Primary and Secondary Prevention of Cardiovascular Disease PDF

Primary and Secondary Prevention of Cardiovascular Disease Lisa Cohen, Pharm.D., CDCES, CDOE, CVDOE Professor of Pharmacy Objectives Define atherosclerotic disease, primary prevention Define atherosclerotic disease, secondary prevention Identify ways to reduce the risk of atherosclerotic ca...

Primary and Secondary Prevention of Cardiovascular Disease Lisa Cohen, Pharm.D., CDCES, CDOE, CVDOE Professor of Pharmacy Objectives Define atherosclerotic disease, primary prevention Define atherosclerotic disease, secondary prevention Identify ways to reduce the risk of atherosclerotic cardiovascular disease (ASCVD) outcomes Acute coronary syndromes, myocardial infarction, stable or unstable angina, arterial revascularization, stroke/transient ischemic attacks, peripheral arterial disease What is the Definition of Primary Prevention? Facts: In 2017, US spent $3.5 trillion on health care, but only 2.5% was dedicated to government public health activities to prevent illness Primary prevention Seeks to avert the occurrence of disease or injury What is Atherosclerotic Cardiovascular Disease? Disease in which plaque builds up in the arteries Plaque Fat, cholesterol, calcium, other substances What Are Some Types of Atherosclerosis? It can affect any artery in the body Heart Brain Arms Legs Pelvis Kidney Therefore, different diseases may develop depending on where the arteries are affected What Are Atherosclerotic-Related Diseases? Ischemic heart disease (IHD) Coronary heart disease (also called coronary artery disease - CAD) Angina Carotid artery disease Peripheral artery disease (PAD) Chronic kidney disease (CKD) Levels of Prevention of Cardiovascular Disease Label Primary Prevention Secondary Prevention Definition An intervention An intervention implemented before there implemented after is evidence of cardiovascular disease has cardiovascular disease or begun event Intent Reduce or eliminate Early identification causative risk factors (risk through treatment and reduction) testing Examples Person with diabetes A person that has had a before they have a heart heart attack and trying to attack prevent another attack  Important for primary health care givers, cardiologists and pharmacists Prevention: Begins with risk assessment Preventing Attention to lifestyle Heart Disease Weight, physical activity Then aggressive treatment of all abnormal risk factors Hypertension, hyperlipidemia, diabetes  Healthy patients – follow up not as frequent Options for Patients Being No evidence of Plan for reducing risks cardiovascular Evaluated for disease but patient Retest at intervals to assess adherence and efficacy in risk Primary has risk factors reduction Prevention Patients with Evaluate current coronary artery recommendations disease  Primary Prevention of Cardiovascular Disease Things We Can’t Change Age Genetic Factors Ethnicity  Gender Differences in ASCVD Prevention Racial Disparities in Cardiovascular Disease  A team-based care approach is recommended for the control of risk factors associated with ASCVD Patient-Centered Approaches to Shared decision making should guide Comprehensive discussions about the best strategies to ASCVD reduce ASCVD risk Prevention Social determinants of health should inform optimal implementation of treatment recommendations for the prevention of ASCVD  1. For adults 40-75 years old, routinely assess traditional risk factors and calculate 10-year risk of ASCVD 2. For adults 20-39 years old, it is reasonable to assess ASCVD risk factors at least every 4 to 6 years 3. In adults at borderline risk (5% to