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41 Cards in this Set
- Front
- Back
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what is the leading cause of death in the US
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heart disease
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screening objection for hyperlipidemia in Healthy People 2010
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screen 80%o fadults over age 20
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who has higher CHD and CV disease mortality, whites or Latinos?
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Latinos
But proportion of toatal deaths due to these two diseases is similar as for whites |
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what kind of asians have higher CHD risk among this group
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south asians (higher prevalence of metabolic syndrome, insulin resistance, hyperlipidemia)
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which of these are risk factors for cardiovascular risk in Framingham scoring?
smloking BP 135/80 BMI 28 Chol 220 LDL 162 HDL 38 TGL 165 |
smoking and low hdl
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what is Framingham risk if you have CHD or CHD risk equivalents
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> 20% over 10 years
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how does diabetes fit into Framingham scoring
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it's a CHD equivalent
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what does family history of CHD in a first degree relative count as in Framingham
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CHD equivalent
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what is the major cause of coronary heart disease
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elevated LDL
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screening procedure for hyperlipidemia
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all adults over 20 should get a 9-12 hour fasting lipoprotien profile every 5 years
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if patient hasn't fasted, what parts of the lipid panel are informative
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cholesterol
HDL |
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what is optimal LDL level
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<100
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what is desirable cholesterol
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<200
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what is low HDL
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40 or lower
high is 60 or higher |
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what is borderline high LDL
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130-159
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what is high LDL
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160-189
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what is very high LDL
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190 or greater
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what is borderline high cholesterol
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200-239
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what is high cholesterol
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240 or higher
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what are the CHD risk equivalents
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symptomatic carotid artery diesease
peripheral arterial disease AAA diabetes |
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risk factors (non CHD equivalents) that modify LDL goals
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cigarettes
HTN 140/90 or greater low HDL- 40 or lower family hx of premature CHD in 1st degree <55 male <65 female men > 45, women >55 |
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when do you assess 10 year CHD risk
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if 2 or more risk factors other than LDL present
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LDL goal with risk > 20%
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< 100
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LDL goal at which to consider drug therapy with risk > 20
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130 or greater
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LDL targer for 2+ risk factors
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< 130
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if 2+ risk factors, LDL level for TLC or drug therapy
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130 or greater for for TLC
130 or greater of 10-20% risk 160 or greater for <10% risk |
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LDL goal for 0-1 risk factor
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< 160
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TLC and drug therapy levels for 0-1 risk factor
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TLC: 160 or greater
drugs: 190 or greater |
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what is therapeutic lifestyle change
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Diet
- sat fat <7% of cals - chol <200 mg/day - consider increased soluble fiver and plant sterols weight mgmt increased physical activity |
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what kind of drug is ezetimibe
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inhibits absorption of cholesterol and phytosterols
used along with a statin tneds to lower LDL and CRP, but didn't change intima media thickness in patients with familial hypercholesterolemia |
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is there enough evidence for recommendations on high dose omega 3?
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not yet
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determinants of NCEP ATP III's assessment of 10 year risk
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cigarette smoking
blood pressure HDL gender age |
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clinical ID of metabolic sydrome
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abdominal obesity
men >40 in, women > 35 in TGL 150 or greater HDL <40 for men, <50 for women BP 130/85 or greater fastin glucose 110 or greater |
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T/F?
a diet low in saturated fat, transfatty acids and cholesterol and that contains soy protein and plant sterols/stanols can be just as effective as a statin at decreasing serum total cholesterol and LDL level |
true
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T/F?
for every 1% increase in calories from saturated fatty acids as a percent of total energy, serum LDL rises about 2% |
true
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T/F?
total fat consumd is a primary target of TLC diet |
false
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T/F?
substitution of low-fiber carbs for saturated fatty acids can decrease HDL and increase TGLs |
true
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T/F?
increased viscous solumble fiber is recommended in TLC diet |
true
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what is risk reduction in patients that go 30% below LDL of 100
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30% risk reduction
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what is current thinking on the ideal LDL target
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<70
BUT goal not officially lowered because HPS and PROVE IT studies alone are not enough to justify ALSO - goal of <70 does not apply to patients who aren't high risk |
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what is CVD risk for patients wtih very low cholesterol
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High
this is the J curve phenomenon |
