温州医学院附属第一医院心值内科张怀勤.pptVIP

Risk factors for the development of atherosclerotic disease Approximately 37% of American adults reported having 2 risk factors for CVD. 90% o f patients with coronary heart disease have at least 1 atherosclerotic risk factor. Approximately half of all coronary deaths are not preceded by cardiac symptoms or diagnoses Risk factors for the development of atherosclerotic disease CVD was mentioned on the death certificates of 56% of decedents in 2005. It was listed as the underlying cause of death in 35.3% (864,480) of all deaths (2,448,017) in 2005 or 1 of every 2.8 deaths in the U.S. In every year since 1900 (except 1918), CVD accounted for more deaths than any other major cause of death in the United States ( 6). It is estimated that if all forms of major CVD were eliminated, life expectancy would rise by almost 7 years Assessmentof Cardiovascular Risk Family History Other Circulating Blood Markers andAssociated Conditions Hemoglobin A1C (HbA1C) Microalbuminuria Lp-PLA2 ECG CLASS IIa A resting electrocardiogram (ECG) is reasonable for cardiovascular risk assessment in asymptomatic adults with hypertension or dia-betes . ( Level of Evidence: C ) CLASS IIb A resting ECG may be considered for cardiovascular risk assessment in asymptomatic adults without hypertension or diabetes (Level of Evidence: C ) Resting Echocardiography Transthoracic Echocardiography CLASS IIb Echocardiography to detect LVH may be considered for cardiovascular risk assessment in asymptomatic adults with hypertension (Level of Evidence: B ) CLASS III: Echocardiography is not recommended for cardiovascular risk assessment of CHD in asymptomatic adults without hypertension. (Level of Evidence: C ) Carotid Intima-Media Thickness on Ultrasound CLASS IIa Measurement of carotid artery IMT is reasonable for cardiovascular risk assessment in asymptomatic adults at intermediate risk Published recommendations on required equipment, technical approach, and operator t