Nonmodifiable risk factors include age gender race and family history Both

Nonmodifiable risk factors include age gender race

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and exercise are targets of therapy through lifestyle modifications.  Nonmodifiable risk  factors include age, gender, race, and family history. Both categories of risk  factors are part of the calculation of overall risk  for CVD.  Table 39-2  presents the major risk  factors for CVD exclusive  of the serum LDL. Five  factors are considered contributory to low risk and negative  risk for CVD: not smoking, normal BP, normal weight, normal glucose  metabolism, and low cholesterol levels. Look to figure: 39-2 Positive RISK (CHD): Age: Male: ≥45; Female: ≥55 Family history: Premature CHD (MI or sudden death before 55 yr in father or other male first-degree relative or before 65 yr in mother or female first-degree relative) Cigarette smoking: Current smoking (any cigarette smoking in past month) Hypertension: BP ≥140/90 mm Hg or on antihypertensive medication HDL cholesterol: HDL ≤40 mg/dL Diabetes mellitus: Presence, especially if poorly controlled Powerpoint Drug therapies for Hyperlipidemia: HMG CoA reductase inhibitors Lovast atin, pravastatin, simvastatin, fluvastatin, atorvastatin, rosuvastatin Fibrat es: fibric acid derivatives Gemfi brozil, micronized fenofibrate, clofibrate
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81 Bile acid sequestrants Chole styramine, colestipol, colesevelam Niaci n (has lost its luster) Ezeti mibe ( Zetia ): most effective in combination with statin Vitam ins/antioxidants/herbs/natural products Vitam in E, C, folic acid, garlic, fish oils, fiber, coenzyme Q10, flaxseed * Acti ve liver disease is a contraindication for all except the bile acid sequestrants. 48.Thiazide diuretics The  thiazide-type diuretics act on the distal renal tubule to inhibit  sodium reabsorption. Their effect is generally longer-lasting, and they  cause less brisk diuresis.  Diuretics are still considered first-line therapy for HTN with the  JNC-8.  Thiazide diuretics are the most commonly prescribed agents for  HTN. Higher doses of these drugs can cause modest and often transient  increases in serum LDL cholesterol and TG, with little or no adverse  effects on HDL cholesterol. Electrolyte imbalances are common in all diuretic classes.  Thiazide and loop diuretics cause hypokalemia and may cause hypercalcemia,  hyponatremia, and hypomagnesemia. Several  thiazide and loop diuretics are Pregnancy Category C and  should be used only when benefits clearly outweigh risks. Thiazide and loop diuretics decrease the renal excretion of lithium and may induce lithium toxicity. These two classes may decrease the action   of   sulfonylureas   and   insulin.   Thiazide  diuretics   and spironolactone diminish the anticoagulant effects of warfarin.
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