Case Study #7: Cardiovascular Disease with Multiple Risk ...



Case Study #7: Cardiovascular Disease with Multiple Risk Factors

1. The factors found in the medical and social history that are pertinent for determining Mr. Gates CHD risk category include:

• Markers in blood: high LDL cholesterol and TG, low HDL cholesterol.

• Lifestyle risk factors: tobacco, poor diet (eggs, red meat, and butter regularly), physical inactivity, and a stressful job.

• Related diseases: hypertension, family hx of CAD, and class I obesity.

2. To further assess Mr. Gates’s nutritional needs I would ask for the following information:

• 24 hour recall

• Why is breakfast and lunch eaten outside of the home?

• Are meals prepared by him or his wife?

• Have there ever been dietary changes made to lower blood pressure or cholesterol?

• What amount of physical activity do you receive?

• How are meals on workdays in comparison to non-work days?

3. Based on the nutrition information obtained from Mr. Gates he is usually taking in approximately:

2750 kcal/day, 114 grams total fat/day, and 43.3 grams of saturated fat/day.

4. BMI = (Wt. x 703 / Ht^2)

(225 x [703/(70X70)]) = 32.3

A BMI of 32.3 is Class I Obesity, I would interpret his obesity as significant because obesity is a risk factor of CVD and is included in the etiology of many cardiovascular diseases.

5. Mr. Gates’s lipid profile:

|Parameter |Normal Value |Patient’s Value (In./6 mo/9mo) |

|Cholesterol |140-199 mg/dL |270/230/210 |

|HDL-C |37-70 mg/dL |30/35/38 |

|LDL-C |< 130 mg/dL |210/169/147 |

|LDL/HDL ratio | ................
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