Cv - Risk Factors Of Atherosclerosis

Front 1

primary prevention

Back 1

prevention of first occurrence of cardiovascular disease

more expensive because many treated people will never get the disease regardless

risk factor evaluation at age 18

Front 2

2ndary prevention

Back 2

prevention of 2nd occurance of CVD

vigorous risk modification

better money spent

Front 3

nonmodifiable risk factors

Back 3

age - older

sex - men before 70, women after 70

family history - smoking/dietary habits learned, genetics,

Front 4

modifiable risk factors

Back 4

smoking - #1
hypertension
lipid abnormalities (cholesterol)
diabetes

others:
obesity
phys infactivity
left ventricular hypertrophy

Front 5

magnitude of risk is determined by

Back 5

amount of a given risk factor

number of risk factors over the lifetime

Front 6

number of risk factors

Back 6

2 risk factors doubles a person risk

3 risk factors = 4x the risk

removing one risk factor is a huge change

Front 7

risk markers

Back 7

associated with development of artheroscleosis but NOT CAUSITIVE

altering a risk marker does not affect progression or regression of disease

e.g. homocystine, uric acid

Front 8

global risk score

Back 8

assess primary risk only - not secondary risk

e.g. framingham risk scores

high risk = 20% or greater risk of event in 10 years

intermediate = 10-19%

low risk < 10%

Front 9

current guidelines on risk factor identification

Back 9

every five years after 18 determine risk factors

global risk score every 5 years after 35 for males and 45 for female

Front 10

primary prevention of atherosclerosis

Back 10

lifestyle behavior change even more valuable than any drug

smoking cessation, eat less

drugs: weigh cost, toxicity, treat more people to prevent events

Front 11

2ndary prevention of atherosclerosis

Back 11

individuals with CVD

single greatest benefit = smoking cessation

lifestyle

more aggressive lipid targeting

diabetes over 40 should be considered for 2ndary prevention

Front 12

T/F atherosclerosis is a systemic illness

Back 12

true

likely if you have atherosclerotic disease in one area (like in periphery), likely to have coronary artery disease

Front 13

patient adherence

Back 13

intervention is long term and sustained

Front 14

smoking effects on atherosclerosis

Back 14

effects endothelial function and vasomotion

plaque formation

Front 15

hypertension effect on atherosclerosis

Back 15

elevation of either systolic or diastolic pressure

lifestyle and medication

DASH diet

Front 16

hyperlipidemia

Back 16

lipid metabolic abnormalities are often genetically biased

diet and inactivity -> overexpression of abnormalities

Front 17

LDL

Back 17

LDL is major component of plaque - most associated with atherosclerotic plaque formation

most useful drug target

control of LDL will cause already formed plaques to regress

caused by increased calories and saturated fats

Front 18

HDL

Back 18

inversely associated with atherosclerosis

reverse cholesterol transport from tissue to liver disposal

too high levels not good

Front 19

triglycerides

Back 19

2ndary drug target

TGs make LDL more atherogenic

made worse with high carbs

linked with metabolic syndrome and diabetes

Front 20

metabolic syndrome

Back 20

cluster of risk factors

defined by:
abdominal obesity

hypertension

glucose intolerance (prediabets or diabetes)

lipid abnormalities - high TGs and depressed HDL

insulin resistance link

Front 21

diabetes

Back 21

want to control glucose, BUT most important is controlling macrovascular effects

macrovascular effects contributes the most to deaths and includes eyes, peripheral nevers, and kidney

control LDL, BP, smoking is important

Front 22

need to focus on what 3 things to reduce atherosclerosis

Back 22

exercise

diet

smoking