{"id":41293,"date":"2014-01-27T15:28:02","date_gmt":"2014-01-27T20:28:02","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&#038;p=41293"},"modified":"2014-01-27T15:28:02","modified_gmt":"2014-01-27T20:28:02","slug":"prevention-guidelines-in-practice-vignette-3","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/01\/27\/prevention-guidelines-in-practice-vignette-3\/","title":{"rendered":"Prevention Guidelines in Practice: Vignette 3"},"content":{"rendered":"<p><em>This vignette is the third in our series \u201c<a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/voices\/series-making-sense-of-the-new-prevention-guidelines-the-view-from-clinical-practice\/\">Making Sense of the New Prevention Guidelines \u2014 The View from Clinical Practice<\/a>\u201d<\/em><\/p>\n<p>A 41-year-old African-American woman presents to clinic. She has a total cholesterol of 165 mg\/dL, HDL of 40 mg\/dL, and SBP of 145 mm Hg. She is a smoker and is not taking medical treatment for hypertension. Her Pooled Cohort Equations estimated 10-year CVD risk is 4.2%.<\/p>\n<p>A week later, she presents to the clinic again for a repeat blood-pressure check. Her SBP is now 166 mm Hg, which changes her estimated 10-year CVD risk to 8.4%.<\/p>\n<ul>\n<li><strong>Would you start this patient on a statin?<\/strong><\/li>\n<li><strong>Would you measure her BP again or use the average of the two SBPs already obtained to calculate estimated 10-year CVD risk?<\/strong><\/li>\n<li><strong>Would you assess other risk markers, as recommended by the new <a href=\"http:\/\/jaccjacc.cardiosource.com\/acc_documents\/2013_FULL_Guideline_Assesment_Cardiac_Risk.pdf\">AHA guideline for cardiovascular risk estimation<\/a>, such as family history, hs-CRP, CAC scores, or ABI? If so, how would these results guide your recommendation for or against statin initiation?<\/strong><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tell us how you&#8217;d determine this 41-year-old African American woman&#8217;s 10-year CVD risk, and if you&#8217;d put her on a statin.<\/p>\n","protected":false},"author":532,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,7],"tags":[456,202,215,584],"class_list":["post-41293","post","type-post","status-publish","format-standard","hentry","category-general","category-prevention","tag-blood-pressure","tag-practice-guidelines","tag-risk-assessment","tag-statins"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/41293","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/532"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=41293"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/41293\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=41293"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=41293"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=41293"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}