Risk Stratification Flashcards
The PAR - Q+ is used as an ______ risk assessment tool.
initial
The questions in the PAR - Q+ are worded to obtain information that generally _____ an individual’s ____.
- stratifies
- risk
The PAR - Q+ ____ the assessment of risk, but we should perform a _____ ______ _____ ourselves as well.
- simplifies
- secondary risk assessment
Secondary risk assessment provides the health/fitness, clinical exercise, and health care professionals with important information for…
the development of an individual’s exercise prescription
Secondary risk assessment is important when making decisions about:
- the level of medical clearance
- the need for pre-exercise testing
- the level of supervision for exercise testing and exercise program participation
3 parts to the secondary risk factor assessment:
- do we KNOW there is pathology present?
- do we SUSPECT there is pathology present?
- are there other risk factors for CVD present? How many?
If we suspect that there is pathology present, then the patient immediately becomes…
high risk
Positive CVD risk factors (ACSM): Are they non-modifiable or modifiable?
- age (non-modifiable)
- family history (non-modifiable)
- cigarette smoking (modifiable)
- hypertension (modifiable)
- dyslipidemia (modifiable)
- prediabetes (modifiable)
- obesity (modifiable)
- sedentary lifestyle (modifiable)
Defining criteria for age:
- men: > (or equal to) 45 years
- women: > (or equal to) 55 years
Defining criteria for family history:
- myocardial infarction (heart attack)
- coronary revascularization (heart surgery)
- sudden death
- before 55 years of age for father or first degree male relative
- before 65 years of age in mother or other first degree female relative
Other non-modifiable risk factors:
- sex
- ethnicity
How is sex a non-modifiable risk factor?
sex hormones protect against CVD
Why is the defining criteria for age lower in males than females?
- menopause: lose protection from sex hormones
- women often catch up to and surpass men after menopause
How is ethnicity a non-modifiable risk factor?
- genetic predisposition
- African Americans have higher risk of renal disease, CVD
- Asians have higher risk of high BP during pregnancy
Defining criteria for cigarette smoking:
current smoker or those who quit with the previous 6 months
Defining criteria for hypertension:
- SBP > (or equal to) 140/90 mmHg
- or DBP > (or equal to) 90 mmHg
- measured on 2 separate occasions
- or taking anti-hypertensive medication
Defining criteria for dyslipidemia:
- LDL > 3.37 mmol/l
- or HDL < 1.04 mmol/l
- or on lipid lowering meds
- if total serum cholesterol is all that is available, use > 5.18 mmol/l
Defining criteria for prediabetes:
- impaired fasting blood glucose of > (or equal to) 5.5 mmol/L
- or impaired glucose tolerance > (or equal to) 7.7 mmol/L
- confirmed on 2 seperate occasions
Describe the interactive effect between LDL and HDL.
- LDL = bad
- as LDL gets higher, risk goes up
- HDL = good
- regardless of where your LDL is, the risk comes down if you have elevated HDL
Positive risk factor vs negative risk factor:
- positive risk factor contributes to risk
- negative risk factor takes away from risk
- negative risk factor is a positive thing
Defining criteria for obesity:
- BMI: > (or equal to) 30 kg/m^2
- or waist girth: > 102 cm for men and > 88 cm for women
Defining criteria for sedentary lifestyle:
- not participating in PA
- or not meeting the min. recommendation of 30 min of moderate exercise at least 3 days of the week for the last 3 months
If information is absent….
it should be counted as a risk factor
Prediabetes is counted as a risk factor if:
- age > (or equal to) 45 years and BMI > (or equal to) 25a
- OR age < (or equal to) 45 years and BMI > (or equal to) 25 and additional risk factors
