The Assessment and Management of Cardiovascular Risk

Purpose......Page 9
About the Guideline......Page 11
Summary......Page 23
CHAPTERS......Page 5
1 Background......Page 31
2 Cardiovascular Health of Maori......Page 33
3 Cardiovascular Risk Assessment......Page 39
Targeting cardiovascular risk assessment......Page 40
Absolute cardiovascular risk assessment......Page 41
Cardiovascular risk factors......Page 42
Measurement of risk factors......Page 46
How to determine cardiovascular risk......Page 47
4 Treatment Decisions......Page 51
5 Intervention: Cardioprotective Dietary Patterns......Page 55
Cardioprotective Dietary Patterns......Page 57
Dietary interventions that reduce morbidity and mortality......Page 66
Population health approach......Page 69
Assessment of physical activity......Page 71
Risks of physical activity......Page 74
Physical activity interventions......Page 75
7 Intervention: Weight Management......Page 77
8: Classification of overweight in adults according to BMI......Page 78
Weight management interventions......Page 79
8 Intervention: Smoking Cessation......Page 87
9 Intervention: Lipid Modification......Page 89
Lipids and cardiovascular risk......Page 90
Dietary interventions that modify risk......Page 91
Drug interventions that modify lipids......Page 95
14: Doses of various statins required to reach a target......Page 99
Monitoring and duration of treatment......Page 101
10 Intervention: Blood Pressure Lowering......Page 103
Blood pressure and cardiovascular risk......Page 104
Dietary interventions that reduce blood pressure......Page 107
Drug interventions that lower blood pressure......Page 109
20: Target blood pressure levels......Page 113
Monitoring and duration of treatment......Page 114
11 Intervention: Antiplatelet Therapy......Page 115
12 Intervention: Complementary and Alternative Therapies......Page 117
13 Management of People with Diabetes, Hyperglycaemic States or The Metabolic Syndrome......Page 119
Diagnostic criteria for type 2 diabetes, IGT and IFG......Page 120
23: A definition of the metabolic syndrome......Page 122
Diabetes and cardiovascular risk......Page 123
Dietary interventions......Page 126
Drug interventions......Page 137
The overall goal of interventions......Page 140
24: Optimal risk factor levels in people with diabetes......Page 141
Aspirin......Page 143
Clopidogrel......Page 144
Dipyridamole......Page 146
Warfarin......Page 147
Beta-blockers......Page 148
ACE-inhibitors......Page 150
Lipid-modifying agents......Page 152
Antiarrhymthmic agents......Page 153
Calcium channel blockers......Page 154
When to start therapy after myocardial infarction or stroke......Page 155
15 Cardiovascular Health of Pacific People......Page 157
16 Implementation......Page 161
APPENDICES......Page 169
Abbreviations......Page 179
Glossary......Page 183
References......Page 189
FIGURES......Page 7
1: Recommended age levels for initiating cardiovascular risk assessment......Page 25
2: Intervention according to cardiovascular risk assessment......Page 29
2: Intervention according to cardiovascular risk assessment......Page 54
3: Cardioprotective dietary patterns......Page 58
4: Including carbohydrate in the cardioprotective dietary pattern......Page 62
5: Changing the ratio of unsaturated:saturated fatty acids......Page 65
6: Safe drinking guidelines......Page 67
7: Metabolic equivalents (METs) for selected activities......Page 73
10: A dietary strategy for weight loss and cardioprotection......Page 81
11: Checklist for evaluating a cardioprotective weight loss programme......Page 85
12: Risks for side effects from ingestion of EPA and DHA supplements......Page 94
13: The effect of various drug classes and plant sterols on lipid profi les......Page 98
15: Optimal lipid levels......Page 100
17: Acceptable blood pressure cuff dimensions for arms of different sizes......Page 105
18: Recommended investigations prior to treatment of raised blood pressure......Page 106
19: Indications and contraindications for the use of various drug classes to lower blood pressure......Page 112
22: Action following the fasting venous plasma glucose......Page 121
1: Steps in the assessment of cardiovascular risk......Page 24
2: Assessing 5-year cardiovascular risk and treatment benefit......Page 26
3: Treatment decisions based on 5-year cardiovascular risk......Page 28
4: Jones model on the impact of racism on health......Page 36
5: Stepwise approach to glycaemic control in type 2 diabetes......Page 139
6: A framework for performance indicators......Page 167