Categorizing risk in .NET

Make UPC - 13 in .NET Categorizing risk

ATP III divided Americans into four large categories based on their risk of heart disease The categories are High risk: Known coronary artery disease and/or blocked arteries in the legs or brain, plus multiple major risk factors Intermediate risk: No known vascular disease, at least two major risk factors, and 10 to 20 percent risk of heart attack in the next ten years Moderate risk: No known vascular disease, at least two major risk factors Low risk: One or no major risk factors, less than 10 percent risk of heart attack in the next ten years

The ATP III Update revised the risk categories as follows Very high risk: Previous heart attack or stroke, plus several major risk factors High risk: Known coronary artery disease and/or blocked arteries in the legs or brain, plus multiple major risk factors Moderately high risk: No known vascular disease, at least two major risk factors Moderate risk: No known vascular disease, at least two major risk factors Low risk: One or no major risk factors, less than 10 percent risk of heart attack in the next ten years As a result of this update, several million more Americans were now classified as being at high risk or very high risk, necessitating you guessed it more meds

The treatment recommendations in both ATP III and ATP III Update are both based on the proposition that lowering a person s level of LDLs lowers her risk of heart attack The difference lies in the decision about who needs to be treated and how low she needs to go ATP III s treatment recommendations were simple: The first line of defense in ATP III is diet The report recommends that a whopping 65 million Americans change what they eat in order to lower their cholesterol If changing the diet doesn t do the trick, the NHLBI recommends that an almost-equally-whopping 35 million Americans with a more than 20-percent risk of heart attack in the next ten years and/or an LDL level higher than 130 mg/dL begin drug treatment to push their LDLs down to 100 mg/dL The treatment recommendations in the ATP III Update are dramatically different: For people in the very high risk and high risk categories, the recommended level of LDLs was lowered to 70 mg/dL, a level virtually impossible to reach without drugs If a very high-risk or high-risk person has high levels of triglycerides, a fibrate or nicotinic acid should be given along with a cholesterollowering med

The best option for moderately high-risk people is to aim for LDL levels less than 100 mg/dL Any moderately high-risk person with LDL levels of more than 130 mg/dL plus major risk factors is a candidate for cholesterollowering drugs Low-risk people don t have to take cholesterol-lowering drugs Seems like practically everyone you know is a candidate for cholesterol-buster meds Not surprisingly, that conclusion hasn t been universally applauded Many critics note (correctly) that the ATP III Update pretty much ignores the benefits of lifestyle changes such as diet and exercise, while passing over studies showing virtually no benefits in giving cholesterol-lowering meds to older people Others are distressed by the makeup of the ATP III Update panel: Eight of the nine panel members had financial ties to companies producing cholesterol-lowering drugs Ooops As the debate simmers, will the ATP III Update recommendations become the norm Maybe Should you check with your own doctor before diving into drugs You bet Case closed

13

Finding the facts on hormones and HDLs Discovering how diuretics affect blood fats Protecting statins Naming the problems with vasoconstrictors

elieve it or not, several common medications, such as diuretics (also known as water pills), work like a dream to cure or alleviate conditions they were designed to treat, such as swelling caused by water retention, but may send your bad cholesterol up, your good cholesterol down, and your triglycerides heavenknows-where (see the section Lowering Fluids with Diuretics later in this chapter) The following sections make up a representative list of medicines that may alter your cholesterol levels, sending some kinds of cholesterol up and others down But hey, forewarned is forearmed