W8 Case Studies Htn, lifestyle, met synd, Lp(a) genetic defect

Question 1

In adults, blood pressure rises by approximately ______ mmHg per year:

a. 1.0
b. 0.6
c. 0.3
d. 1.3

Answer 1

b. 0.6

90% of individuals age 55+ with normal BP ultimately develop hypertension during their lifetime.

Question 2

Ranges indicating a person is pre-hypertensive are:

a. 140-145/85-89 mmHg
b. 125-130/80-89 mmHg
c. 120-139/80-89 mmHg

Answer 2

c. 120-139/80-89 mmHg is considered prehypertensive.
* A BP of 130-139 mmHg/85-89 mmHg is associated with a more than two-fold increase in relative risk of cardiovascular disease compared to levels below 120/80 mmHg.

Question 3

_______ hypertension accounts for 95% of all hypertension cases, and is defined as having a SBP of 140 mmHg or greater, having a DBP of 90 mmHg or greater, or taking antihypertensive medications.

a. primary
b. secondary
c. tertiary

Answer 3

a. primary

* secondary hypertension occurs secondary to certain medications.

Question 4

Populations who eat a _________ diet and have low ______ intake have virtually no increase in BP with age.

a. vegan, sodium
b. plant based, saturated fat
c. plant based, sodium
d. paleo, processed food

Answer 4

c. plant based, sodium

Question 5

Hypertension compared to normotension is associated with a 3-4 fold increased risk of _____- and a 2-fold increased risk of _______.

a. stroke, pulmonary embolism
b. stroke, coronary artery disease
c. heart attack, stroke

Answer 5

b. stroke, coronary artery disease

• Hypertension is the leading cause of preventable deaths, accounting for 13% of deaths worldwide.
• anti-hypertensive medications have been associated with a 35-40% reduction in stroke risk, a 20-25% reduction in myocardial infarction, and a 50% reduction in heart failure, in clinical trials.

Question 6

There are _____(#)_____ criteria for metabolic syndrome?
A. 4
B. 5
C. 6

Answer 6

B. 5

abdominal obesity
elevated triglycerides
low HDL-C
elevated systolic blood pressure
elevated fasting blood glucose

Question 7

What is the minimum number of criteria for metabolic syndrome that must be met to be officially diagnosed?
A. 2
B. 3
C. 4

Answer 7

B. 3

Question 8

What ethnic group is more at risk for CHD and CVD in general?
A. White, caucasian
B. African American
C. Asian-Indian
D. Hispanic-Latino

Answer 8

C. Asian-Indian

Asian–Indian descent have increased CHD risk compared with other ethnicities, as the disease in Asian–Indians tends to manifest 5 to 10 years earlier than in other populations.

This increased risk is largely attributable to higher rates of metabolic syndrome, insulin resistance, and diabetes, which often present at earlier ages.

Asian–Indians are also at increased risk for ischemic heart disease and cardiovascular disease at elevated Lp(a) levels, compared to other ethnicities.

Question 9

Valuable predictors/markers of CHD risk include:
A. apolipoprotein B (apo B)
B. hsCRP
C. Lp(a)
D. B & C
E. A, B, &C

Answer 9

E. A, B, & C

measurement of apo B is only warranted in patients at intermediate or high CHD risk

Question 10

Studies show that the risk of CHD is increased when the levels of Lp(a) are more than ___ mg/dL and there is a 2- to 3-fold increased risk of myocardial infarction at Lp(a) levels more than ___ mg/dL.

A. 20, 40
B. 30, 50
C. 40, 60

Answer 10

B. 30, 50

Question 11

_______ is the only agent shown to consistently reduce Lp(a) levels.
A. Niacin
B. CoQ10
C. Folic acid

Answer 11

A. Niacin

Dosing at 1 to 3 g/day can reduce Lp(a) levels by 30 to 40% in a dose-dependent manner while also reducing LDL-C, total cholesterol, and triglycerides and raising HDL-C levels. However, it is unknown if lowering Lp(a) with niacin leads to improved CHD outcomes and caution must be used as niacin can raise glucose levels.