Risk Assessment

Question 1

Atherosclerotic Cardiovascular disease
(ASCVD)
Ischemia _________
TIA
______________
h/o CABG/PCI/stent (any revascularization)
__________- (stable or unstable)
Peripheral artery disease (PAD)
Renal artery stenosis (from atherosclerosis)

Answer 1

stroke

MI

angina

Question 2

Risk factors of ASCVD-reversible lifestyle

___________
Consuming foods with a high ____________ index or load, saturated fat

Too few fruits, vegetables, fiber-rich foods

__________life-style

Excessive alcohol

Poor ___________

Answer 2

smoking

glycemic index

sedentary

poor sleep

Question 3

Abdominal Obesity

Women: >____________

Answer 3

35 inches

Question 4

Abdominal Obesity

Men>_____________

Answer 4

40 inches

Question 5

Obesity (BMI)

Overweight 25.0-29.9
Obese 30.0+

Question 6

Risk factors- irreversible (depending)

Diabetes (you can control this)
High blood pressure/HTN (you can control this)
The rest below you can’t control
Family history (CVD at young age)
Age
Sex: Men>women (except after menopause)
_____________- SDoH
Inflammatory disease: ___________protein
Interleukin-6
HIV
Chest wall radiation

Answer 6

air pollution

C-reactive protein

Question 7

Metabolic syndrome

Includes
Abdominal obesity: women >35 inches
men >40 inches
Hypertension
Diabetes/insulin resistance (includes prediabetes)
Dyslipidemia
Role of sleep apnea?

Question 8

Risk assessment tools

AHA/ACC Guidelines
Risk of developing atherosclerotic cardiovascular disease (ASCVD)
-arteriosclerotic heart disease
-peripheral arterial disease
-carotid artery disease.

Question 9

AHA/ACC Guidelines cont…

10 year risk only for age 40-79 year olds.
Lifetime risk can be assessed for 20-59 year olds
Includes…
Sex
Race
Age
Treated or untreated systolic blood pressure level
Total cholesterol
High-density lipoprotein cholesterol (HDL-C) levels
Current smoking status (Y/N)
History of diabetes (Y/N)

Question 10

Let’s calculate SC’s risk…
SC, a 55-year-old white man, went to his PCP for his
yearly physical. His PCP referred to you for lifestyle
education. No medication, or health conditions
BMI of 26
BP 120/80, HR 80
No cigarettes, no smokeless tobacco, 1 beer per day
Total Cholesterol 213mg/dL, HDL 50mg/dL, cLDL 110,
TRIG 265
Diet: Breakfast sandwich in morning (egg/sausage/bagel),
sandwich for lunch (roast beef/ham/turkey), dinner varies: pasta, meat-potato-veg. Snacks on pretzels, chips, peanuts.

SC does not eat healthy. His diet is full of high sodium and saturated fat items. More fruits and vegetables. He has one beer per day, which is acceptable; but we should ask for more details about the % alcohol content. One 12 ounce serving of 5% beer is considered one. It is acceptable for a man to have two. Do not encourage him to drink more. People often underestimate how much they drink. He is overweight with a BMI of 25.

Question 11

PREVENT (Predicting Risk of cardiovascular
disease EVENTs) risk calculator
Estimates heart attack, stroke, and heart failure risk
Incorporates cardiovascular-kidney-metabolic syndrome
Same as ASCVD risk score, but also includes…
GFR
BMI
Optional inclusion factors
Zip code (SDoH)
UACR
HbA1C
Not included in guidelines yet

Question 12

ASCVD is anything where arteries is the cause of the issue. So if pt had an ischemic stroke, a TIA, MI in the past, in the past they had any revascularization this could be of the leg arteries for peripheral artery disease or the heart
Most common reason for renal artery stenosis is atherosclerosis

Question 13

Which of the following is an example of ASCVD?

Heart failure
MI
CKD
Diabetes

Question 14

Recognize things in the pt chart that will increase the risk of ASCVD: smoking,