By Neil R. Poulter
Here are quick solutions to universal medical questions when it comes to cardiovascular hazard. Taking a guidelines-driven procedure, the writer has simplified the significant variety of scientific offerings on hand to the health practitioner assessing their sufferer for cardiovascular risk.
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Additional resources for Clinical manual of total cardiovascular risk
LVH), established vascular disease, or an estimated 10-year CVD risk of у20% (see Fig. 4). 2. 4. Combining Antihypertensive Agents Results from almost all the major trials, including the Hypertension Optimal Treatment (HOT) trial and the UK Prospective Diabetes Study (UKPDS), show that the majority of patients with hypertension require at least two BP-lowering agents if the current recommended targets are to be reached (see Fig. 5). Although most antihypertensive drug trials have involved the use of BP-lowering regimens with two or more agents, the choice of a second or third agent has usually been unstructured and therefore cannot provide recommendations for optimal drug combinations.
Area of square proportional to amount of statistical information in that category. Broken vertical line indicates overall rate ratio (RR) for any type of major vascular event. Reproduced with permission from Cholesterol Treatment Trialists” collaborators. Lancet 2005; 366:1267–1278. 46 • STRATEGIES FOR CARDIOVASCULAR RISK MANAGEMENT When to Start Therapy? People with Coronary and Other Atherosclerotic Diseases Although the traditional approach has been to start with dietary advice and then consider lipid-lowering therapy some months after the acute event, there have been three clinical trials assessing the impact of starting statin treatment early.
1 Antihypertensive treatment reduces cardiovascular events 17 trials, 47,653 patients, systolic blood pressure difference 10–12 mmHg, diastolic blood pressure difference 5–6 mmHg. CHD, coronary heart disease; SD, standard deviation. Reproduced with permission from MacMahon S et al. J Vasc Med Biol 1993; 4:265–271. ANTIHYPERTENSIVE AGENTS • 29 out to compare the benefits of more contemporary drugs over standard therapy. In 2000, the Blood Pressure-Lowering Treatment Trialists (BPLTT) collaboration published a meta-analysis of these trials, which included data from approximately 75,000 patients.