Risk markers Flashcards
It remains the leading preventable cause of death and disease; and the single most important risk factor for CAD
Smoking
Smoking cessation reduces the risk of coranary event by how many percent within the first 2 years?
50%
Which of the ff is/are true re: NRT except
- No overall diffrences in effectiveness between different forms of NRT
- NRT was effective with or w/o counseling
- NRT + bupropion was more effective than bupropion alone
- No evidence that NRT increased risk of heart attacks
None of the above
It is the major risk factor for CHD, heart failure, CVD, PAD, Renal Failure, AF and total mortality
Hypertension
Prehypertension* BP range ?
*associated with almost 2x the risk of MI amd stroke in WOMEN compared with normal BP
SBP 120-139mmHg
DBP 80-89mmHg
This measurement predict CV events independently and provides prognostic utility beyond the MAP
Pulse pressure*
Defined as the difference between SBP and DBP
This measurement provide a stronger predictor of CV morbidity and mortality than office-based measures
24h ABPM
This trial randomly assigned non-diabetics with vascular risk and BP > 130mmHg to a target BP < 120 and < 140mmg. the study was halted due to 25% reduction in MACE in 120mmHg group and 27% reduction in all cause mortality
SPRINT - Systolic Blood Pressure Intervention Trial
This trial evaluated the potential benefit of < 120 vs <140mmHg among DM patients
ACCORD - Action to Control Cardiovascular risk in Diabetes
This trial enrolled internediate risk without known CVD allocated to a combination candesartan 16mg + HCTZ OR to a placebo.
HOPE-3
Heart outcomes Prevention Evaluation 3
Result: No significant effect on primary outcomes, but for BP (>143.5mmHg) had a significant reduction on vascular events
It is the best-established risk factor causally linked to incident MI and CV death.
LDL
This trial demonstrated ~50% reduction in MI and stroke with rosuvastatin
JUPITER trial
This trial affirmed the concept of “lower is better”, where the addition of ezetimibe to statin therapy alone further modestly reduced LDLC, hsCRP and vascular events
IMROVE IT trial
PCSK9 inhibitor in FOURIER trial
Evolocumab
These trials randomly allocated high risk patients to niacin supplementation to increase HDL but showed no beneficial effects at all on clinical events
AIM- HIGH and HPS-Thrive trials
This trial used fenofibrate to reduce TGL and increase HDL but showed no significant reduction in vascular events
ACCORD trial
This trial showed an increased all cause mortality with CETP inhibitor, torcetrapib
ILLUMINATE trial
Key regulator of TG concentrations in blood
Lipoprotein lipase
Define metabolic syndrome
A cluster of glucose intolerance and hyperinsulinemia accompanied by hypertryglyceridemia, low HDL, hypofibrinolysis, hypertension, microabuminuria, predominance of small dense LDL particles and central obesity
A medication which provides benefit for persons at high risk for subsequent events 2 to existing CVD
Low-dose aspirin
- No clear net benefit of low dose aspirin in PRIMARY PREVENTION of CVD
- DM in itself DOES NOT qualify inviduals for aspirin therapy except for patients > 50 yo + 1 additional major CVD risk factor
A sulfhydryl containing amino acid derived from the demethylation of dietary methionine
Homocysteine
Common carotid intima thickness of what value increases future CV risk by 9%
0.1mm increase in CIMT thickness
A zero coronary calcium score would entail how many percent of future vascular events
17%
2 genetic markers of inflammation for CV risk
IL6R and CXCL12
BMI formula
Weight in Kg divided by height in meters squared
Overweight BMI > 25
Obese > 30
Habitual heavy alcohol consumption means..
8 or more drinks per week for women and 15 or more drinks a week for men
