By Neil R. Poulter
Here are quick solutions to universal scientific questions when it comes to cardiovascular danger. Taking a guidelines-driven procedure, the writer has simplified the mammoth variety of medical offerings on hand to the doctor assessing their sufferer for cardiovascular risk.
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Extra resources for Clinical manual of total cardiovascular risk
96). There were no significant differences in disease outcomes between exercise only and comprehensive rehabilitation, but this comparison may be confounded by those taking exercise changing other aspects of their lifestyle. Body Weight and Abdominal Fat As body weight (defined as body mass index [BMI]) increases, so does the risk of CVD, but the distribution of fat, particularly visceral fat, is also an important LIFESTYLE MODIFICATION • 27 factor. Overweight and abdominal obesity, usually measured by waist circumference in clinical practice, are associated with other risk factors including elevated BP, high LDL cholesterol, low HDL cholesterol, raised triglycerides, insulin resistance, and impaired glucose regulation, including diabetes.
Glycemic Control in Diabetes Good glycemic control has been shown in clinical trials to prevent microvascular complications in both type 1 and type 2 diabetes. 9%. This study also showed that good glycemic control had no beneficial effect on stroke OTHER AGENTS • 55 Fig. 0mmol/l Impaired fasting glycemia (or impaired glucose tolerance* from an OGTT) Lifestyle advice and appropriate management of blood pressure, lipids, and glucose Repeat CVD risk assessment and glucose in 1 year CVD, cardiovascular disease.
Combination Treatments There is a continuing need for more effective agents from among currently available cholesterol or BP-lowering drug classes, ideally with fewer side effects. Perhaps more importantly, newer classes of agents are being developed. To provide real advances over currently available agents, such products will need to have a long duration of action and low side-effect rates, with cholesterol or BP-lowering efficacy associated with commensurate reduction in CV events. The benefits of pharmacogenetics, whereby drugs may be targeted on the basis of genetic profiling, are considered by some to be on the horizon, although others believe it to be a rather distant horizon.