Chapter 9 Part II (1)

## Chapter 9 - Modifiable Cardiovascular Disease Risk Factors - Part II

### Overview
This chapter outlines assessment and intervention strategies related to modifiable risk factors for cardiovascular disease (CVD). These factors include:
- Tobacco use
- Dyslipidemia
- Hypertension
- Physical inactivity
- Diabetes
- Psychosocial concerns
- Obesity
- Emerging risk factors

### Purpose of the Chapter
The purpose is to guide healthcare professionals through the necessary assessments and interventions to help mitigate these risk factors effectively, which can be critical in managing CVD and improving patient outcomes.

## Hypertension

### Prevalence of Hypertension
- Approximately **1 in 3 U.S. adults** has hypertension.
- **2/3** of individuals over the age of 65 are diagnosed with hypertension.
- Hypertension is more common in men than women until age 55, after which the prevalence in women increases.
- Hypertension is reported in about **48%** of participants in cardiac rehabilitation (CR) and secondary prevention (SP) programs.

### Medical History Considerations
When assessing a patient's medical history, focus on the following:
- Dietary sodium intake
- Excessive alcohol consumption
- Caloric intake and diet
- Levels of physical activity

### Physical Examination Protocol
#### Initial Assessment
- Obtain two or more blood pressure (BP) measurements, taken two minutes apart, after allowing the patient five minutes of rest while seated with uncrossed legs.
- Verify BP with the contralateral arm; use the higher value for assessment.

#### Comprehensive Assessment Includes:
- Eye examination
- Neck assessment
- Cardiac examination for increased heart rate, murmurs, EKG changes, etc.
- Examination of the abdominal region and extremities
- Complete neurologic assessment

### Classification and Management of Blood Pressure
| BP Class | SBP mmHg | DBP mmHg | Lifestyle Modification |
|-----------------------|--------------------|--------------------|------------------------|
| Normal |