scholarly journals Impact of clinical pharmacists on atherosclerotic risk factor management in an integrated heart and vascular clinic

2018 ◽  
Vol 23 (1) ◽  
pp. 80-81
Author(s):  
Marie N Waddles ◽  
Ginny Mitchell ◽  
Melissa J Snider ◽  
Michael R Go ◽  
Talal Attar
Keyword(s):  
Risk Factor ◽  
Risk Factor Management ◽  
Clinical Pharmacists ◽  
Atherosclerotic Risk Factor

How Do Vascular Surgeons Perceive Atherosclerotic Risk Factor Management?

2000 ◽  
Vol 14 (6) ◽  
pp. 652-658 ◽  
Author(s):  
Peter G. Kalman ◽  
Jane Irvine ◽  
Paul Ritvo
Keyword(s):  
Risk Factor ◽  
Risk Factor Management ◽  
Atherosclerotic Risk Factor

An absolute risk-guided approach to cardiovascular risk management within a chest pain clinic: the ARCPAC randomized trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.A Black ◽  
J Campbell ◽  
J Sharman ◽  
M Nelson ◽  
S Parker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Smoking Status ◽  
Absolute Risk ◽  
Pain Clinic ◽  
Risk Scores ◽  
Cardiovascular Risk Management ◽  
Risk Factor Management

Abstract Background The majority of patients attending chest pain clinics are found not to have a cardiac cause of their symptoms, but have a high burden of cardiovascular risk factors that may be opportunistically addressed. Absolute risk calculators are recommended to guide risk factor management, although it is uncertain to what extent these calculations may assist with patient engagement in risk factor modification. Purpose We sought to determine the usefulness of a proactive, absolute risk-based approach, to guide opportunistic cardiovascular risk factor management within a chest pain clinic. Methods This was a prospective, open-label, blinded-endpoint study in 192 enhanced risk (estimated 5-year risk ≥8%, based on Australian Absolute Risk Calculator) patients presenting to a tertiary hospital chest pain clinic. Patients were randomized to best practice usual care, or intervention with development of a proactive cardiovascular risk management strategy framed around a discussion of the individual's absolute risk. Patients found to have a cardiac cause of symptoms were excluded as they constitute a secondary prevention population. Primary outcome was 5-year absolute cardiovascular risk score at minimum 12 months follow up. Secondary outcomes were individual modifiable risk factors (lipid profile, blood pressure, smoking status). Results 192 people entered the study; 100 in the intervention arm and 92 in usual care. There was no statistical difference between the two groups' baseline sociodemographic and clinical variables. The intervention group showed greater reduction in 5-year absolute risk scores (difference −2.77; p<0.001), and more favourable individual risk factors, although only smoking status and LDL cholesterol reached statistical significance (table). Conclusion An absolute risk-guided proactive risk factor management strategy employed opportunistically in a chest pain clinic significantly improves 5-year cardiovascular risk scores. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Tasmanian Community Fund

Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011990
Author(s):  
Liisa Karjalainen ◽  
Minna Tikkanen ◽  
Kirsi Rantanen ◽  
Karoliina Aarnio ◽  
Aino Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postpartum Period ◽  
First Trimester ◽  
Class Iii ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Factor Management ◽  
Incidence Trends ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

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