Adult Cardiovascular Disease Prevention

General Instructions: In the following activity, you will apply research methodology concepts to collect data, run analyses, synthesize results, and use statistical methods. Read the case study and develop points for the different populations.

Step 1 - Review: Imagine the following scenario:

You are tasked with investigating Hospital X. The research involves understanding the population's knowledge about the risk factors of cardiovascular diseases, and the same subject must be researched across two different populations. The first population consists of adults between 30 and 60 years of age (Population A) who are treated in various specialties at Hospital X. The second population includes adolescents between 13 and 17 years of age who attend the same hospital (Population B).

Step 2 - Respond: Develop the following points for Populations A and B:

What characteristics (qualitative or quantitative) will the two investigations have? Will they be qualitative or quantitative?

• Write three inclusion criteria that you would use in the investigations.
• What data collection tool would you use for each population?
• What data analysis methods would you use?
• What biases should you consider in each of the populations?
• What essential points should you consider to avoid biases in both populations?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. All references should follow the 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from word counts).

Step 4 - Interact: To complete the activity, you must reply to at least two posts made by your peers in a respectful and professional manner. Make sure your post engages your peers' ideas by including a reflection on their comments, sharing ideas about other potential difficulties and involved parties, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a particular discussion, write your feedback, and then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: In this activity, you will write a research proposal that examines the morbidity, mortality, and criteria of vascular diseases with the greatest impact in your country. The proposal should include the following subsections, each developed in no more than 200 words.

Step 1 - Review: Consider and review the following points, and if necessary, gather updated information for your writing (from up to five years ago).

Choose a potential research topic based on the epidemiological data of cardiovascular disease (CVD) and its associated lifestyle, medical, and psychosocial risk factors in your country. Select a population group from the following: women, older people, ethnic minorities, or migrants.

At the end of the investigation, include a subsection for proposals: consider the latest evidence-based guidelines for managing individuals with multifactorial cardiovascular risk profiles. Outline the key critical success factors for delivering, and discuss what could be the most important health policies for effective CVD prevention.

Step 2 - Respond: Taking into account the points mentioned above, write brief paragraphs explaining and justifying your research topic, proposal, and chosen population, considering your context. Keep in mind that each explanation should not exceed 200 words.

• What would be the research topic?
• Provide a summarized paragraph to explain the justification.
• What methodology and characteristics would the research have?
• Mention possible titles for the content of your theoretical framework (at least five).
• What data collection tools would you use?
• What measures or actions would you propose once your research problem has been analyzed? (Campaigns, workshops, or other awareness actions aimed at your study population).

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property as necessary. Make sure all references follow the 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from word counts).

Step 4 - Interact: To complete the activity, you must reply to at least two posts made by your peers in a respectful and professional manner. Ensure your post engages with your peers' ideas by reflecting on their comments, sharing ideas about potential difficulties and involved parties, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: In this activity, you will review and recall criteria and concepts, then answer the questions based on the resources read and the standards learned. Stay focused.

Step 1 - Review: Read the clinical case below:

A 55-year-old male patient presented to our clinic with complaints of chest pain, shortness of breath, and fatigue. Upon further evaluation, he had a history of smoking and high blood pressure. A physical examination revealed decreased pulses in his lower extremities and a reduced ankle-brachial index. Coronary and Peripheral Vascular Atherosclerosis was suspected based on his medical history and symptoms.

Reviewing his measurements, his blood pressure was 150/90 mmHg, his BMI was 30 kg/m2, and his waist circumference was 105 cm. A cardiovascular examination revealed a regular rate and rhythm with a grade 2/6 systolic murmur at the aortic area. His electrocardiogram showed evidence of left ventricular hypertrophy.

Further investigations included a lipid profile, fasting glucose, and hemoglobin A1C. The results indicated a high total cholesterol level of 280 mg/dl, a low HDL cholesterol level of 30 mg/dl, a high triglyceride level of 230 mg/dl, a fasting glucose level of 170 mg/dl, and a hemoglobin A1C level of 8%.

Additional tests included an echocardiogram showing severe aortic stenosis with an ejection fraction of 50%. Coronary angiography revealed significant stenosis of the left anterior descending artery and the right coronary artery.

Step 2 - Respond: Answer the following questions based on the provided clinical case:

• What were the patient's neurohormonal evaluation results?
• What is the diagnostic impression?
• What treatment options are available for managing the patient's symptoms and underlying condition?
• After speaking with the patient, he reveals that he has no friends, has been a widower for four years, and lives alone in a small, closed apartment. He does not engage in physical activities, and most of his needs are met through phone calls, the internet, and delivery services. What lifestyle changes can be recommended to improve the patient's overall health and reduce the risk of further complications?
• How important would it be to advise the patient to quit smoking and follow a low-salt diet to manage his high blood pressure?
• Are there any medications or interventions that can help improve blood flow to the patient's lower extremities?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. Make sure all references follow the 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from the word counts).

Step 4 - Interact: To complete the activity, you must reply to at least two posts made by your peers in a respectful and professional manner. Make sure your post engages with your peers' ideas by reflecting on their comments, sharing ideas on potential difficulties and involved parties, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: In this activity, you will review and recall criteria and concepts about preventive medicine, drug dosage, and the need to adjust it according to age and gender. Review the clinical case and answer the subsequent six questions.

Step 1 - Review:

Jhona, a 67-year-old Asian male with a family history of heart disease, visits the clinic for a regular check-up. He is concerned about his potential risk for developing cardiovascular disease considering his increasing age, overweight status, history of hypertension, Type 2 Diabetes, mild chronic kidney disease, and family history. His medical history, family history of heart disease, concurrent comorbidities, and personal concerns underscore a potential complexity in pharmacological treatment and the possible need for dose adjustments tailored to his specific circumstances, making his case an enriching study for students to examine.

Step 2 - Respond: Answer the following questions based on the given scenario:

• How might these comorbidities impact the choice of pharmacologic therapy (e.g., antihypertensive medications, cholesterol-lowering drugs) to mitigate his cardiovascular risk? 
• What monitoring would you recommend to ensure his medication regimen is safe and effective?
• This patient is of Asian descent. Are there any specific considerations around dosage or medication selection that should be considered, given his ethnicity and age?
• How would you approach a discussion with Jhona about the role of genetic testing in preventative cardiology and why?
• How would you address Jhona's concerns about the financial cost and insurance coverage for genetic testing and additional cardiovascular screening tests? 
• What resources or referral options could you provide to assist with this issue?
• Based on existing evidence, what recommendations would you prioritize to reduce Jhona's risk of developing cardiovascular disease, and how would you work with the patient to implement them effectively?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. All references should follow the 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: References are excluded from word counts).

Step 4 - Interact: To complete the activity, you must reply to at least two posts made by your peers in a respectful and professional manner. Make sure your post engages your peers' ideas by reflecting on their comments, sharing ideas on potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: In this activity, you will review and recall criteria and concepts about cardiac risks and their estimation, distinguish between vital concepts such as precision medicine, deep phenotyping, and clinical decision-making, and recognize the components that make a prevention program successful.

Review the four essential points of the case and answer the fifth question based on the clinical case.

Step 1 - Review: Consider the following scenario:

Clinical Case: A 45-year-old female patient presents to the clinic for a routine check-up. She has no current complaints but has a family history of heart disease. The physician, Dr. McRife, decides to assess her cardiovascular risk using various risk estimation tools.

Dr. McRife explains to the patient the importance of estimating her risk for cardiovascular disease (CVD) to implement preventative measures and reduce her chances of developing heart disease.

Dr. McRife uses various risk estimation tools, such as the Framingham Risk Score and the American College of Cardiology/American Heart Association Pooled Cohort Equations, to assess the patient’s risk for CVD. These tools consider age, sex, blood pressure, cholesterol levels, and smoking status to estimate the patient’s 10-year risk for developing CVD.

Dr. McRife also discusses with the patient the potential benefits of precision medicine and deep phenotyping in clinical decision-making. By using advanced technologies to gather detailed information about the patient’s genetics, lifestyle, and environment, the physician can tailor prevention and treatment strategies to the patient’s unique needs.

Based on the results of the risk estimation tools and the patient’s characteristics, the physician recommends a CVD prevention program that includes lifestyle changes such as healthy eating, regular exercise, and smoking cessation. The physician also discusses successful CVD prevention programs that have been implemented in various settings, such as community clinics and workplace wellness programs.

Step 2 - Respond: Answer the following questions based on Dr. McRife's actions:

• Explain why estimating your risk for CVD is essential.
• Describe some of the risk estimation tools used in CVD prevention.
• Explain the relationship between precision medicine, deep phenotyping, and clinical decision-making.
• How can advanced technologies be used to gather detailed information about a person’s genetics, lifestyle, and environment?
• How can this information be used to tailor prevention and treatment strategies for CVD?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. Make sure all references follow the 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from word counts).

Step 4 - Interact: To complete the activity, you must reply to at least two posts made by your peers in a respectful and professional manner. Make sure your post engages with your peers' ideas by reflecting on their comments, sharing ideas about potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: In this activity, you will review and recall concepts about preventive medicine, drug dosage, and the necessity to adjust it, considering age, gender, and non-traditional risk factors. Furthermore, be aware of the significance of laboratory testing when planning personal health strategies.

Review the clinical case and answer the subsequent five questions.

Step 1 - Review: Carefully read the following scenario and answer the questions accordingly.

Patient Information: Samantha, a 45-year-old woman, visits your clinic for a routine check-up. Although she has a family history of heart disease, she considers herself healthy. Her lifestyle is sedentary; she works long hours at a desk job, experiences high stress levels, and has a diet high in processed foods and added sugars. As part of her routine evaluation, you note that her Ankle Brachial Index Test (ABI) score is >1.3, and her hsCRP is 0.286. A tomographic calcium score study shows extracoronary calcification at the level of the aortic valve, mitral annulus, and descending aorta, yielding a score of 101-300 AU, indicating moderate calcification.

Step 2 - Respond:

Answer the following questions based on Samantha's case:

• Differentiate and list common and uncommon risk factors.
• Explain her traditional risk factors, such as family history, sedentary lifestyle, and poor diet. Educate her on the lifestyle and dietary modifications that can help mitigate these risks. Consider medication options if necessary.
• What risk estimation tool that considers non-traditional risk factors can you use for this patient?
• What laboratory testing can help identify and monitor non-traditional and traditional cardiovascular disease risk factors?
• How can laboratory results be used to plan personal health strategies and monitor the patient?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. All references should follow the 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from word counts).

Step 4 - Interact: To complete the activity, you must reply to at least two posts made by your peers in a respectful and professional manner. Ensure your post engages with your peers' ideas by reflecting on their comments, sharing ideas on other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: Read the case study and respond to the questions about the content learned in the lesson.

Step 1 - Review: John, a 55-year-old man recently diagnosed with coronary heart disease (CHD), has a history of smoking and hypertension. He was hospitalized due to chest pain. Following an angiogram, John underwent angioplasty to relieve a blockage in his coronary artery. After being discharged from the hospital, John is referred to the cardiac rehabilitation program.

Step 2 - Respond:

Answer the following questions based on John's case:

• What is the FITT-VP model for exercise prescription, and how can it be used to develop a personalized exercise plan for a cardiovascular disease patient?
• Why is family and social support important for cardiovascular disease patients, and how can healthcare providers encourage patients to seek and utilize support from loved ones?
• What is patient education management, and how can it help improve outcomes for cardiovascular disease patients? Provide examples of strategies that can be used to promote patient empowerment, self-management, self-efficacy, and adherence to treatment plans.
• How does hypertension contribute to the development and progression of cardiovascular disease, and what are some key strategies for managing hypertension in patients with CVD? 
• How can healthcare providers work with patients to develop a personalized treatment plan that addresses their unique risk factors and health needs?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. Ensure all references follow the 7th Edition APA formatting. For additional guidance, refer to the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from word counts).

Step 4 - Interact: Complete the activity by replying to at least two posts made by your peers in a respectful and professional manner. Be sure your post engages with your peers' ideas by providing reflections on their comments, sharing ideas on other potential difficulties and involved parties, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions: In this activity, you will review a clinical case and answer questions related to the concepts discussed in the lesson.

Step 1 - Review: Mrs. Smith, a 65-year-old woman, visits the clinic with complaints of shortness of breath, fatigue, and mild chest discomfort over the past few weeks. She also mentions occasional palpitations and dizziness. She has a history of hypertension and hyperlipidemia, for which she takes medication. She has no previous history of cardiovascular disease or hospitalization.

During her physical examination, Mrs. Smith shows no signs of fever, but her blood pressure is slightly elevated at 150/90 mmHg. A grade 2/6 systolic murmur is detected at the apex of the heart during a cardiac examination, radiating to the axilla. No jugular venous distension or peripheral edema is found, but respiratory sounds are slightly diminished at the lung bases.

A cardiologist further evaluates Mrs. Smith, given her symptoms and murmur. The cardiologist orders an electrocardiogram that shows sinus rhythm with occasional premature ventricular contractions. An echocardiogram reveals mild left ventricular hypertrophy with segmental wall motion abnormalities and moderate mitral regurgitation.

Suspecting underlying coronary artery disease, the cardiologist orders a cardiac stress test, which reveals exercise-induced ischemia with a functional capacity of 6 METS. Mrs. Smith underwent coronary angiography, and based on the evaluation, medical therapy and cardiovascular rehabilitation for ischemic heart disease was recommended. The cardiologist emphasizes the importance of comprehensive cardiovascular prevention and rehabilitation programs to reduce her risk factors and improve her overall health.

Step 2 - Respond:

Answer the following questions based on Mrs. Smith's case:

• How would you describe the benefits of comprehensive cardiovascular prevention and rehabilitation for Mrs. Smith?
• What would be the appropriate timing for referral to comprehensive cardiovascular prevention and rehabilitation programs for Mrs. Smith?
• Based on Mrs. Smith's medical history, which modalities of exercise would be most appropriate for her?
• What are some existing contraindications to comprehensive cardiovascular prevention and rehabilitation programs, and how should they be addressed in Mrs. Smith's care plan?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Remember to reference others' intellectual property when necessary. All references should follow the 7th Edition APA formatting. For additional guidance, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are excluded from word counts).

Step 4 - Interact: To complete the activity, you must respectfully and professionally reply to at least two posts made by your peers. Engage with your peers' ideas by reflecting on their comments, sharing ideas on potential challenges and parties involved, or asking thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

General Instructions:

In this activity, you will need to read the development of a clinical case and answer questions about the concepts learned in the lesson.

Step 1 - Review: Mr. Johnson, a 55-year-old man, has recently been diagnosed with stage III colon cancer. He is scheduled to begin a chemotherapy regimen known as FOLFOX, which involves 12 cycles. Mr. Johnson expresses concerns about cardiovascular toxicity during his initial consultation due to his family history of heart disease. This concern is taken into account by the oncologist when formulating his treatment plan.

Step 2 - Respond:

Write a 500-word essay responding to the questions that follow. 

• Start by briefly summarizing Mr. Johnson's case and his concerns about cardiovascular toxicity from chemotherapy. 
• Then, for each of the four questions, discuss the relevant information and research in greater detail. For example, for the first question, explain how certain chemotherapy and radiotherapy treatments can cause cardiovascular toxicity and provide examples of standard drugs or protocols known to have this effect. 
• In addressing the second question, delve into the various risk factors associated with cancer and cardiovascular disease and discuss how they combine to intensify the risk for patients like Mr. Johnson. 
• When addressing the third question, examine the growing evidence supporting the role of exercise and cardio-oncology rehabilitation in enhancing cancer outcomes and decreasing the risk of cardiovascular complications, citing specific examples of successful exercise programs or interventions. 

Lastly, for the fourth question, review existing interventions and programs available for cancer patients at risk of cardiovascular complications.

Questions:

1. How do specific chemotherapy and radiotherapy treatments contribute to cardiovascular damage in cancer patients?
2. What are the common risk factors for cancer and cardiovascular disease, and how do they intersect?
3. How can exercise and cardio-oncology rehabilitation programs help limit cancer progression and relapse and minimize the risk of cardiovascular complications from cancer treatment?
4. What are some existing interventions or programs for managing and preventing cardiovascular complications in cancer patients, and how effective are they?

Step 3 - Share: To share your work, click the "Add a new discussion topic" button under this post and paste your work into the "Message" box. Be sure to reference others' intellectual property when necessary. All references should follow the 7th Edition APA formatting. For further instructions, refer to the resource on the Himmelfarb Health Sciences Library: APA citation resource (Note: references are not included in word counts).

Step 4 - Interact: Complete the activity by replying to at least two posts made by your peers in a respectful and professional manner. Be sure your post engages with your peers' ideas by reflecting on their comments, sharing thoughts on additional potential challenges and involved parties, or posing thought-provoking questions. If a peer comments on your post, please reply. To post a reply, click "Reply" on a specific discussion, write your feedback, then click "Post to forum."

OPTIONAL Step 5: Interact (10 minutes)

If you would like to, you can reply to your peers' posts in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”