Describe some primary prevention strategies set forth by Health People 2020
for cardiovascular disease - ANSWER - Achieve & maintain a healthy weight
- Reduce sodium intake
- Increase the level of physical activity
- avoid use & exposure to all tobacco products
- limit daily alcohol intake to small/moderate amounts
- choose a diet low in cholesterol & total/saturated fat & high in fruits/veggies
arteriosclerotic/atherosclerotic cardiovascular disease includes 4 disease
categories. What are they? - ANSWER Peripheral Arterial Disease
Hypertension
Coronary Artery Disease
Cerebrovascular Disease
Non-modifiable risk factors of ASCD include age, heredity, & gender.
Elaborate on these 3 - ANSWER Age: >65yo majority of those who die,
women >65yo who have MI are at greater risk of dying
Heredity: children of those w/ heart disease at greater risk, AA have more
severe HTN, increased risk among Mexican-Americans, Native Americans,
Hawaiians, & some Asian Americans
Gender: men have greater risk for MI & for MI earlier in life, women's risk
increases after menopause
Modifiable risk factors for ASCVD include... - ANSWER -
Obesity/overweight (goal BMI <25)
- Obstructive sleep apnea
- Diet
- Tobacco use
- Illicit drug use; OTC use
- Stress
- Heavy alcohol use
- High total cholesterol, high LDL/triglycerides, low HDL
- Hypertension
,What is the maximum recommended alcohol intake for women in regards to
ASCVD? - ANSWER 4oz wine/day
12oz beer/day
1oz (100 proof) - 1.5oz (80 proof) liquor/day
What is the maximum recommended alcohol intake for men in regards to
ASCVD? - ANSWER 4-8oz wine/day
12-24oz beer/day
1oz (100 proof)-3oz (80 proof) liquor/day
There are 2 types of hyperlipidemia, what are they? - ANSWER
Hypertriglyceridemia (stores excess energy from your diet)
Hypercholesterolemia
What is the LDL goal? - ANSWER <100 optimal
100-129 optimal
130-159 borderline high
160-189 high
>190 very high
What is the triglyceride goal? - ANSWER <150 optimal
150-199 borderline high
200-499 high
What is the HDL goal? - ANSWER <40 low
>60 high (good!!)
What is the total cholesterol goal? - ANSWER <200 desirable
200-239 borderline high
>240 high
chronic disease of the arterial system; thickening & hardening of vessel walls -
ANSWER arteriosclerosis
form of arteriosclerosis; soft deposits of fat & fibrin on the vessels harden over
time - ANSWER atherosclerosis
,There are 3 body mechanisms that maintain blood pressure, they include:
______ located in the arterial wall that stimulate the _____; the _____ system
that is activated when the _____ sense low BP; and the posterior ______ which
senses low perfusion & secretes _____ - ANSWER Baroreceptors located in
the arterial wall that stimulate the SNS (which acts on the heart to increase rate
& activate arterial vasoconstriction)
RAAS system that is activated when the kidneys sense low BP (effect is
increased blood volume & vasoconstriction)
Posterior pituitary gland which senses low perfusion & secretes ADH (which
acts at the nephron to increase water reabsorption that raises blood volume &
BP)
The 3 primary factors that affect blood pressure are _____, _____/_____, &
_______ - ANSWER Blood volume
Peripheral resistance/diameter of arterioles
Cardiac output
An elevated BP is _____ and _____ & the treatment is _____ - ANSWER 120-
129 & <80
lifestyle modifications
Stage I hypertension is ______ or _____ & the treatment is _____ - ANSWER
130-139 or 80-89
lifestyle modifications (and medication if diabetic or CKD)
Stage II hypertension is _____ or ______ & the treatment is _______ -
ANSWER >140 or >90
lifestyle modifications & medication
Primary hypertension is what percent of cases? It is usually due to the
interaction of ___, ____, & ____ - ANSWER 90-95% of cases
Increased BP = increased CO and/or SVR
Usually due to the interaction of genetic, environmental, & demographic factors
, Secondary hypertension is what percent of cases? Give some examples of
secondary HTN - ANSWER 5-10% of cases
Find & treat the cause
Examples: sleep apnea, drug induced, CKD, pheochromacytoma, thyroid
disease
What are some of the primary HTN pathophysiology? - ANSWER Genetics &
Genomics like:
H2O & Na Retention
Altered renin-angiotensin mechanism
Stress & increased sympathetic nervous system activity
Insulin resistance & hyperinsulinemia
Endothelial cell dysfunction
True or false: HTN is more common in diabetic patients - ANSWER TRUE
insulin resistance is a risk factor for HTN & CAD
More severe target organ disease when DM & HTN are both present
Goal- Keep BG <110 fasting, A1C target <7
Elevated cholesterol & triglycerides are primary risk factors in ______ -
ANSWER atherosclerosis
Hyperlipidemia is common in pts w/ HTN
Should everyone at risk of HTN consider taking low dose aspirin daily? -
ANSWER YES
What are some subjective (if any) symptoms of HTN? - ANSWER Dizziness
Activity intolerance
Palpitations
Angina
Dyspnea
Headache
Nose bleeds
HTN called the silent killer b/c most people are asymptomatic
for cardiovascular disease - ANSWER - Achieve & maintain a healthy weight
- Reduce sodium intake
- Increase the level of physical activity
- avoid use & exposure to all tobacco products
- limit daily alcohol intake to small/moderate amounts
- choose a diet low in cholesterol & total/saturated fat & high in fruits/veggies
arteriosclerotic/atherosclerotic cardiovascular disease includes 4 disease
categories. What are they? - ANSWER Peripheral Arterial Disease
Hypertension
Coronary Artery Disease
Cerebrovascular Disease
Non-modifiable risk factors of ASCD include age, heredity, & gender.
Elaborate on these 3 - ANSWER Age: >65yo majority of those who die,
women >65yo who have MI are at greater risk of dying
Heredity: children of those w/ heart disease at greater risk, AA have more
severe HTN, increased risk among Mexican-Americans, Native Americans,
Hawaiians, & some Asian Americans
Gender: men have greater risk for MI & for MI earlier in life, women's risk
increases after menopause
Modifiable risk factors for ASCVD include... - ANSWER -
Obesity/overweight (goal BMI <25)
- Obstructive sleep apnea
- Diet
- Tobacco use
- Illicit drug use; OTC use
- Stress
- Heavy alcohol use
- High total cholesterol, high LDL/triglycerides, low HDL
- Hypertension
,What is the maximum recommended alcohol intake for women in regards to
ASCVD? - ANSWER 4oz wine/day
12oz beer/day
1oz (100 proof) - 1.5oz (80 proof) liquor/day
What is the maximum recommended alcohol intake for men in regards to
ASCVD? - ANSWER 4-8oz wine/day
12-24oz beer/day
1oz (100 proof)-3oz (80 proof) liquor/day
There are 2 types of hyperlipidemia, what are they? - ANSWER
Hypertriglyceridemia (stores excess energy from your diet)
Hypercholesterolemia
What is the LDL goal? - ANSWER <100 optimal
100-129 optimal
130-159 borderline high
160-189 high
>190 very high
What is the triglyceride goal? - ANSWER <150 optimal
150-199 borderline high
200-499 high
What is the HDL goal? - ANSWER <40 low
>60 high (good!!)
What is the total cholesterol goal? - ANSWER <200 desirable
200-239 borderline high
>240 high
chronic disease of the arterial system; thickening & hardening of vessel walls -
ANSWER arteriosclerosis
form of arteriosclerosis; soft deposits of fat & fibrin on the vessels harden over
time - ANSWER atherosclerosis
,There are 3 body mechanisms that maintain blood pressure, they include:
______ located in the arterial wall that stimulate the _____; the _____ system
that is activated when the _____ sense low BP; and the posterior ______ which
senses low perfusion & secretes _____ - ANSWER Baroreceptors located in
the arterial wall that stimulate the SNS (which acts on the heart to increase rate
& activate arterial vasoconstriction)
RAAS system that is activated when the kidneys sense low BP (effect is
increased blood volume & vasoconstriction)
Posterior pituitary gland which senses low perfusion & secretes ADH (which
acts at the nephron to increase water reabsorption that raises blood volume &
BP)
The 3 primary factors that affect blood pressure are _____, _____/_____, &
_______ - ANSWER Blood volume
Peripheral resistance/diameter of arterioles
Cardiac output
An elevated BP is _____ and _____ & the treatment is _____ - ANSWER 120-
129 & <80
lifestyle modifications
Stage I hypertension is ______ or _____ & the treatment is _____ - ANSWER
130-139 or 80-89
lifestyle modifications (and medication if diabetic or CKD)
Stage II hypertension is _____ or ______ & the treatment is _______ -
ANSWER >140 or >90
lifestyle modifications & medication
Primary hypertension is what percent of cases? It is usually due to the
interaction of ___, ____, & ____ - ANSWER 90-95% of cases
Increased BP = increased CO and/or SVR
Usually due to the interaction of genetic, environmental, & demographic factors
, Secondary hypertension is what percent of cases? Give some examples of
secondary HTN - ANSWER 5-10% of cases
Find & treat the cause
Examples: sleep apnea, drug induced, CKD, pheochromacytoma, thyroid
disease
What are some of the primary HTN pathophysiology? - ANSWER Genetics &
Genomics like:
H2O & Na Retention
Altered renin-angiotensin mechanism
Stress & increased sympathetic nervous system activity
Insulin resistance & hyperinsulinemia
Endothelial cell dysfunction
True or false: HTN is more common in diabetic patients - ANSWER TRUE
insulin resistance is a risk factor for HTN & CAD
More severe target organ disease when DM & HTN are both present
Goal- Keep BG <110 fasting, A1C target <7
Elevated cholesterol & triglycerides are primary risk factors in ______ -
ANSWER atherosclerosis
Hyperlipidemia is common in pts w/ HTN
Should everyone at risk of HTN consider taking low dose aspirin daily? -
ANSWER YES
What are some subjective (if any) symptoms of HTN? - ANSWER Dizziness
Activity intolerance
Palpitations
Angina
Dyspnea
Headache
Nose bleeds
HTN called the silent killer b/c most people are asymptomatic
