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According to the National. Cholesterol Educational Program Report III (Adult Treatment Panel III, or known as ATPIII） released by National Heart, Lung, and Blood Institute in 2001, the main risk factors of cardiovascular diseases include hypercholesterolemia, smoking, hypertension, family heredity, age, and diabetes. Diabetes are regarded as the same disease as coronary artery disease. The risk factors of lifestyle include obesity and missing involvement of physical activities. Emerging risk factors include lipoprotein (a), Cysteine, thrombosis, or pro-inflammatory factor.
Recent discoveries show that people with CRP (C-Reactive Protein) for in-vivo inflammation over 3mg may look normal on the outside but the chance for such people to have cardiovascular disease over the next ten years is a lot higher than those with CRP under 1mg. Risk assessment is the first step to choosing the treatment method.
The average people can try to find out if any of their family members die because of heart disease or strokes, then take the examinations on blood sugar, measurement of total cholesterol, and the two cholesterols, namely good (High Density Lipoprotein) and bad (Low Density Lipoprotein), followed by taking HS-CRP in order to estimate the cardiovascular disease incidence rate of the public in 10 years.
ATPIII adopts the risk assessment method from Framingham and divides the danger of the cardiovascular diseases in the last 10 years:
- Low-Risk Group
None or one risk factor, the 10-year incidence rate <10 %
Patients can improve the dieting and lifestyle, and take medicine is necessary, which should be sufficient.
- Intermediate Risk Group
Two and more risk factors with 10-year incidence rate ≤ 20 %
The physicians will suggest patients to take the CT without injecting the contrast media to check on the calcium score of blood vessel. If the score is high, the physician will determine if the patients shall take angiography from the high-speed CT injected with contrast media, depending on the situation.
- High Risk Group
Coronary artery disease and the names alike have 10-year incidence rate > 20 %.
The physician will suggest if the patients should angiography from the high-speed CT injected with contrast media.
Prevention is better than cure
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Hypertension |
Control the blood pressure under 140 / 90 mmHg and if the patients have complications in diabetes and chronic renal diseases, the patients must control the blood pressure under 130 / 80 mmHg. |
|
Diabetes |
Control the fasting plasma glucose between 90 - 130 mg/dl, and post-meal plasma glucose under 180 mg/dl, while the HbA1c is maintained fewer than 7%. |
|
Hypercholesterolemia |
Low risk group (none or one risk factor with 10-year incidence rate <10 % must keep LDL under 160 mg/dl. Intermediate risk group ( two and more risk factor with 10-year incidence ≤ 20 %) must keep LDL under 130 mg/dl. High risk group (Coronary artery disease or similar disease with 10-year >20 %) must control LDL under 100 mg/dl. |
|
Smoking |
Immediately quick smoking and avoid inhaling second-hand smoke. |
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Obesity |
Control BMI (weight/height 2 ) value under 25 Kg/m2 , male waist under 90 cm and female waist under 80 cm. |
|
Lack of Exercise |
Maintain regular and proper exercise 3 times a week and 30 minutes per session. Increase the heartbeat progressively to 120 beats of 130 beats per minutes (such as taking a stroll, fast walking, riding bicycles, or swimming). |
|
Age |
( Male > 45 year old and female > 55 year old ) and family medical history (first-degree male relatives of the family before 45 years old or first-degree female relatives of the family before 55 years old have had coronary artery disease) are the risk factor of force majeure. |
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