This document contains a CVD risk assessment for 20 patients and a grant proposal focused on smoking cessation. The risk assessment finds that a 56-year-old male patient has a 23.8% 10-year risk of coronary death, MI, or stroke due to factors like diabetes, hypertension, smoking, and a family history of early CAD death. The grant proposal aims to reduce CVD risk in smokers by having a health coach spend 15 minutes developing quit plans and tracking cessation success over 1, 5, and 10 years, arguing that smoking cessation can hugely impact health outcomes and costs.

1. CVD Risk
Assessment for 20
Patients and Grant
Proposal
Mitch Hayes
VMS 3
August 28, 2016

2. Case
 PMH
 HLD
 T2DM
 HTN
 Gout
 SH: single, one child, smokes 1/2 ppd,
drinks occasionally, drives forklift
 FH: father died at 49 of CAD

3. Case continued
 PE:
 P 85, BP 132/74, RR 18, BMI 29.6
 CV: no rubs, murmurs, gallops
 Resp: CTAB
 Abd: nontender, NABS
 Labs:
 Total chol 194, HDL 52
 Meds:
 multiple

4. ASCVD Risk Calculation
 2015: age 56
 Total chol 194, HDL 52 (with statin
therapy)
 SBP 122 from annual clinic visit
 +HTN tx, +DM, current smoker (1/2ppd for
>32 years)
 10 year risk for coronary death, nonfatal MI,
and all stroke:
23.8%

5. Deaths due to CVD have
decreased in recent years

6. But CVD continues to be #1
cause of death in USA

7. Many community resources
available for improvement

8. ASCVD Risk calculation

9. Aggregate data
0
10
20
30
40
50
60
40 45 50 55 60 65 70 75 80 85
ASCVD10yearrisk
Age
ASCVD 10 year risk by age
13.8%

10. Grant Proposal: Smoking
Cessation as a Target of Risk
Reduction
 Smoking cessation
 Why?
 Huge impact on CVD risk
 Huge impact on other risks and overall
health
 Rates of smoking have decreased
significantly in recent decades
 Increased awareness of smoking as a
health risk

11. Planned intervention
 PCPs will screen patients who smoke and
may be interested in quitting
 Pay health coach $5000 to spend 15
minutes with patients who smoke to develop
plans to quit smoking
 Follow up in 1 year to track success rate

12. Metric to determine
improvement
 Track patient-reported success rate of
smoking cessation at 1 year
 Continue to provide support to patients
 Continue to track smoking use amongst
patients

13. Time course
 Review annual physical notes for update on
smoking cessation progress at 1, 2, and 5
years

14. Defense
 Smoking continues to be a risk factor for
many diseases including CVD
 Smoking cessation interventions can make a
huge impact on a patient’s overall health
 Improvement in health outcomes can lead to
huge cost savings
 $5000 pales in comparison to even one
hospitalization due to nonfatal MI or stroke

15. Thank you