Based on the assessment undertaken, identify cardiac risk factors that require attention. Behaviour change and patient education strategies are critical to supporting risk factor modification. The clinician should act as a lifestyle coach working with patients to prioritise goals as multiple life-style changes can be overwhelming.
Full Answer
Do patients with multiple risk factors require intensive risk modification?
For the latter purpose, patients at high risk because of multiple risk factors may require intensive modification of ≥1 risk factors to maximize risk reduction.
Do risk-reducing drugs reduce the risk of heart disease in later years?
Although the use of risk-reducing drugs can significantly lower risk when begun in later years, there is no evidence that it can return a patient to the low-risk status of a younger person. This reduction can only be accomplished by decreasing the magnitude of coronary plaque burden through long-term control of risk factors.
What do the AHA and ACC recommend for treatment of heart disease?
The American Heart Association (AHA) and the American College of Cardiology (ACC) have published joint recommendations for medical intervention in patients with CHD and other forms of atherosclerotic disease. 1 A similar potential exists for risk reduction in patients without established CHD (primary prevention).
What are the cardiovascular considerations for patients with multiple myeloma (MM)?
There are many cardiovascular (CV) considerations for patients with multiple myeloma because this population has a high prevalence of pre-existing CV comorbidities and can have increased cardiac risks from the disease burden of multiple myeloma and the treatments administered.
What is the best form of preventative treatment for a person at risk of CVD?
Eat a healthy diet. Try to limit saturated fats, foods high in sodium, and added sugars. Eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.
What are the three main approaches to the treatment of cardiovascular disease?
medication, such as to reduce low density lipoprotein cholesterol, improve blood flow, or regulate heart rhythm. surgery, such as coronary artery bypass grafting or valve repair or replacement surgery. cardiac rehabilitation, including exercise prescriptions and lifestyle counseling.
What are 4 ways a person can reduce the risk for cardiovascular disease?
AdvertisementDon't smoke or use tobacco. One of the best things you can do for your heart is to stop smoking or using smokeless tobacco. ... Get moving: Aim for at least 30 to 60 minutes of activity daily. ... Eat a heart-healthy diet. ... Maintain a healthy weight. ... Get good quality sleep. ... Manage stress. ... Get regular health screenings.
What is multiple cardiovascular risk factors?
The multiple risk factors we evaluated included high values for body-mass index, systolic blood pressure, and LDL cholesterol and triglycerides in serum. Cardiovascular risk factors such as dyslipidemia, hypertension, hyperinsulinemia or insulin resistance, and obesity often coexist in both children and young adults.
What are the best treatments for heart disease?
In general, treatment for heart disease usually includes: Lifestyle changes. You can lower your risk of heart disease by eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise on most days of the week, quitting smoking, and limiting alcohol intake.
What is the prevention and treatment of cardiovascular disease?
Prevention of cardiovascular disease can be achieved by practising regular exercise, by keeping to a balanced healthy diet, by avoiding tobacco smoking and by the maintenance of an optimal blood pressure and normal LDL-cholesterol and glucose levels.
What can you do to reduce your risk for cardiovascular disease consider all aspects of wellness and how they may influence heart health?
Lifestyle ChangesStop smoking. If you smoke, quit. ... Choose good nutrition. A healthy diet is one of the best weapons you have to fight cardiovascular disease. ... High blood cholesterol. ... Lower high blood pressure. ... Be physically active every day. ... Aim for a healthy weight. ... Manage diabetes. ... Reduce stress.More items...•
What is secondary prevention of cardiovascular disease?
Definition. Secondary Prevention refers to preventing heart attack and stroke through drug therapy and counseling for high risk individuals – such as those with previous events or known cardiovascular diseases (CVD).
How can CCF be prevented?
You can begin with a few of these simple steps:Stay active. Check with your doctor before starting an exercise routine. ... Don't use illegal drugs. ... Treat heart and other conditions. ... Don't smoke. ... Eat right. ... Limit alcohol. ... Lose weight if you need to. ... Manage stress.More items...
What is multiple risk factor reduction?
In hypertensive patients at high risk for coronary artery disease, multiple risk factor reduction interventions reduce risk factors and mortality. In other patients, multiple risk factor reduction interventions reduce total cholesterol levels, blood pressure (systolic and diastolic) levels, and smoking rates.
What is cardiovascular risk factor assessment?
A heart disease risk assessment, also known as a cardiovascular disease (CVD) risk assessment, is a type of screening tool that measures your risk of heart disease or CVD. Heart disease is a type of CVD, which is a group of diseases of the heart and blood vessels.
What is the most important non controllable risk factor for cardiovascular disease?
The "uncontrollable" risk factors are: Age (the risk increases with age) Gender (men develop CAD 10 years earlier than women) Family history (genetic predisposition and common lifestyles increase risk)
What are the recommendations of the American Heart Association?
The American Heart Association (AHA) and the American College of Cardiology (ACC) have published joint recommendations for medical intervention in patients with CHD and other forms of atherosclerotic disease. 1 A similar potential exists for risk reduction in patients without established CHD (primary prevention).
What is a 3-fold increase in relative risk above the lowest risk level?
A 3-fold increase in relative risk above the lowest risk level is designated moderately high risk; a 4-fold or greater increase is called high risk. Absolute risk levels rise progressively with age, even in the absence of risk factors.
What is absolute risk?
Absolute risk is defined as the probability of developing CHD over a given time period. The recent Framingham report 2 specifies absolute risk for CHD over the next 10 years. Although absolute risk scores can be used to evaluate preventive strategies, 4 caveats must be kept in mind. First, Framingham scores derive from measurements made some years ago; the possibility exists that absolute risk for any given level of risk factors in the general population may have changed since that time. Second, absolute risk in the Framingham population for any given set of risk factors may not be the same as that for all other populations, for example, those of differing ethnic characteristics. Third, Framingham risk scores represent average values; however, considerable individual variability in risk exists within the Framingham population. For example, several other factors not included in the Framingham scores potentially modify absolute risk for individuals (see Table 2 ). Finally, Framingham scores are not necessarily elastic; the magnitude of risk reduction achieved by modifying each risk factor may not equal (in reverse) the increment in risk accompanying the factors.
What is relative risk?
The relative risk is the ratio of the absolute risk of a given patient (or group) to that of a low-risk group. Literally, the term relative risk represents the ratio of the incidence in the exposed population divided by the incidence in unexposed persons. The denominator of the ratio can be either the average risk of the entire population or the risk of a group devoid of risk factors. The Framingham definition of the low-risk state provides a useful denominator to determine the effect of risk factors on a patient’s risk. Both the absolute and relative risk can be derived from the recently published risk score sheets. 2
What are the predisposing factors?
The predisposing risk factors are those that worsen the independent risk factors. Two of them—obesity and physical inactivity —are designated major risk factors by the AHA. 34 The adverse effects of obesity are worsened when it is expressed as abdominal obesity, 5 an indicator of insulin resistance.
What is the purpose of the present statement of the AHA and ACC?
The present statement is being published jointly by the AHA and ACC to outline current issues and approaches to global risk assessment for primary prevention.
Does glucose control reduce cardiovascular endpoints?
Clinical trials strongly suggest that glucose control reduces the incidence of various cardiovascular end points in patients with either type 1 diabetes 112 or type 2 diabetes. 113 Other clinical trials 114115 strongly suggest that aggressive LDL-lowering therapy reduces risk for CHD in patients with type 2 diabetes.
What is the presenting feature of multiple myeloma?
Common presenting features include hypercalcemia, renal insufficiency, anemia, and lytic bone lesions.
Is Carfilzomib an inhibitor?
8 Carfilzomib is an irreversible proteasome inhibitor currently approved by the Food and Drug Administration (FDA) for patients with relapsed and/or refractory multiple myeloma who have received at least two lines of chemotherapy. A safety analysis of phase 2 clinical trials with 526 patients with relapsed and/or refractory multiple myeloma treated with single-agent carfilzomib was notable for cardiac failure in 7.2%, ischemic heart disease in 3.4%, cardiac arrhythmia in 13.3%, hypertension in 14.3%, and pulmonary hypertension in 2%. 8 Cardiac adverse events demonstrated early effect, with highest incidence associated with cycle 1 of chemotherapy. In 11.8%, these events occurred within 1 day of receiving chemotherapy. Additionally, there was a low incidence of sudden cardiac-related deaths, often occurring within 1 day of chemotherapy. Of note, carfilzomib standard dosing is 20 mg/ m 2 intravenously on days 1 and 2 and then 27 mg/ m 2 on days 8, 9, 15, 16, on 28-day cycles. Thereafter, 27 mg/ m 2 is given on the aforementioned days. The label was recently changed to escalate dosing up to 56 mg/ m 2 instead of 27mg/ m 2 based on results from ENDEAVOR (Phase 3 Study With Carfilzomib and Dexamethasone Versus Bortezomib and Dexamethasone for Relapsed Multiple Myeloma Patients). 9 In this study, carfilzomib + dexamethasone was superior to bortezomib + dexamethasone, demonstrating significant progression-free survival benefit in the relapsed setting. The cardiac signal, while still present, was not significantly increased despite the higher dose. A cardiac sub-study was performed as part of this trial, and the incidence of heart failure (HF), hypertension, and pulmonary hypertension were higher in the carfilzomib + dexamethasone group compared with the bortezomib + dexamethasone group (3.2 vs. 0.9%, 24.8 vs. 8.8%, and 1.3 vs. 0%, respectively).
Is ixazomib approved for multiple myeloma?
In 2015, the FDA granted approval for ixazomib, panobinostat, daratumumab, and elotuzumab for relapsed and/or refractory multiple myeloma treatment (Figures 3A and 3B). Although in early use, there does not appear to be a strong cardiac signal associated with these therapies.
Do migrants have a high incidence of CHD?
Migrants have a high incidence of CHD. According to the research by Gallacher et al., (1999) and Boyle et al., (2004), which of the following emotions increases the risk of heart disease, predicts poor likelihood of survival, and acts as a potential trigger for heart attacks. anger.
Is Raj a risk factor for CHD?
It is an independent risk factor for CHD. Raj, who complains of chest pain, is admitted to a hospital. The diagnosis reveals that his blood vessels have narrowed and the flow of oxygen and nourishment to his heart is partially obstructed. He is most likely suffering from: