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Patient is a middle aged African American male with a history of a previous heart attack. Patient also has a strong family history of heart disease as well, which makes him a strong candidate for potential cardiac problems. According to the American College of Cardiology (ACC) and the American Heart Association (AHA) risk estimator, this patient has a 50% lifetime atherosclerotic cardiovascular disease (ASCVD) risk (American College of Cardiology, 2018). Based upon the patientâ€™s medication list, he must have been seen previously by a provider for management for not only heart disease but possibly for hypertension as well. The patientâ€™s blood pressure upon presentation was high. Patients with increased blood pressure can result in atherosclerotic changes in the arteries and during physical activity, as such with the patient bike riding and becoming short of breath, the blood flow is restricted (Arcangelo & Peterson, 2022). The recommendations from the ACC/AHA are that patients with moderate risk are to start moderate intensity statin if their LDL is between 70-189 (American College of Cardiology, 2018). The appropriate medications for patients who are at high risk or previously had a MI are ACE inhibitors, beta-blockers, antiplatelet agents, and others (Arcangelo & Peterson, 2022).
After modifying the data parameters for the patient and adding that he is a diabetic and smoker, he would be at a 69% lifetime ASCVD risk. Individuals who have a variety of ASVD risk factors and are diabetic, it is recommended that they are given a high-intensity statin medication that will help reduce their LDL at least by half (American College of Cardiology, 2018). Patients who have a prior history of cardiovascular disease (CVD) have the strongest factors that are associated with high-intensity statin therapy, such as Atorvastatin (Ho et al., 2018).
There are a wide variety of helpful tools that can be found on the American Heart Association website to help people look for signs and symptoms of heart disease and other cardiovascular disorders. These tools also help manage and steps to take to prevent further heart disease. The LDL Manager is another great tool to make it easier for those who check their blood pressure and cholesterol from home. Any recent changes in oneâ€™s lifestyle can be inputted in this tool and it can guide them on what to do step by step.
American College of Cardiology. (2018). ASCVD risk estimator intended for patients with LDL-C. ASCVD Risk Estimator. Retrieved September 26, 2021, from https://tools.acc.org/LDL/ascvd_risk_estimator/index.html#!/calulate/recommendation/.
Arcangelo, V. P., & Peterson, A. M. (2022). Chronic Stable Angina. In Pharmacotherapeutics for advanced practice: A practical approach (4th ed., pp. 290â€“299). essay, Wolters Kluwer.
Ho, K., Jamsen, K. M., Bell, J. S., Korhonen, M. J., Mc Namara, K. P., Magliano, D. J., Liew, D., Ryan-Atwood, T. E., Shaw, J. E., Luc, S., & IlomÃ¤ki, J. (2018). Demographic, clinical and lifestyle factors associated with high-intensity statin therapy in Australia: The AusDiab study. European Journal of Clinical Pharmacology, 74(11), 1493â€“1501. https://doi-org./10.1007/s00228-018-2518-1