1. The document provides guidelines for assessing and treating high blood cholesterol according to a patient's risk level. It outlines 5 steps to determine a patient's risk category and appropriate cholesterol goals and treatment.
2. Risk is determined based on LDL cholesterol levels, presence of cardiovascular disease or risk equivalents, additional risk factors, and 10-year heart disease risk scores.
3. Based on risk category, LDL cholesterol goals and thresholds for lifestyle changes and drug therapy are established. Lifestyle modification and drug therapy options to lower cholesterol and treat related conditions are also described.
This document summarizes the key guidelines from the Adult Treatment Panel III (ATP III) on cholesterol treatment and prevention. The guidelines focus on multiple risk factors like diabetes, which is considered a cardiovascular disease risk equivalent. It modifies lipid classification cut-offs and recommends a complete lipoprotein profile for screening. It provides LDL cholesterol goals and criteria for lifestyle changes or drug therapy based on a patient's risk category of having cardiovascular disease, multiple risk factors, or 0-1 risk factor. The metabolic syndrome is highlighted as a secondary target of therapy beyond LDL lowering. Case examples are given to demonstrate how the guidelines would be applied.
The document outlines guidelines for lifestyle interventions and drug therapy based on LDL cholesterol levels and cardiovascular risk categories. It recommends initiating lifestyle changes and considering drug therapy for high risk patients when LDL is over 100 mg/dL, moderately high risk patients when over 130 mg/dL, moderate risk patients when over 160 mg/dL, and low risk patients when over 190 mg/dL.
The document discusses drugs, drug abuse, and drug addiction. It defines drugs as chemicals that affect a person's physiology, emotions, or behavior. Drug abuse exists when a person uses drugs for non-medical purposes, which can lead to dependence. Drug addiction is a chronic brain disease characterized by compulsive drug seeking and use despite harmful consequences. The document also lists several dangerous drugs and outlines penalties for drug possession and trafficking according to Republic Act No. 9165, the Comprehensive Dangerous Drugs Act of 2002.
El Prof. Alberico L. Catapano, profesor de Farmacología en la Facultad de Farmacia de la Universidad de Milán (Italia) y presidente de la European Atherosclerosis Society (EAS), participa en la sesión 'Nuevos enfoques y evidencias cone statinas en ECV y control lipídico', perteneciente a la 'Jornada Galáctica sobre Guías de Lípidos y objetivos a alcanzar en los pacientes de más alto riesgo cardiovascular' (Málaga, 4-5 abril, 2014).
Accede a la jornada completa en http://guiaslipidos.secardiologia.es
The document provides guidelines for cholesterol management and cardiovascular disease (CVD) risk assessment. It discusses guidelines for measuring cholesterol and lipid levels, calculating LDL and VLDL values, and assessing CVD risk. It recommends starting moderate- or high-intensity statin therapy for most adults aged 40-75 years with diabetes or LDL ≥70 mg/dL. For those without diabetes but with a CVD risk of 7.5% or higher, it recommends discussing statin therapy. The guidelines also provide recommendations for managing statin side effects, evaluating risk factors, and refining risk assessment using coronary artery calcium scoring. The main messages are to emphasize lifestyle changes, use high-intensity statins for high-risk patients, and consider patient risk
Dyslipidemia management an evidence based approachDr Vivek Baliga
In this presentation by Dr Vivek Baliga, he discusses the different available statins and how you can choose the right one in different clinical situations. See articles from Dr Baliga on http://drvivekbaliga.net
This document defines cholesterol and provides information about lab values, signs and symptoms, medication categories, and specific medications used to treat high cholesterol. It discusses definitions of LDL, total, and HDL cholesterol and their normal and abnormal lab ranges. It notes that high cholesterol has no symptoms but can be treated with statin medications like atorvastatin and lovastatin, as well as fiber supplements and gemfibrozil. Demographic information is also included about medication therapy management services, local health screenings, and prescription drug coverage.
This document summarizes the key guidelines from the Adult Treatment Panel III (ATP III) on cholesterol treatment and prevention. The guidelines focus on multiple risk factors like diabetes, which is considered a cardiovascular disease risk equivalent. It modifies lipid classification cut-offs and recommends a complete lipoprotein profile for screening. It provides LDL cholesterol goals and criteria for lifestyle changes or drug therapy based on a patient's risk category of having cardiovascular disease, multiple risk factors, or 0-1 risk factor. The metabolic syndrome is highlighted as a secondary target of therapy beyond LDL lowering. Case examples are given to demonstrate how the guidelines would be applied.
The document outlines guidelines for lifestyle interventions and drug therapy based on LDL cholesterol levels and cardiovascular risk categories. It recommends initiating lifestyle changes and considering drug therapy for high risk patients when LDL is over 100 mg/dL, moderately high risk patients when over 130 mg/dL, moderate risk patients when over 160 mg/dL, and low risk patients when over 190 mg/dL.
The document discusses drugs, drug abuse, and drug addiction. It defines drugs as chemicals that affect a person's physiology, emotions, or behavior. Drug abuse exists when a person uses drugs for non-medical purposes, which can lead to dependence. Drug addiction is a chronic brain disease characterized by compulsive drug seeking and use despite harmful consequences. The document also lists several dangerous drugs and outlines penalties for drug possession and trafficking according to Republic Act No. 9165, the Comprehensive Dangerous Drugs Act of 2002.
El Prof. Alberico L. Catapano, profesor de Farmacología en la Facultad de Farmacia de la Universidad de Milán (Italia) y presidente de la European Atherosclerosis Society (EAS), participa en la sesión 'Nuevos enfoques y evidencias cone statinas en ECV y control lipídico', perteneciente a la 'Jornada Galáctica sobre Guías de Lípidos y objetivos a alcanzar en los pacientes de más alto riesgo cardiovascular' (Málaga, 4-5 abril, 2014).
Accede a la jornada completa en http://guiaslipidos.secardiologia.es
The document provides guidelines for cholesterol management and cardiovascular disease (CVD) risk assessment. It discusses guidelines for measuring cholesterol and lipid levels, calculating LDL and VLDL values, and assessing CVD risk. It recommends starting moderate- or high-intensity statin therapy for most adults aged 40-75 years with diabetes or LDL ≥70 mg/dL. For those without diabetes but with a CVD risk of 7.5% or higher, it recommends discussing statin therapy. The guidelines also provide recommendations for managing statin side effects, evaluating risk factors, and refining risk assessment using coronary artery calcium scoring. The main messages are to emphasize lifestyle changes, use high-intensity statins for high-risk patients, and consider patient risk
Dyslipidemia management an evidence based approachDr Vivek Baliga
In this presentation by Dr Vivek Baliga, he discusses the different available statins and how you can choose the right one in different clinical situations. See articles from Dr Baliga on http://drvivekbaliga.net
This document defines cholesterol and provides information about lab values, signs and symptoms, medication categories, and specific medications used to treat high cholesterol. It discusses definitions of LDL, total, and HDL cholesterol and their normal and abnormal lab ranges. It notes that high cholesterol has no symptoms but can be treated with statin medications like atorvastatin and lovastatin, as well as fiber supplements and gemfibrozil. Demographic information is also included about medication therapy management services, local health screenings, and prescription drug coverage.
Le HDL-c, où en est-on aujourd’hui ? par John Chapmanall-in-web
This document summarizes a presentation given by Dr. M. John Chapman on HDL-C (high-density lipoprotein cholesterol). It discusses the structure and composition of HDL particles, their role in reverse cholesterol transport from tissues to the liver, and functions such as promoting cholesterol efflux from cells. While HDL-C level is commonly used clinically, Dr. Chapman questions whether it accurately reflects HDL functionality in protecting against cardiovascular disease. The document presents evidence that HDL's ability to efflux cholesterol from macrophages better predicts atherosclerosis and coronary artery disease than HDL-C level alone.
India has a large pool of diabetic patients
ICMR-INDIAB study – extrapolated estimations suggest 62.4 million people with diabetes and 77.2 million are prediabetic
Estimates show ~ 85.5% men and 97.8% women who are diabetic in India have concomitant dyslipidemia
Dr. Vivek Baliga discusses diabetic dyslipidemia and emerging concepts in its management. Non-HDL cholesterol is a better indicator of cardiovascular risk than LDL cholesterol. It encompasses all potentially atherogenic lipoproteins. Dual PPAR alpha/gamma agonists like saroglitazar can effectively control dyslipidemia and maintain glycemic control in patients with diabetes by reducing triglycerides and non-HDL cholesterol while improving other lipid and glucose parameters. Saroglitazar is approved in India for the treatment of diabetic dyslipidemia.
Diabetic patients are at high risk for cardiovascular disease due to dyslipidemia and should be treated aggressively to target lipid levels. Lifestyle modifications such as diet, exercise, and weight management are first-line treatment along with statin therapy. Statins should be prescribed to diabetic patients over age 40 with one or more other cardiovascular risk factors, or to those of any age with existing cardiovascular disease, to reduce LDL cholesterol. The main treatment goals are lowering LDL cholesterol to less than 100 mg/dL for patients without cardiovascular disease and less than 70 mg/dL for those with cardiovascular disease.
The document summarizes key points from the 2018 Lipid Guidelines. It discusses the evolution of guidelines from ATP III in 2001 to 2013 and how the 2018 guidelines incorporate aspects of both. Several new drug classes are reviewed including PCSK9 inhibitors, cholesterol absorption inhibitors, and omega-3 fatty acid supplements. Case studies are presented and recommendations are made in line with the 2018 guidelines, focusing on risk stratification, statin intensity, and use of newer drug classes for high-risk patients.
Ueda2016 new horizon in the management of dyslipidemia - diaa ewaisueda2015
1) PCSK9 inhibitors are a new class of drugs that lower LDL cholesterol by blocking the PCSK9 protein and preventing degradation of LDL receptors.
2) Clinical trials of the PCSK9 inhibitors evolocumab and alirocumab showed reductions of LDL cholesterol up to 60-70% and reduced cardiovascular events.
3) PCSK9 inhibitors are effective in lowering cholesterol in patients who cannot tolerate high intensity statins and in those with familial hypercholesterolemia. They are intended for use in addition to, not instead of, statin therapy.
This document discusses strategies for treating dyslipidemia and lowering LDL cholesterol levels. It notes that statins are the primary pharmacological treatment but that many patients do not reach LDL cholesterol goals with statin monotherapy alone. It recommends combining statins with other drugs, such as ezetimibe, which inhibits cholesterol absorption in the gut, or PCSK9 inhibitors. Combination therapy provides complementary mechanisms of action and is more effective at reducing LDL cholesterol than doubling the statin dose alone. Outcome trials show further health benefits from achieving lower LDL levels below currently recommended targets.
1) The document discusses guidelines for statin use in Indians and highlights several non-traditional cardiovascular risk factors for Indians.
2) It notes Indians are more likely to have atherogenic dyslipidemia characterized by high triglycerides and low HDL rather than high LDL.
3) The document advocates estimating lifetime cardiovascular risk for Indians based on traditional and non-traditional factors rather than 10-year risk to better guide statin therapy.
This document discusses cardiovascular disease (CAD) in South Asians and a clinical trial on the use of statins. It contains the following key points:
1) South Asians have a higher prevalence of CAD than other ethnicities due to genetic and environmental/lifestyle factors such as metabolic syndrome and central obesity.
2) The JUPITER trial found that treating individuals with low LDL cholesterol but high C-reactive protein with rosuvastatin reduced cardiovascular events like heart attack and stroke by 44% compared to placebo, showing statins can benefit those not currently eligible for treatment.
3) Rosuvastatin was well-tolerated in JUPITER and showed no increase in side effects even when LDL
This document provides guidelines for the diagnosis and management of dyslipidemia for adults over 18 years old. It was developed by a multidisciplinary task force and has been reviewed and approved regularly since 1999. The guidelines establish screening recommendations and lipid treatment goals based on a patient's risk level. They provide a sequence of medication recommendations depending on a patient's lipid patterns. The guidelines are intended to help clinicians manage dyslipidemia and reduce patients' risk of coronary heart disease.
Guatemala is a multicultural country with over 15 million inhabitants and 24 different ethnic groups. It has a land area of 108,889 square kilometers and was originally named "Place of many trees" in Náhuatl. Guatemala has a strong Mayan cultural influence and is a popular tourist destination, known for its diverse landscapes, cultures, and ethnic groups located primarily in regions like Sololá, San Marcos, and Petén. Several ethnic groups include the Mam, Q'eqchi, and Quiche peoples. Organizations in Guatemala teach organic farming techniques to producers, focusing on solid and liquid organic fertilizers as well as natural insect and disease controls, in order to promote the sustainable production and export of
Bogotá is flatter than Medellin but shorter than Bogotá, and the Bogota food is healthier than Medellin's while Medellin's transport system is more modern than Bogota's and its people are more friendly.
En 3 oraciones o menos:
El texto narra la experiencia de los niños de segundo grado al llegar por primera vez a su salón de clases y encontrarlo desordenado y descuidado. Sin embargo, con la ayuda de su maestra y padres, los niños organizaron y decoraron el salón para que se viera bonito y funcional, poniendo carteles, pintando las paredes y agregando muebles y útiles escolares. Ahora los niños se sienten orgullosos de su salón organizado y decorado gracias a su esfuerzo y trabajo en equip
This document describes a physical data model called PDM_Produccion_Corregido created in Sybase PowerDesigner. It contains descriptions of 11 tables, including Atencion, Categorias, Clientes, Compañias de envios, Empleados, HOLDING, PERTENECE, Productos, Proveedores and their columns and relationships. The tables contain information about customer service, categories, clients, shipping companies, employees, company structure, product suppliers.
This document provides information about La Cusinga Eco Lodge located in an unspecified location. It mentions the lodge offers walking trails and activities. Bedrooms, prices, and food options are listed but no details are given.
Un tour desde San Carlos, pasando por el Parque Nacional Volcán Tenorio y llegando finalmente a Río Celeste, el punto final del tour. Se pretende disfrutar de la naturaleza con toda su belleza escénica e involucrarnos con el medio ambiente en un Bosque Lluvioso...
Pedro Pablo Kuczynski es un economista y político peruano que actualmente se desempeña como presidente electo del Perú. Tuvo una destacada carrera como ministro de Economía y Finanzas y presidente del Consejo de Ministros durante el gobierno de Alejandro Toledo. También se ha desempeñado como ministro de Energía y Minas durante el segundo gobierno de Fernando Belaúnde Terry. Kuczynski se postuló infructuosamente a la presidencia en 2011 y logró ganar las elecciones de 2016.
Le HDL-c, où en est-on aujourd’hui ? par John Chapmanall-in-web
This document summarizes a presentation given by Dr. M. John Chapman on HDL-C (high-density lipoprotein cholesterol). It discusses the structure and composition of HDL particles, their role in reverse cholesterol transport from tissues to the liver, and functions such as promoting cholesterol efflux from cells. While HDL-C level is commonly used clinically, Dr. Chapman questions whether it accurately reflects HDL functionality in protecting against cardiovascular disease. The document presents evidence that HDL's ability to efflux cholesterol from macrophages better predicts atherosclerosis and coronary artery disease than HDL-C level alone.
India has a large pool of diabetic patients
ICMR-INDIAB study – extrapolated estimations suggest 62.4 million people with diabetes and 77.2 million are prediabetic
Estimates show ~ 85.5% men and 97.8% women who are diabetic in India have concomitant dyslipidemia
Dr. Vivek Baliga discusses diabetic dyslipidemia and emerging concepts in its management. Non-HDL cholesterol is a better indicator of cardiovascular risk than LDL cholesterol. It encompasses all potentially atherogenic lipoproteins. Dual PPAR alpha/gamma agonists like saroglitazar can effectively control dyslipidemia and maintain glycemic control in patients with diabetes by reducing triglycerides and non-HDL cholesterol while improving other lipid and glucose parameters. Saroglitazar is approved in India for the treatment of diabetic dyslipidemia.
Diabetic patients are at high risk for cardiovascular disease due to dyslipidemia and should be treated aggressively to target lipid levels. Lifestyle modifications such as diet, exercise, and weight management are first-line treatment along with statin therapy. Statins should be prescribed to diabetic patients over age 40 with one or more other cardiovascular risk factors, or to those of any age with existing cardiovascular disease, to reduce LDL cholesterol. The main treatment goals are lowering LDL cholesterol to less than 100 mg/dL for patients without cardiovascular disease and less than 70 mg/dL for those with cardiovascular disease.
The document summarizes key points from the 2018 Lipid Guidelines. It discusses the evolution of guidelines from ATP III in 2001 to 2013 and how the 2018 guidelines incorporate aspects of both. Several new drug classes are reviewed including PCSK9 inhibitors, cholesterol absorption inhibitors, and omega-3 fatty acid supplements. Case studies are presented and recommendations are made in line with the 2018 guidelines, focusing on risk stratification, statin intensity, and use of newer drug classes for high-risk patients.
Ueda2016 new horizon in the management of dyslipidemia - diaa ewaisueda2015
1) PCSK9 inhibitors are a new class of drugs that lower LDL cholesterol by blocking the PCSK9 protein and preventing degradation of LDL receptors.
2) Clinical trials of the PCSK9 inhibitors evolocumab and alirocumab showed reductions of LDL cholesterol up to 60-70% and reduced cardiovascular events.
3) PCSK9 inhibitors are effective in lowering cholesterol in patients who cannot tolerate high intensity statins and in those with familial hypercholesterolemia. They are intended for use in addition to, not instead of, statin therapy.
This document discusses strategies for treating dyslipidemia and lowering LDL cholesterol levels. It notes that statins are the primary pharmacological treatment but that many patients do not reach LDL cholesterol goals with statin monotherapy alone. It recommends combining statins with other drugs, such as ezetimibe, which inhibits cholesterol absorption in the gut, or PCSK9 inhibitors. Combination therapy provides complementary mechanisms of action and is more effective at reducing LDL cholesterol than doubling the statin dose alone. Outcome trials show further health benefits from achieving lower LDL levels below currently recommended targets.
1) The document discusses guidelines for statin use in Indians and highlights several non-traditional cardiovascular risk factors for Indians.
2) It notes Indians are more likely to have atherogenic dyslipidemia characterized by high triglycerides and low HDL rather than high LDL.
3) The document advocates estimating lifetime cardiovascular risk for Indians based on traditional and non-traditional factors rather than 10-year risk to better guide statin therapy.
This document discusses cardiovascular disease (CAD) in South Asians and a clinical trial on the use of statins. It contains the following key points:
1) South Asians have a higher prevalence of CAD than other ethnicities due to genetic and environmental/lifestyle factors such as metabolic syndrome and central obesity.
2) The JUPITER trial found that treating individuals with low LDL cholesterol but high C-reactive protein with rosuvastatin reduced cardiovascular events like heart attack and stroke by 44% compared to placebo, showing statins can benefit those not currently eligible for treatment.
3) Rosuvastatin was well-tolerated in JUPITER and showed no increase in side effects even when LDL
This document provides guidelines for the diagnosis and management of dyslipidemia for adults over 18 years old. It was developed by a multidisciplinary task force and has been reviewed and approved regularly since 1999. The guidelines establish screening recommendations and lipid treatment goals based on a patient's risk level. They provide a sequence of medication recommendations depending on a patient's lipid patterns. The guidelines are intended to help clinicians manage dyslipidemia and reduce patients' risk of coronary heart disease.
Guatemala is a multicultural country with over 15 million inhabitants and 24 different ethnic groups. It has a land area of 108,889 square kilometers and was originally named "Place of many trees" in Náhuatl. Guatemala has a strong Mayan cultural influence and is a popular tourist destination, known for its diverse landscapes, cultures, and ethnic groups located primarily in regions like Sololá, San Marcos, and Petén. Several ethnic groups include the Mam, Q'eqchi, and Quiche peoples. Organizations in Guatemala teach organic farming techniques to producers, focusing on solid and liquid organic fertilizers as well as natural insect and disease controls, in order to promote the sustainable production and export of
Bogotá is flatter than Medellin but shorter than Bogotá, and the Bogota food is healthier than Medellin's while Medellin's transport system is more modern than Bogota's and its people are more friendly.
En 3 oraciones o menos:
El texto narra la experiencia de los niños de segundo grado al llegar por primera vez a su salón de clases y encontrarlo desordenado y descuidado. Sin embargo, con la ayuda de su maestra y padres, los niños organizaron y decoraron el salón para que se viera bonito y funcional, poniendo carteles, pintando las paredes y agregando muebles y útiles escolares. Ahora los niños se sienten orgullosos de su salón organizado y decorado gracias a su esfuerzo y trabajo en equip
This document describes a physical data model called PDM_Produccion_Corregido created in Sybase PowerDesigner. It contains descriptions of 11 tables, including Atencion, Categorias, Clientes, Compañias de envios, Empleados, HOLDING, PERTENECE, Productos, Proveedores and their columns and relationships. The tables contain information about customer service, categories, clients, shipping companies, employees, company structure, product suppliers.
This document provides information about La Cusinga Eco Lodge located in an unspecified location. It mentions the lodge offers walking trails and activities. Bedrooms, prices, and food options are listed but no details are given.
Un tour desde San Carlos, pasando por el Parque Nacional Volcán Tenorio y llegando finalmente a Río Celeste, el punto final del tour. Se pretende disfrutar de la naturaleza con toda su belleza escénica e involucrarnos con el medio ambiente en un Bosque Lluvioso...
Pedro Pablo Kuczynski es un economista y político peruano que actualmente se desempeña como presidente electo del Perú. Tuvo una destacada carrera como ministro de Economía y Finanzas y presidente del Consejo de Ministros durante el gobierno de Alejandro Toledo. También se ha desempeñado como ministro de Energía y Minas durante el segundo gobierno de Fernando Belaúnde Terry. Kuczynski se postuló infructuosamente a la presidencia en 2011 y logró ganar las elecciones de 2016.
This patient is a 45-year-old premenopausal nonsmoker with a sedentary lifestyle and family history of diabetes, heart disease, and stroke. Her labs show a total cholesterol of 236 mg/dL, triglycerides of 200 mg/dL, LDL-C of 140 mg/dL, and HDL-C of 46 mg/dL. She meets the criteria for metabolic syndrome due to her abdominal obesity, triglycerides, HDL-C, and blood pressure. Though her LDL-C is below threshold for drug therapy, lifestyle changes are recommended to control her metabolic syndrome and lower her cardiovascular risk.
This document summarizes clinical guidelines for cholesterol management and cardiovascular risk reduction. It compares the 2013 ACC/AHA guidelines to previous NCEP ATP III guidelines. The new guidelines have a focus on reducing atherosclerotic cardiovascular disease risk rather than just coronary heart disease risk. They recommend high-intensity statin therapy for more patient groups based on revised risk assessment categories and calculators. Key changes include expanding statin benefit to those with diabetes or a 7.5% or higher 10-year risk without cardiovascular disease. Management of high triglycerides is also discussed.
- The document discusses guidelines for statin use in primary prevention from the 2014 ACC/AHA, including algorithms for determining statin eligibility based on estimated 10-year risk of atherosclerotic cardiovascular disease (ASCVD).
- It notes that the guidelines lower the risk threshold for statin recommendation from greater than 7.5% 10-year ASCVD risk to greater than 5% for some patients.
- Concerns raised about the guidelines include the selection of studies included in reviews and the lack of consideration of observational data or post-hoc analyses of randomized controlled trials.
The document discusses guidelines for managing dyslipidemia and cardiovascular disease risk, including:
1) It provides risk levels (very high, high, moderate, low) based on calculated cardiovascular risk and clinical factors and recommends LDL-C treatment targets for each level.
2) It discusses statin treatment for different risk levels, recommending the highest tolerated dose to reach LDL-C targets.
3) It summarizes trials comparing different statins and their average LDL-C reduction, finding some are more effective than others at reducing LDL-C.
This document discusses hyperlipidemia and dyslipidemia. It begins by defining hyperlipidemia and dyslipidemia as elevated blood levels of lipoproteins including cholesterol, triglycerides, and phospholipids. Abnormal lipoprotein levels increase the risk of coronary heart disease. The document then covers the pathophysiology of lipoprotein transport and metabolism. It describes the clinical presentation of hyperlipidemia, which is often asymptomatic initially. Diagnosis involves lipid profiling and classification of cholesterol and triglyceride levels. The focus of treatment is lowering LDL cholesterol through lifestyle changes and lipid-lowering drugs like statins when necessary.
The document discusses lipids and lipoproteins, providing information on their structure, function, and roles in cardiovascular disease. It outlines guidelines for lipid profiling and therapeutic lifestyle changes and drug therapies to control lipid levels and reduce cardiovascular risk. Key points include classifications of lipoproteins and lipid levels, goals for lowering LDL and triglycerides, and drug classes like statins, fibrates, and niacin that are used to treat dyslipidemia.
The document discusses dyslipidemia prevalence and screening guidelines, summarizes studies on cholesterol-lowering drug efficacy for primary and secondary prevention, and provides treatment guidelines including lifestyle modification, medications, and combination therapy options. Prevalence of high cholesterol in Saudi Arabia is reported from various studies. Drug treatment goals and general management guidelines are outlined based on cardiovascular risk factors and disease status.
This document provides information on hyperlipidemic drugs. It begins with an introduction to hyperlipidemia and its causes. It then discusses various drug classes for treating hyperlipidemia, including their mechanisms of action, effects on lipid levels, pharmacokinetics, therapeutic uses, adverse effects and interactions. The major drug classes discussed are HMG-CoA reductase inhibitors (statins), bile acid sequestrants, fibrates, and niacin. For each class, specific drugs are highlighted and their properties compared.
This document discusses the role of statins in primary prevention of cardiovascular disease. It begins by outlining how cardiovascular disease is a leading cause of death worldwide. It then describes the pathogenesis of atherosclerosis and defines clinical forms of ASCVD. The main mechanisms of action and effects of statins on lipids are explained. The document recommends assessing cardiovascular risk and initiating statin therapy based on risk level. It also discusses risk-enhancing factors, adverse effects of statins, and contraindications. Guidelines from major cardiovascular organizations are referenced.
This document provides guidelines for the assessment and management of dyslipidemia from several major organizations. It discusses risk assessment tools for cardiovascular disease from ATP III, ADA, ACC/AHA, and QRISK2. It also compares statin intensity categories between NICE and ACC/AHA guidelines. The document recommends lifestyle modification as first-line treatment and the use of high-intensity statins for primary and secondary prevention of CVD according to the guidelines of NICE, ADA, and ACC/AHA.
1. The new guidelines recommend initiating moderate or high-intensity statin therapy for patients in four categories based on their cardiovascular risk, rather than targeting a specific LDL-C level.
2. The four categories are: individuals with clinical atherosclerotic cardiovascular disease, LDL-C over 190 mg/dL, diabetes between ages 40-75 with LDL-C 70-189 mg/dL, and 10-year risk over 7.5% for ages 40-75 with LDL-C 70-189 mg/dL.
3. Lipids should be measured during follow-ups to assess adherence, not to achieve a specific target level.
Dyslipidemia and Management of Dyslipidemia | Muhammad-Nizam-UddinMuhammad Nizam Uddin
Dyslipidemia and it's management is such a topic that one single PPT is not enough to express all sorts of problems or scopes. This PPT will give you an overview on "Dyslipidemia and it's management"
1. Dyslipidemia is an important risk factor for cardiovascular disease and is defined by disorders of lipoprotein metabolism that result in high cholesterol, LDL, and triglycerides or low HDL.
2. Lifestyle changes and medications like statins are recommended to lower LDL levels and reduce cardiovascular risk, with lower LDL targets for those at highest risk.
3. Statins are the first-line treatment for lowering LDL but can cause side effects like muscle pain; newer drugs like PCSK9 inhibitors can further lower LDL in those unable to tolerate statins.
the aim of sharing this material to help students and provide delayed information regarding topic.You all are most welcome for you suggestion to make i more easy, graspable and attractive.(easy to learn in creative way)
The document discusses new guidelines for hypertension from organizations like JNC 8, ESC, and ASH/ISH.
The guidelines stratify total cardiovascular risk and recommend treatment thresholds and goals based on risk factors. For general patients under 60, treatment is recommended for those with systolic BP over 140 or diastolic over 90. The guidelines also recommend initial treatment options including ACE inhibitors, calcium channel blockers, thiazide diuretics, and others.
The guidelines aim to provide evidence-based recommendations for hypertension treatment worldwide while allowing flexibility based on individual patient characteristics. Overall, the focus is on improving health outcomes through treating patients and controlling blood pressure levels rather than rigidly adhering to specific numbers.
1. Advise lifestyle modifications like a heart-healthy diet, exercise, weight control, and smoking cessation.
2. Reassess risk factors and calculate 10-year ASCVD risk in 5 years.
3. Consider a moderate-intensity statin if additional risk factors emerge or 10-year risk reaches 7.5% at the next assessment.
The document provides guidelines from a committee for managing blood cholesterol to reduce atherosclerotic cardiovascular disease risk. It includes 10 key recommendations, such as emphasizing lifestyle changes for all ages, using high-intensity statin therapy for patients with clinical ASCVD, considering additional nonstatin drugs for very high risk patients, and assessing adherence to medication and lifestyle changes. The guidelines cover measuring cholesterol levels, risk assessment, and treatment approaches for different patient groups including those with diabetes or severe hypercholesterolemia.
2. prof. bambang irawan cv assessment in met s and t2dm [compatibility mode]yoga buana
This document summarizes guidelines from several organizations on cardiovascular assessment and management of risk factors for patients with metabolic syndrome and diabetes. The guidelines address:
1) Definitions of metabolic syndrome from organizations like WHO, NCEP ATP III, IDF which include criteria like waist circumference, blood pressure, lipids, and glucose.
2) Cardiovascular risk assessment recommendations including considering patients with diabetes as high risk and using risk scores.
3) Management strategies focusing on lifestyle changes and treating multiple risk factors like dyslipidemia, hypertension, and hyperglycemia to reduce cardiovascular risk.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
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How to Create a More Engaging and Human Online Learning Experience
Atglance
1. High Blood Cholesterol
National Cholesterol Education Program
ATP III Guidelines At-A-Glance
Quick Desk Reference
1
Step 1 Determine lipoprotein levels–obtain complete lipoprotein profile after
9- to 12-hour fast.
ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL)
LDL Cholesterol – Primary Target of Therapy
<100 Optimal
100-129 Near optimal/above optimal
130-159 Borderline high
160-189 High
>190 Very high
Total Cholesterol
<200 Desirable
200-239 Borderline high
>240 High
HDL Cholesterol
<40 Low
>60 High
2
Step 2 Identify presence of clinical atherosclerotic disease that confers high risk
for coronary heart disease (CHD) events (CHD risk equivalent):
s Clinical CHD
s Symptomatic carotid artery disease
s Peripheral arterial disease
Abdominal aortic aneurysm.
3
s
Step 3 Determine presence of major risk factors (other than LDL):
Major Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals
Cigarette smoking
Hypertension (BP >140/90 mmHg or on antihypertensive medication)
Low HDL cholesterol (<40 mg/dL)*
Family history of premature CHD (CHD in male first degree relative <55 years;
CHD in female first degree relative <65 years)
Age (men >45 years; women >55 years)
* HDL cholesterol >60 mg/dL counts as a “negative” risk factor; its presence removes one
risk factor from the total count.
s Note: in ATP III, diabetes is regarded as a CHD risk equivalent.
N A T I O N A L I N S T I T U T E S O F H E A L T H
N A T I O N A L H E A R T , L U N G , A N D B L O O D I N S T I T U T E
2. 4
Step 4 If 2+ risk factors (other than LDL) are present without CHD or CHD risk equivalent, assess
10-year (short-term) CHD risk (see Framingham tables).
Three levels of 10-year risk:
s >20% — CHD risk equivalent
s 10-20%
s <10%
5
Step 5 Determine risk category:
s Establish LDL goal of therapy
s Determine need for therapeutic lifestyle changes (TLC)
s Determine level for drug consideration
LDL Cholesterol Goals and Cutpoints for Therapeutic Lifestyle Changes (TLC) and Drug Therapy in Different
Risk Categories.
LDL Level at Which
to Initiate Therapeutic LDL Level at Which to
Risk Category LDL Goal Lifestyle Changes (TLC) Consider Drug Therapy
CHD or CHD Risk Equivalents <100 mg/dL >100 mg/dL >130 mg/dL
(10-year risk >20%) (100-129 mg/dL: drug optional)*
10-year risk 10-20%:
2+ Risk Factors <130 mg/dL >130 mg/dL >130 mg/dL
(10-year risk <20%) 10-year risk <10%:
>160 mg/dL
0-1 Risk Factor† <160 mg/dL >160 mg/dL >190 mg/dL
(160-189 mg/dL: LDL-lowering
drug optional)
* Some authorities recommend use of LDL-lowering drugs in this category if an LDL cholesterol <100 mg/dL cannot be achieved by
therapeutic lifestyle changes. Others prefer use of drugs that primarily modify triglycerides and HDL, e.g., nicotinic acid or fibrate.
Clinical judgment also may call for deferring drug therapy in this subcategory.
† Almost all people with 0-1 risk factor have a 10-year risk <10%, thus 10-year risk assessment in people with 0-1 risk factor is
not necessary.
6
Step 6
Initiate therapeutic lifestyle changes (TLC) if LDL is above goal.
TLC Features
s TLC Diet:
— Saturated fat <7% of calories, cholesterol <200 mg/day
— Consider increased viscous (soluble) fiber (10-25 g/day) and plant stanols/sterols
(2g/day) as therapeutic options to enhance LDL lowering
s Weight management
s Increased physical activity.
3. 7
Step 7 Consider adding drug therapy if LDL exceeds levels shown in Step 5 table:
s Consider drug simultaneously with TLC for CHD and CHD equivalents
s Consider adding drug to TLC after 3 months for other risk categories.
Drugs Affecting Lipoprotein Metabolism
Drug Class Agents and Lipid/Lipoprotein Side Effects Contraindications
Daily Doses Effects
HMG CoA reductase Lovastatin (20-80 mg) LDL ↓18-55% Myopathy Absolute:
inhibitors (statins) Pravastatin (20-40 mg) HDL ↑5-15% Increased liver • Active or chronic
Simvastatin (20-80 mg) TG ↓7-30% enzymes liver disease
Fluvastatin (20-80 mg) Relative:
• Concomitant use of
Atorvastatin (10-80 mg)
certain drugs*
Cerivastatin (0.4-0.8 mg)
Bile acid sequestrants Cholestyramine (4-16 g) LDL ↓15-30% Gastrointestinal Absolute:
Colestipol (5-20 g) HDL ↑3-5% distress • dysbeta-
Constipation lipoproteinemia
Colesevelam (2.6-3.8 g) TG No change
or increase Decreased absorp- • TG >400 mg/dL
tion of other drugs Relative:
• TG >200 mg/dL
Nicotinic acid Immediate release LDL ↓5-25% Flushing Absolute:
(crystalline) nicotinic acid HDL ↑15-35% Hyperglycemia • Chronic liver disease
(1.5-3 gm), extended TG ↓20-50% Hyperuricemia • Severe gout
release nicotinic acid (or gout) Relative:
(Niaspan®) (1-2 g), Upper GI distress • Diabetes
sustained release Hepatotoxicity • Hyperuricemia
nicotinic acid (1-2 g) • Peptic ulcer disease
Fibric acids Gemfibrozil LDL ↓5-20% Dyspepsia Absolute:
(600 mg BID) (may be increased in Gallstones • Severe renal disease
Fenofibrate (200 mg) patients with high TG) Myopathy • Severe hepatic
Clofibrate HDL ↑10-20% disease
(1000 mg BID) TG ↓20-50%
* Cyclosporine, macrolide antibiotics, various anti-fungal agents, and cytochrome P-450 inhibitors (fibrates and niacin should be used with
appropriate caution).
4. 8
Step 8 Identify metabolic syndrome and treat, if present, after 3 months of TLC.
Clinical Identification of the Metabolic Syndrome – Any 3 of the Following:
Risk Factor Defining Level
Abdominal obesity* Waist circumference†
Men >102 cm (>40 in)
Women >88 cm (>35 in)
Triglycerides >150 mg/dL
HDL cholesterol
Men <40 mg/dL
Women <50 mg/dL
Blood pressure >130/>85 mmHg
Fasting glucose >110 mg/dL
* Overweight and obesity are associated with insulin resistance and the metabolic syndrome.
However, the presence of abdominal obesity is more highly correlated with the metabolic risk
factors than is an elevated body mass index (BMI). Therefore, the simple measure of waist cir-
cumference is recommended to identify the body weight component of the metabolic syndrome.
† Some male patients can develop multiple metabolic risk factors when the waist circumference is
only marginally increased, e.g., 94-102 cm (37-39 in). Such patients may have a strong genetic
contribution to insulin resistance. They should benefit from changes in life habits, similarly to
men with categorical increases in waist circumference.
Treatment of the metabolic syndrome
s Treat underlying causes (overweight/obesity and physical inactivity):
– Intensify weight management
– Increase physical activity.
s Treat lipid and non-lipid risk factors if they persist despite these lifestyle therapies:
– Treat hypertension
– Use aspirin for CHD patients to reduce prothrombotic state
– Treat elevated triglycerides and/or low HDL (as shown in Step 9).
5. 9
Step 9 Treat elevated triglycerides.
ATP III Classification of Serum Triglycerides (mg/dL)
<150 Normal
150-199 Borderline high
200-499 High
≥500 Very high
Treatment of elevated triglycerides (≥150 mg/dL)
s Primary aim of therapy is to reach LDL goal
s Intensify weight management
s Increase physical activity
s If triglycerides are >200 mg/dL after LDL goal is reached, set
secondary goal for non-HDL cholesterol (total – HDL)
30 mg/dL higher than LDL goal.
Comparison of LDL Cholesterol and Non-HDL Cholesterol Goals for Three Risk Categories
Risk Category LDL Goal (mg/dL) Non-HDL Goal (mg/dL)
CHD and CHD Risk Equivalent <100 <130
(10-year risk for CHD >20%)
Multiple (2+) Risk Factors and <130 <160
10-year risk <20%
0-1 Risk Factor <160 <190
If triglycerides 200-499 mg/dL after LDL goal is reached, consider adding drug if needed to
reach non-HDL goal:
• intensify therapy with LDL-lowering drug, or
• add nicotinic acid or fibrate to further lower VLDL.
If triglycerides >500 mg/dL, first lower triglycerides to prevent pancreatitis:
• very low-fat diet (<15% of calories from fat)
• weight management and physical activity
• fibrate or nicotinic acid
• when triglycerides <500 mg/dL, turn to LDL-lowering therapy.
Treatment of low HDL cholesterol (<40 mg/dL)
s First reach LDL goal, then:
s Intensify weight management and increase physical activity
s If triglycerides 200-499 mg/dL, achieve non-HDL goal
s If triglycerides <200 mg/dL (isolated low HDL) in CHD or CHD equivalent
consider nicotinic acid or fibrate.
6. Men
Estimate of 10-Year Risk for Men
Women
Estimate of 10-Year Risk for Women
(Framingham Point Scores) (Framingham Point Scores)
Age Points Age Points
20-34 -9 20-34 -7
35-39 -4 35-39 -3
40-44 0 40-44 0
45-49 3 45-49 3
50-54 6 50-54 6
55-59 8 55-59 8
60-64 10 60-64 10
65-69 11 65-69 12
70-74 12 70-74 14
75-79 13 75-79 16
Points Total Points
Total
Cholesterol Cholesterol
Age 20-39 Age 40-49 Age 50-59 Age 60-69 Age 70-79 Age 20-39 Age 40-49 Age 50-59 Age 60-69 Age 70-79
<160 0 0 0 0 0 <160 0 0 0 0 0
160-199 4 3 2 1 0 160-199 4 3 2 1 1
200-239 7 5 3 1 0 200-239 8 6 4 2 1
240-279 9 6 4 2 1 240-279 11 8 5 3 2
≥280 11 8 5 3 1 ≥280 13 10 7 4 2
Points Points
Age 20-39 Age 40-49 Age 50-59 Age 60-69 Age 70-79 Age 20-39 Age 40-49 Age 50-59 Age 60-69 Age 70-79
Nonsmoker 0 0 0 0 0 Nonsmoker 0 0 0 0 0
Smoker 8 5 3 1 1 Smoker 9 7 4 2 1
HDL (mg/dL) Points HDL (mg/dL) Points
≥60 -1 ≥60 -1
50-59 0 50-59 0
40-49 1 40-49 1
<40 2 <40 2
Systolic BP (mmHg) If Untreated If Treated Systolic BP (mmHg) If Untreated If Treated
<120 0 0 <120 0 0
120-129 0 1 120-129 1 3
130-139 1 2 130-139 2 4
140-159 1 2 140-159 3 5
≥160 2 3 ≥160 4 6
Point Total 10-Year Risk % Point Total 10-Year Risk %
<0 <1 <9 <1
0 1 9 1
1 1 10 1
2 1 11 1
3 1 12 1
4 1 13 2
5 2 14 2
6 2 15 3
7 3 16 4
8 4
17 5
9 5
10 6 18 6
11 8 19 8
12 10 20 11
13 12 21 14
14 16 22 17
15 20 23 22
16 25 10-Year risk ______% 24 27 10-Year risk ______%
≥17 ≥ 30 ≥25 ≥ 30
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES NIH Publication No. 01-3305
Public Health Service May 2001
National Institutes of Health
National Heart, Lung, and Blood Institute