Secondary Prevention In Patients With Cardiovascular Disease

From Anvita Health Wiki

Contents 1 Management 2 More General Terms 3 Additional Terms 4 References

Management

• antiplatelet therapy

• aspirin

• 81-162 mg QD for most patients (see aspirin)
• 325 mg QD for up to 6 months* after stent or up to 1 year after CABG

• clopidogrel

• 75 mg QD
• 75 mg QD + aspirin for up to 12 months after stent or acute coronary syndrome

• LDL goal: < 100 mg/dL & < 70 mg/dL in high-risk patients

• statin may be of benefit regardless of LDL cholesterol

• if triglycerides > 200 mg/dL, goal non HDL cholesterol: < 130 mg/dL, < 100 mg/dL in high-risk patients
• blood pressure

• goal: < 140/90
• start with ACE inhibitors &/or beta-blockers
• add thiazide & other antihypertensives if needed

• annual influenza vaccine
• 30-60 minutes of moderate exercise 5 days/week
• weight loss:

• initial goal: 10% (if overweight)
• BMI < 25
• waistline < 40 inches (men); < 35 inches (women)

• smoking cessation
• HgbA1c < 7% in diabetics
• cognitive behavioral therapy to alleviate stress & hostility reduces subsequent cardiovascular events [5]

More General Terms

• cardiology
• prophylaxis (prevention, ppx)

Additional Terms

• cardiovascular disease (CVD)
• coronary artery disease (CAD)
• ischemic stroke
• peripheral vascular disease; PVD; peripheral arterial disease; PAD
• primary prevention of cardiovascular disease
• sexual activity & cardiovascular disease

References

1. Smith SC et al, AHA/ACC Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update Circulation 2006; 113:2363 <PubMed> PMID: [1] <Internet> [2]
2. Smith SC et al, AHA/ACC Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update J Am Coll Cardiol 2006; 47:2130 PMID: [3]
3. Prescriber's Letter 13(5): 2006 Summary of 2006 AHA/ACC secondary prevention for patients with coronary and other atherosclerotic vascular disease Detail-Document#: [4] (subscription needed) [5]
4. Prescriber's Letter 13(7): 2006 Summary of 2006 Recommendations for Primary and Secondary Prevention of Stroke Detail-Document#: [6] (subscription needed) [7]
5. Gulliksson M et al. Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Arch Intern Med 2011 Jan 24; 171:134. PMID: [8]
6. Smith SC et al AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update A Guideline From the American Heart Association and American College of Cardiology Foundation Circulation [9]

secondary prevention in patients with cardiovascular disease