Case study application, CVD, Risk factors, Application to clinical practice

Case study application, CVD, Risk factors, Application to clinical practice

***ASSIGNMENT: after completing case study, discuss about risk factors for CVD, but mainly focus about genetics and application to clinical practice (As a nurse practitioner). Please address all questions, but mainly #3 & 4

FIRST DISCUSS ABOUT THE CASE STUDY FINDINGS_____CASE STUDY Findings: Maria’s case study: *** Modifiable risk factors: very active runs, does pilates twice a week, vegetarian for 15 years, good body weight (has low BMI), Stopped smoking long time ago (smoked x 4 yrs); HOWEVER: she is very busy at work as an accountant and her job is very stressful and sedentary, also she lives in a large city, downtown (pollution contributes to CVD)

***Her Nonmodifiable risk factors: She had a full genome scan and results revealed an increased risk of cardiovascular disease and heart attack (GENETICS). Also her Pedigree construction showed Red flags for significant family history of coronary artery disease (FAMILY HISTORY).

* She hasn’t been seen yet by primary healthcare provider yet, therefore no laboratory results are available to identify more risk factor or health conditions.

Discuss Just briefly about CVD, Risk factors and some statistics: Brief in this section!!!

CVD is a class of diseases which are related to the heart or blood vessels including stroke, heart failure, hypertension, coronary artery diseases, heart arrhythmia, peripheral artery disease, and atherosclerosis.

Cardiovascular disease (CVD) is the leading cause of death in the world[1] and accounts for 48% of deaths from noncommunicable diseases. REFERENCE: (Svensson, T., Kitlinski, M., Engström, G., & Melander, O. (2017). A genetic risk score for CAD, psychological stress, and their interaction as predictors of CAD, fatal MI, non-fatal MI and cardiovascular death. PLoS One, 12(4), 1-17. DOI:10.1371/journal.pone.0176029

Cardiovascular illnesses are sometimes caused by modifiable risk factors such as diet, weight, exercise, stress, sleep, non-smoking, environmental pollutants and other lifestyle choices; while on certain occasions they are caused by unmodifiable factors such as age, gender, family history, and genetic predisposition for the disease. REFERENCE: (Karunathilake, S. P., & Gamage, U. G. (2018). Secondary prevention of cardiovascular diseases and application of technology for early diagnosis.BioMed Research International, 9(1), 1-10. DOI:10.1155/2018/5767864)

**Multiple risk factors (Multifactorial disease) contributing to CVD include obesity, high blood pressure, diabetes, aging, male sex, smoking, sleep, environmental factors, metabolic syndrome, and physical inactivity and genetics. SEE ARTICLE: (Tian, D., & Meng, J. (2019). Exercise for prevention and relief of cardiovascular disease: Prognoses, mechanisms, and approaches. Oxidative Medicine and Cellular Longevity, 11(1), 1-12. DOI:10.1155/2019/3756750

Discuss about the unmodifiable risk factor such as GENETICS and APPLICATION TO CLINICAL PRACTICE from case study. (MAIN POINT OF DISCUSSION)

—discuss primary and secondary prevention of CVD as mentioned in Karunathilake article.

Although modifiable risk factors are known to contribute to cardiovascular disease risk, genetic factors also play an important role.

**Genetic factors contribute to the risk of developing coronary artery disease (CAD) and its major complication, myocardial infarction (MI), which is the result of the accumulation of atherosclerotic plaques in the walls of the coronary arteries. Existing knowledge of genetic components affecting the risk of CAD is largely based on results from genome-wide association studies. SEE ARTICLE (Guo, Y., Wang, F., Li, L., Gao, H., Arckacki, S., Wang, I. Z., . . . Wang, Q. K. (2017). Genome-wide linkage analysis of large multiple multigenerational families identifies novel genetic loci for coronary artery disease. Scientific Reports (Nature Publisher Group), 7, 1-11. DOI:10.1038/s41598-017-05381-2)

**GENETICS: Coronary artery disease (CAD) is the leading cause of death, and genetic factors contribute significantly to risk of CAD.

SEE ARTICLE, great!: (Karunathilake, S. P., & Gamage, U. G. (2018). Secondary prevention of cardiovascular diseases and application of technology for early diagnosis.BioMed Research International, 9(1), 1-10. DOI:10.1155/2018/5767864)

Preventive healthcare has three main stages. Primary prevention of CVD refers to the adjusting modifiable risk factors in order to prevent the onset of disease. This includes lifestyle changes such as diets and regular exercise, discarding harmful behaviors such as smoking. Constant monitoring of risk factors would allow the patients to keep them in check thus leading to a healthier cardiovascular system. However, the one drawback of primary prevention is that it only focuses on modifiable risk factors. Although lifestyles play a major factor to susceptibility of CVD, there are many other genetic and environmental factors that cannot be controlled by an individual. This drawback of primary prevention is addressed by secondary prevention which focuses on early detection of diseases prior to critical and permanent damage, allowing the medical professionals to treat the patients and secure the quality of life. Early detection requires an in-depth knowledge of the disease itself, family history of the patient, lifestyle, and many other related factors. Although the process is more complex compared to primary prevention, benefits are far superior to tertiary prevention in terms of quality of life of patients as well as in a financial perspective. Medical professionals ordinarily use indicators such as age, blood sugar levels, and lipids to predict CVD and screen for particular diseases. (Karunathilake, S. P., & Gamage, U. G. (2018). Secondary prevention of cardiovascular diseases and application of technology for early diagnosis.BioMed Research International, 9(1), 1-10. DOI:10.1155/2018/5767864)

Cardiovascular diseases result in millions of deaths around the globe annually, most of which are avoidable if identified early. Preventive healthcare has a major role in the fight against cardiovascular diseases. Primary, secondary, and tertiary prevention have their own applications along with benefits. Cardiovascular diseases cause an average of 17.7 million deaths each year (44% of NCD fatalities) making it one of the most deserving topics for research on prevention. Cardiovascular diseases (CVD) are a group of disorders of the heart and blood vessels which is the most significant cause of death globally. Despite the critical fatality rate 90% CVD can be prevented by taking necessary precautions [2]. . (Karunathilake, S. P., & Gamage, U. G. (2018). Secondary prevention of cardiovascular diseases and application of technology for early diagnosis.BioMed Research International, 9(1), 1-10. DOI:10.1155/2018/5767864)

HOW WILL THIS INFORMATION PREPARE YOU IN YOUR ROLE AS A DNP NURSE (Doctor of Nursing Practice)

(MERRILL, 2017)—“Genetic and genomic science is impacting nursing care. Advances in science have uncovered that mostly all diseases and conditions have genetic or genomic roots. Application of these principles is critical in all aspects of clinical practice”

“Family health histories are important to gather to determine the degree of risk to 3 generations of family members. Sharing the same genes and environments can expose patients to chronic diseases. Health promotion and prevention activities are developed based upon the risk factors. It is difficult for patients to have knowledge of all family members and their health” (Merrill, 2017)

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