- Physical inactivity
- Obesity
Highest risk by sex & race?
Hispanic black women > non-hispanic black men > non-hispanic black women > non-hispanic while or Hispanic women
Guidelines for blood cholesterol?
2018 aca/aha blood cholesterol guidelines
How long after smoking cessation for risk of ASCVD to fall to that of nonsmoker?
10 years
Nonmodifiable risk factors for ASCVD? (4)
- Age - women > 55 and men >45
- Sex
- Family history of premature disease ( age < 55 year in men or >65 year in women). First-degree relative
- Ethnicity
Most common way for CV risk to be estimated?
Acc/aha pooled cohort equations - 10 year ASCVD Risk.
- For ages 40-75
- High risk = 20%
- intermediate- 7.5 - 19.9%
- borderline = 5% - 7.4%
When should 30-year ASCVD Risk be calculated/ used?
Adults aged 20-39
Adults aged 40 - 59 years with 10-year risk less than 7.5%
Risk factors that require additional discussion with patient? ( 9)
- Premature family history
- Primary hypercholesterolemia
- Metabolic syndrome
4.ckd
5, chronic inflammatory conditions - History of premature menopause.
- History of pregnancy- associated conditions that increase CV risk
- High risk race/ethnicity
- Lipid biomarkers
- apob > 130
- lipoprotein (a) >50
- triglycerides > 175
What additional assessments can be done after initially looking at patient risk? (4)
- High-sensitivity C-reactive protein
- Coronary artery calcium score
- Ankle-brachial index
- Family history of CV disease
Lifestyle modifications for Lipids? (4)
- Heart-healthy diet
- Regular exercise
- Maintain healthy weight
- Smoking cessation
USPSTF recommendations for statins?
- Start statin in age 40-75 with one or more risk factor and 10-year ASCVD Risk 10% or more. Start with moderate intensity
- Offer statin for risk 7.5-9.9%
3, NOT enough data for age >75
2018 acc/aha guidelines- when to statins for primary prevention?
- Primary hypercholesterolemia - goal of 50% reduction in LDL
- DM
- Based on ASCVD Risk.
Diabetes-specific risk factors? (6)
- Long duration of DM (10 year DM2)
2, Albuminuria > 30 - G.F.R. <60
- Retinopathy
- Neuropathy
- A.B.I. <0.9
Moderate intensity statins?
Atorvastatin - 10, 20mg
Fluvastatin- 80mg
Pitavastatin- 1, 2, 4 mg
Lovastatin- 40mg, 80mg
Pravastatin- 40, 80 mg
Rosuvastatin- 5, 10 mg
Simvastatin - 20, 40 mg (10 mg with ezetemibe)
Which dietary component raises ldl-c?
Saturated fats
Goal potassium intake to reduce hypertension & stroke?
3500 mg to 4700 mg
What did the PREDIMED study show?
Mediterranean diet reduces CV death & disease by 30%
Acc/aha 2019 primary prevention of CV disease - goal exercise minutes per week?
150 minutes
USPSTF -goal exercise minutes per week?
150 minutes
Success rate annually for smoking cessation?
4 to 6%
