Prevention is the key. CVD - Is it preventable ?? - Very much Yes. The risk assessment must start very early At the age of 20 years itself Healthy life style and hearty eating habits Regular physical exercise from young age Maintaining ideal weight and hour glass waist
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6. Phenotype B
4. F. Hx CVD
6. Physical Inactive
5. Obesity, ↑ WC
4. Lipid Abnor
5. ApoA1/ ApoB
4. hs- CRP
The Makers – Risk Factors
The Markers – Surrogate tests
Adult Treatment Panel III. NIH publication 01-3095.
[TC x TG x Lp(a) ] 200 x 150 x 25
= 15000; Normal is up to 10 K
10 K to 20 K is boarder line
More than 20 K is abnormal
Central adiposity causes
↑IL6, which ↑hepatic hs-CRP
Abdominal Obesity Waist Circumference
Men >90 cm (>36 in)
Women >80 cm (>32 in)
Triglycerides >150 mg/dl
Men <40 mg/dl
Women <50 mg/dl
Blood pressure >130/>85 mmHg
Fasting glucose >110 mg/dlMetabolic Syndrome, Syndrome X, Deadly Quartet, Reaven’s Syndrome
NCEP guidelines 2001 (WHO Modified for Indians)
Occurs in DM and HT
Detected by new dipstick tests for MAU
Most accurate assessment is 24hr collection
Screening by ACR on spot urine (first morning)
MAU is a marker of early stage renal damage
Regression of MAU decreases risk
A marker of generalized CVD riskMicro Albuminuria (MAU)
Braunstein JB et al. Cardiol Rev. 2001;9:96-105.
Components of the TLC Diet
<7% of total calories
Up to 10% of total calories
Up to 20% of total calories
25%–35% of total calories
Carbohydrate (esp. complex carbs)
50%–60% of total calories
~15% of total calories
*Trans fatty acids also raise LDL-C and should be kept at a low intake.
Note: Regarding total calories, balance energy intake and expenditure to maintain desirable body weight.
Expert Panel on Detection, Evaluation, and Treatment ofHigh Blood Cholesterol in Adults. JAMA. 2001;285:2486-2497.