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