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Coronary Prevention



  Coronary Prevention

Is defined as modifying risk factors to reduce the chance of a first of subsequent cardiac event. A cardiac event may be defined as any need for a cardiologist's intervention- e.g. new onset angina, unstoppable angina, heart attack, coronary bypass, coronary angioplasty/stent. The underlying mechanism of these is unstable, degenerating cholesterol plaque in the coronary artery attracting clot that narrow or closes the vessel channel.


Cardiovascular Risk Factors

  • Tobacco
  • Diabetes
  • Family History of premature disease
  • Hypertension
  • Hypercholesterolemia
  • Low HDL
  • Male Gender
  • Obesity
  • Sedentary
  • Stress
Modifiable
Risk Factors

Hypertension
Dyslipidemia
Diabetes
Cigarette Smoking
Obesity
Physical Inactivity

  Nonmodifiable
Risk Factors

Family History
Age
Gender


Lipid Goals

  • HDL > (greater than) 45
  • LDL < (less than) 100




Primary Prevention
An abecedarian approach
*

  • Alcohol
  • Blood Pressure
  • Cholesterol
  • Diabetes / Diet
  • Exercise
  • Fumes (i.e. tobacco use)




Secondary Prevention
An abecedarian approach
*

  • Aspirin
  • ACE Inhibitor
  • Beta Blocker
  • Cholesterol Drug
  • Diet
  • Exercise
  • Fumes (i.e. tobacco use)

* We use these alphabetical checklists to teach patients how to reduce risk of first or subsequent coronary event.




The Paleolithic Prescription - Nutrition

Ingest the Five F's

  • Fish
  • Fowl
  • Filet/Top Sirloin
  • Fruit and vegetables
  • Fiber (flourless breads)

Avoid / Minimize

  • Sugar
  • Flour
  • Fat
  • Oil
  • Alcohol
  • Rice
  • Potatoes


The Paleolithic Prescription - Exercise

"He or she who is fit, SWEATS"

  • Stretch
  • Warm up
  • Exercise
  • Aerobically
  • Taper down
  • Strength training




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