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Courses Phar 6122

 

ekgcircle3.gif (1164 bytes) Lecture Outlines: Diseases/Syndromes

Positive Risk Factors for Ischemic Heart Disease

 

Risk Factors from NCEP- ATP III other than Elevated LDL-C which determine LDL-C Goal
(see Other Positive Risk Factors)
  1. Age:
    Male >45 years of age
    Female >55 or premature menopause without estrogen replacement therapy.
  2. Family History of premature CHD:
    Definite MI or sudden death before 55 years of age in father or other male 1st-degree relative, or before 65 years of age in mother of other first-degree relative.
  3. Current cigarette smoking
  4. Hypertension:
    Blood pressure >140/90 mmHg or taking antihypertensive medication.
  5. Low HDL cholesterol - < 40mg/dl
Negative Risk Factors
  1. High HDL cholesterol - > 60 mg/dl
Further discussion on Risk factor list interpretations
Risk Factors from JNC 7
  1. Hypertension
  2. Obesity: calculated BMI>30 Kg/meter squared  (How to calculate BMI)
  3. Dyslipidemia: 
  4. Diabetes Mellitus
  5. Cigarette smoking
  6. Physical inactivity:: physical inactivity as enduring <30 minutes of physical activity at least three times a week.
  7. microalbuniuria ore estimated GFR < 60mL/min
  8. Age (older than 55 years for males, 65 years for women) 
  9. Family history of premature cardiovascular disease (event in 1st degree relative who is male under 55 years or female under 65 years)
Obesity as a Risk Factor for CHD: How to Calculate Body Mass Index
Obesity:

AHA defines obesity as follows: "when body weight exceeds "desirable" weight for height and gender by 20% or more and when the excess weight is fat rather than water, muscle or bone."

Practically speaking, this has been defined as a Body Mass Index (BMI) greater than 30. This is calculated by knowing the height and weight of the person.

Example A: for a person who is 5 ft 5 inches tall weighing 149 lbs.

  1. Multiply weight (in pounds) by 703
  2. Multiply height (in inches) by height (in inches)
  3. Divide the answer in step 1 by the answer in step 2

    Answer: (149x703)/(65x65) or 24.8 kg/meters squared.

Example B: for a person weighing 190 lbs., whose height is 6 ft

  1. Calculate weight in kg (one kilogram = 2.2 pounds)
  2. Divide wt. in kg by (height in meters squared). (1 meter = 39.37 inches)

    Answer: 190/2.2 is 86.4kg, 6 ft is 72 inches or 1.83 meters. So, 86.4kg/(1.83x1.83)=86.4kg/3.34meters2 or 25.8kg/meter2.

BMI between 19 and 25 is considered "healthy," whereas BMI in excess of 30 is considered obese. The range between 25 to 30 is overweight:
Healthy = 19-25 kg/sq.meters Overweight =
  25-30 kg/sq.meters		 Obese = >30 kg/sq.meters
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