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ekgcircle3.gif (1164 bytes) Risk Factor List interpretation/discussion

 

Risk Factor Discussion:

1) Current executive summary of AHA Guidelines lists risk factors that modify LDL goals in JAMA may 16, 2001 Vol.285, No. 19 
2) JNC 7 lists hypertension, obesity, dyslipidemia, diabetes mellitus, cigarette smoking, physical inactivity, microalbumiuria (or GFR<60mL/min), Age (male>55, Female>65 years old) and Family history of premature CV disease, as "cardiovascular" risk factors for CAD.
3) These "risk factors" from NCEP ATP III and JNC 7  should not be confused
Case:

A 32 yo male, nonsmoker, no hypertension, HDL-C of 42mg/dL, no diabetes, no family history, exercises 4 times per week >30" each day, BMI of 22 meters/kg sq, no personal or family  history of CHD.
How many risk factors does he have for the purpose of determining his goal
LDL-C according to NCEP ATP III?
Answer: zero
What is his goal LDL-C?
Answer: because he has < one RF- his goal is < 160mg/dL
Now, if I told you he had an LDL-C of 170mg/dL, he still has zero RFs for the
purpose of enumerating risk factors to determine his goal LDL-C.  His goal
remains < 160mg/dL.  However you would council him on following a diet (say
dietary considerations; know this) and tell him his goal LDL-C is <160mg/dL.  You would say that
his risk is higher than average for CHD based on his LDL-C exceeding the
goal of 160mg/dL. That's how you use the LDL- C risk factor included in my list

If this same patient was 46 years old,
How many RFs?
Answer: one
Goal LDL-C ?
Answer: <160mg/dL

http://www.courses.ahc.umn.edu/pharmacy/5822/hyperlipid2.html#GENERAL
TREATMENT ALGORITHMS (Guidelines), versus 190mg/dL for the 46 year old case.
http://www.courses.ahc.umn.edu/pharmacy/5822/hyperlipid5.html

I'm really hoping this helps you understand fully the application and use of the NCEP Risk factor lists.

 

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