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Cleveland Clinic Journal of Medicine

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Risk Factors

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    Cardiac rehabilitation: not just exercise anymore
    Fredric J. Pashkow, MD
    Cleveland Clinic Journal of Medicine March 1996, 63 (2) 116-123;

    The treatment of sicker patients and shorter hospital stays are forcing a rethinking of approaches to cardiac rehabilitation.

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    Preoperative screenings What tests are necessary?
    Troy Jones, MD and J. Harry Isaacson, MD
    Cleveland Clinic Journal of Medicine November 1995, 62 (6) 374-378;

    Ordering preoperative tests is as easy as checking a form. But what tests are worthwhile for which patients?

  • You have access
    Evaluating cardiac risk in noncardiac surgery patients
    David L. Bronson, MD, Alan K. Halperin, MD and Thomas H. Marwick, MD, PhD
    Cleveland Clinic Journal of Medicine November 1995, 62 (6) 391-400;

    The history, examination, and resting EKG are the cornerstone of cardiac risk assessment, but new techniques are available for questionable cases.

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    Coronary heart disease in African Americans: primary and secondary prevention
    Luther T. Clark, MD and Obinnaya Emerole, MD
    Cleveland Clinic Journal of Medicine September 1995, 62 (5) 285-292;

    How physicians can help improve the cardiovascular health of their black patients, who have a high level of CHD risk factors.

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    Cancer prevention: what the physician can do
    Robert W. Gerlach, MPA
    Cleveland Clinic Journal of Medicine May 1995, 62 (3) 184-192;

    The ability to improve the control of cancer today depends more on primary care screening and prevention than on curative interventions at the subspecialty level.

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    Coronary artery disease in renal transplant recipients
    William E. Braun, MD and Thomas H. Marwick, MD
    Cleveland Clinic Journal of Medicine September 1994, 61 (5) 370-385;

    Screening for coronary artery disease before transplantation can identify high -risk patients and save lives and money.

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    Long-term follow-up of children after repair of atrial septal defects
    James Mandelik, MD, Douglas S. Moodie, MD, Richard Sterba, MD, Daniel Murphy, MD, Eliot Rosenkranz, MD, Sharon Medendorp, MPH and Andrea Kovaks, BS
    Cleveland Clinic Journal of Medicine January 1994, 61 (1) 29-33;

    The authors advocate repair of atrial septal defects as early as possible, definitely "before age 5, in order to minimize long-term complications of left-to-right shunting.

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    Coronary artery disease in women: a risk-factor analysis
    Anita Zeiler Arnold, DO and Donald A. Underwood, MD
    Cleveland Clinic Journal of Medicine September 1993, 60 (5) 387-392;

    Coronary artery disease (CAD) has long been considered a disease of men. However, the risk factors for CAD are similar for women and men, and these factors need to be considered when counseling women for the prevention of CAD.

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    Coronary artery disease in young women: risk factor analysis and long-term follow-up
    Anita Zeiler Arnold, DO and Douglas S. Moodie, MD
    Cleveland Clinic Journal of Medicine September 1993, 60 (5) 393-398;

    Risk factors include hypertension, hypercholesterolemia, diabetes mellitus, familial coronary disease, and smoking. The long-term prognosis is excellent for those without advanced diabetes mellitus and renal failure.

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    The role of multiple risk factors in cardiovascular morbidity and mortality
    Ray W. Gifford, MD
    Cleveland Clinic Journal of Medicine May 1993, 60 (3) 211-218;

    BACKGROUND Cardiovascular disease remains the leading cause of death in the United States.

    OBJECTIVE To identify important modifiable cardiovascular risk factors and appropriate interventions.

    DISCUSSION The three most important modifiable risk factors are hypertension, cigarette smoking, and dyslipidemia. Systolic hypertension poses a greater risk than diastolic, but the prognostic significance of diastolic blood pressure may have been underestimated. When a smoker quits, the cardiovascular risk soon approaches that of the nonsmoker. Cardiovascular risk increases progressively with elevations of the serum total cholesterol level above 200 mg/dL. Recently identified risk factors include hyperinsulinemia and left ventricular hypertrophy.

    CONCLUSION Each patient deserves an evaluation of cardiovascular risk followed by education about and therapy for those risk factors that can be changed. When more than one risk factor is present, as is often the case, the increase in risk may be synergistic rather than additive.

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