Case Study Andrews Family

1495 words - 6 pages

The Andrews family consists of an African American father and mother that are in their early 50s and two teenage children. This paper will focus on primary heart health for Mrs. Andrews. Mrs. Andrews has a significant risk for developing heart disease, MI, and stroke. Mrs. Andrews non-modifiable risk factors include being an African American female in her 50s. Her modifiable risk factors include stress, hypertension, being overweight, and not seeing a primary care practitioner for two years. She quit smoking three years ago which is a modifiable risk factor that she has changed prior to this visit, the goal is not to sustain the change long term. According to the American Cancer ...view middle of the document...

, 2004, p. 673).” It is not possible to score Mrs. Andrews at this time because of an incomplete medical history.
Diet modification is the first step in Mrs. Andrews journey. Research suggests reducing saturated fats and excess carbohydrates from the diet. One study showed that protein and monounsaturated fat diets reduced systolic blood pressure substantially in hypertensive patients (Appel et al., 2005). “Data from The 20 Years Follow-up of Nurses’ health study found that a higher polyunsaturated fat intake in women is associated with a reduced risk of coronary heart disease ("Can TLC reduce weight and chronic disease," n.d., p. 1).” Including fish in the diet has an incidence of reduced CVD related to these healthy fats and omega-3 fatty acids. However, for patients that may have allergies, or just do not like fish; alternatives are “flaxseed, walnut, canola, and soybean oils, as well as walnuts (Mosca et al., 2004, p. 678).” The lifestyle heart trial found a 91% reduction in anginal episodes from the intervention (vegetarian) group and a 189% increase from the control group (Sticher, Smith, & Davidson, 2008). Evidence based recommendation calls for a diet “reduced in saturated fat, cholesterol, and sodium, and rich in vegetables, fiber, potassium, and other minerals at recommended levels (Appel et al., 2005, p. 2457).” This recommendation closely resembles the Dietary Approaches to Stop Hypertension (DASH) diet recommended by the American Heart Association (AHA).
The second step in Mrs. Andrews journey to health should be exercise. Results of a study performed by the AHA showed, “physically active subjects demonstrating CAD rates half of the sedentary group, and a graded relationship of decreasing CAD with increasing physical activity (Thompson et al., 2003, p. 3110).” According to a statement from the Council on Clinical Cardiology, “health professionals should prescribe physical activity programs commensurate with those recommended by the CDC and the American College of Sports Medicine, ie, 30 minutes or more of moderate intensity physical activity such as brisk walking most, and preferably all days of the week (Thompson et al., 2003, p. 3114).” It is important to advise patients be mindful of risk that accompanies exercise, as “risk of injury increases with obesity” which is a factor in this patients case (Thompson et al., 2003, p. 3113).
There are recommendations for hormone replacement therapy for menopausal women to reduce the risk of CVD. This recommendation is class III, “based on recent clinical trials showing no benefit for prevention and possible adverse effects (Mosca et al., 2004, p. 679).” “Hormone replacement therapy is not recommended for CVD prevention (Mosca et al., 2004, p. 679).” One drug is recommended for CVD prevention and that is aspirin. The AHA has published evidence based guidelines supporting aspirin use in women (Rivera et al., 2012). “These guidelines are based on multiple randomized...

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