South University NSG6001 ADVANCED PRACTICE NURSING 1 WEEK I A 2 Discussion Discuss any three risk factors associated with the development of cardiovascular diseases For any one of these risk factors discuss what you might include in an educational plan for your patient who has yet to develop heart disease Make sure you adopt an integrated approach to assess your patient s needs Your focus here is on primary prevention Coronary heart disease CHD is a leading cause of death for both men and women and includes acute myocardial infarction MI angina pectoris atherosclerotic cardiovascular disease and all forms of chronic ischemic heart disease Buttaro Trybulski Bailey Sandberg Cook 2013 The risk factors for Cardiovascular Disease can be divided into modifiable and non modifiable risk factors Modifiable risk factors Hypertension HTN is a risk factor that is modifiable and teaching patients about it is important because Hypertension is one of the main risk factors and has a significant role in heart attacks HTN can be prevented by weight reduction salt restriction reducing alcohol consumption exercise and smoking cessation Buttaro et al 2013 p 562 Abnormal blood lipid levels such as high total cholesterol high triglycerides and high levels of low density lipoprotein or low levels of high density lipoprotein HDL cholesterol also increase the risk of cardiovascular diseases Patient education should include changing their diet to a healthy diet exercise and taking medication such as Statins Buttaro et al 2013 Smoking causes damage to blood vessels and increases risks of cardiovascular diseases Smoking cessation reduces the risk of cardiovascular disease significantly Buttaro et al 2013 Physical inactivity increases the risk of cardiovascular disease while obesity adversely affects cardiovascular CV hemodynamics structure and function and increases the prevalence of most CV diseases It is a major risk for cardiovascular disease and predisposes patients to diabetes which is also a risk factor for cardiovascular diseases As noted Obesity increases total blood volume stroke volume and cardiac output so typically systemic vascular resistance in obesity is reduced for any given level of blood pressure Lavie McAuley Church Milani Blair 2014 p 3 Patients who have a diagnosis of diabetes are twice as likely to develop cardiovascular disease compared to someone who does not have a diagnosis of diabetes Non modifiable risk factors Advanced age is a risk factor for cardiovascular disease of stroke doubles every decade after the age of 55 Also Family s history of cardiovascular disease is a risk factor If a first degree blood relative has had coronary heart disease or stroke before the age of 55 years for a male relative or 65 years for a female relative the patient s risk increases Buttaro et al 2013 Gender is important when determining risk for cardiovascular disease with male patients being at greater risk of heart disease than a pre menopausal woman However once past the menopause a woman s risk is similar to a man s Buttaro et al 2013 Ethnicity also determines risk for cardiovascular disease People with African or Asian ancestry are at higher risks of developing cardiovascular disease compared to other racial groups Educational Plan for a Patient Who Has Yet to Develop Heart Disease When providing patient education the provider must make sure that the patient understands the most common causes and risk factors of heart diseases and explain preventable causes The nurse practitioner must explain to the patient that considerable clinical benefit can be derived from the management of three major modifiable cardiovascular disease risk factors hypercholesterolemia hypertension and cigarette smoking Buttaro et al 2013 For a patient who is a smoker and has high cholesterol levels education on smoking cessation and lowering cholesterol level is important in primary prevention High cholesterol is a major risk factor for heart disease Patients need to be educated on ways to lower the Low density lipoprotein LDL cholesterol and raise high density lipoprotein HDL cholesterol Buttaro et al 2013 Eating healthy foods can help lower LDL cholesterol level and a healthy diet may help protect the body from the damaging effect of cholesterol The nurse practitioner must teach preventative therapies and include teaching the patient that he or she can raise HDL cholesterol level by losing weight through diet and exercise Buttaro et al 2013 The nurse practitioner teaching primary prevention must inform the patient that lifestyle interventions is critical in prevention of heart diseases and that abundant evidence also indicates that statin therapy significantly reduces vascular event rates in primary prevention Manto 2013 References Buttaro T Trybulski J Bailey P Sandberg Cook J 2013 Primary Care 4th Edition VitalSource Bookshelf Online Retrieved from https digitalbookshelf southuniversity edu books 978 0 323 07501 5 Lavie C J McAuley P A Church T S Milani R V Blair S N 2014 Obesity and cardiovascular diseases Journal of the American College of Cardiology 63 14 1345 1354 doi http dx doi org 10 1016 j jacc 2014 01 022 Manto J 2013 The role of statins in primary prevention of coronary heart disease in young patients with metabolic syndrome