40111 - Risk Stratification in CVD Prevention How to...

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Risk Stratification in CVD Prevention How to Identify Cardiovascular Risk in the Office Dr. Thomas G. Allison Cardiovascular Diseases and Internal Medicine Mayo Clinic Rochester, MN
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Clinically-Based CVD Prevention 1. Risk assessment for all patients 2. Set evidence- and guideline-based goals for specific risk factors 3. Lifestyle management 4. Pharmacologic intervention for selected risk factors in appropriate patients
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Levels of Risk in Primary Prevention 1. Highest: the patient has evidence of CVD 2. High: the patient has high immediate risk (a probability of > 20% in the next 10 years) for having a CVD event 2 or more major risk factors BP > 160/100 Diabetes Cigarette smoking LDL cholesterol > 160 mg/dL HDL cholesterol < 35 mg/dL men, < 45 mg/dL women Family history of premature CVD
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Levels of Risk in Primary Prevention 3. Intermediate: the patient will not likely have a CVD event in the next 10 years, but has a high lifetime risk 1 major risk factor or > 2 minor risk factors BP 140-159/90-99 mmHg Blood glucose 100-129 mg/dL LDL cholesterol 130-159 mg/dL HDL cholesterol 35-39 mg/dL men, 45-49 mg/dL women
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4. Low: the patient may develop CVD at older ages without lifestyle adjustment 1 or 2 minor risk factors Minor risk factors are generally correctable with lifestyle change Diet change, exercise, weight loss 4. Very low: the patient will not likely develop CVD during his or her lifetime No major or minor risk factors Levels of Risk in Primary Prevention
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What Do We Do with Risk? 1. Highest risk patient Use secondary prevention guidelines to manage risk factors Further evaluation: exercise test ± imaging or angiography 1. High risk patient Treat all major risk factors pharmacologically Provide appropriate lifestyle counseling Exercise test
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What Do We Do with Risk? 3.
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This note was uploaded on 02/26/2012 for the course PHARM 210 taught by Professor Staff during the Fall '10 term at Rutgers.

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40111 - Risk Stratification in CVD Prevention How to...

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