#lipid #gdl
Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline 2020
• 治療目標是預後(心血管疾病、健康、住院、死亡),而不是血脂濃度。
• 血脂(膽固醇、LDL-C、HDL-C、TG):每 10 年檢驗一次,不需要禁食。
• 初級預防:中度劑量的 statins,不要用 PCSK9 抑制劑。高危險群者能加上地中海飲食。
• 次級預防:中度劑量的 statins,高危險群(AMI 之後、ACS 一年內、復發性 AMI/ACS/中風、糖尿病、抽煙、PAOD、PCI、CABG)病人可以用高強度 statins、加上 ezetimibe/PCSK9 抑制劑、禁食 TG > 150 mg/dL(非禁食 TG > 200 mg/dL)者能加上 VASCEPA(Icosapent Ethyl)、地中海飲食。
• 沒有幫助:CAC、CRP、ABI、apolipoproteins。
• 不要用 niacin、fibrates。
Lipitor (atorvastatin 10-20 mg/tablet), Crestor (rosuvastatin 10 mg/tablet).
1. Continue to Treat to Target Dose Not LDL-C Level
2. Use of Additional Tests to Refine Risk Prediction: Evidence Is Still Insufficient
coronary artery calcium (CAC), high-sensitivity C-reactive protein, ankle–brachial index, and apolipoprotein
3. Primary Prevention: Moderate-Dose Statin Therapy Is Still Emphasized; No to Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors
No RCT directly compared high-dose with moderate-dose statin therapy in primary prevention.
4. Secondary Prevention: Moderate Statin Doses Initially, Then Stepped Intensification in Higher-Risk Patients
For higher-risk patients (recent MI or acute coronary syndrome (in the past 12 months); recurrent acute coronary syndrome, MI, or stroke; or established CVD with additional major risk factors (such as current tobacco use, diabetes, peripheral artery disease, or previous coronary artery bypass graft surgery or percutaneous coronary intervention), evidence supports the addition of ezetimibe or PCSK9 inhibitors to moderate- or high-dose statin therapy.
5. Laboratory Testing: No Routine Fasting or Monitoring Is Needed; Less Is More
We recommend measuring lipid levels no more than every 10 years. Note that previously measured lipid levels may be used reliably in serial CVD risk assessments. We do not recommend rechecking lipid levels each time CVD risk is assessed, because lipid levels remain stable within each patient over time and contribute little to predicted risk relative to other factors.
6. Physical Activity: Increased Aerobic Exercise for All and Cardiac Rehabilitation After a Recent CVD Event
7. Nutrition, Supplements, Niacin, and Fibrates: Suggest a Mediterranean Diet for High-Risk Patients, Limit Icosapent Ethyl to Secondary Prevention, Avoid Supplements and Niacin, and Avoid Adding Fibrates to Statin Therapy
https://www.acpjournals.org/doi/full/10.7326/M20-4648
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cardiac rehabilitation 在 atiehilmi.com : Lifestyle Blogger Facebook 的最佳貼文
DAYANG DENO NEED TO DO HEART SURGERY AS SOON AS POSSIBLE.
Dayang Deno , 29 years old lupus fighter who has been suffering the chronic illness of auto-immune disease known as SLE. It started with renal failure and currently Dayang Deno has tough battle to fight for her life. SLE has affected her heart which require immediate surgery to help her to survive.
For the past 20 years, the disease heavily affected her childhood and teen. Life had not been pleasant nor normal because of this illness. The health condition does not permit her to carry outdoor activities. Two years ago Dayang Deno lost left eye sight. Nevertheless, doodling art and blogging have become a healing therapy for her. Now she needs your helping hand. Bless her with your donation for the surgery.
Total cost needed : RM 150,000.00
Estimation breakdown :
i) Surgical cost without complications - RM 60,000.00
(4 consultants involved: 1 cardiologist, 1 cardiothoracic surgeon, 1 nephrologist, 1 cardiac anaesthetist)
ii) Contigency for prolonged CICU recovery and dialysis - RM 30,000.00
iii) 20% of respite care & contigency for prolonged hospitalization ~ RM 40,000.00
iv) Rehabilitation and follow up RM 20,000.00
dayangdeno.com is a very talented doodle artist who had suffered SLE since childhood. She endured prolonged battles with the many complications of the disease, gone through daily dialysis, now SLE is attacking her heart.
We are doing fundraising for her operations. Hope you can help to forward to your family members/friends who may want to contribute. SimplyGiving will send an official receipt to contributor’s email. Many thanks & God bless you.
You can click here the link, it is legitimate fundraising site for her and bless with your contribution : https://www.simplygiving.com/appeal/pleasehelpdayangdeno
#PleaseHelpDayangDeno
#HeartValveReplacementSurgery
#DayangDeno
cardiac rehabilitation 在 ElanaKhong Facebook 的最佳貼文
I wish upon a ⭐️ for a close friend of mine, speedy recovery from musculoskeletal disorders. You know, due to constant climbing, twisting, bending and repetitive motion, musculoskeletal connective tissue disorder is pretty common nowadays.
I would like to nominate him to receive a complimentary rehabilitation treatment from ReGen Rehab for his musculoskeletal conditions. 🙏🏻
‘Wish Upon A Star’ ⭐️
From 4th June to 2nd July 2018 nominate your loved ones for a complimentary rehabilitation treatment from ReGen Rehab for any one of the following services :
1 Neurorehabilitation (e.g. for stroke, Parkinson’s, cerebral palsy)
2 Cardiac rehabilitation (e.g. for heart attacks, cardiovascular diseases)
3 Sports rehabilitation (e.g. for sports injuries)
4 Musculoskeletal rehabiliation (e.g. for spinal problems or leg injuries)
Come join me and nominate someone deserving. 👉🏻 http://www.lettherebehope.rehab/submit.php
#ReGenRehab
#WishUponAStar
#LetThereBeHope
#rehabilitation
#stroke
#physiotherapy
cardiac rehabilitation 在 What is Cardiac Rehab? - YouTube 的推薦與評價
Cardiac rehab or cardiac rehabilitation is a medically supervised exercise and education program designed to improve your cardiovascular ... ... <看更多>