In part 1, screenings to prevent cardiovascular disease were discussed. These included screening for hypertension, and for abnormal blood glucose. Next, we’re going to talk about two medications that are recommended by the task force for people with elevated risk for heart disease. But before we address the medications, we first have to talk about a concept called the “10-year risk for atherosclerotic cardiovascular disease”, as defined by the American Heart Association and the American College of Cardiologists. This calculation uses age, gender, race, blood pressure, cholesterol numbers, diabetes history, and smoking history to estimate an individual's “10-year risk” for heart attack and stroke.¹ This was based off of a review of large cohort studies that looked for correlation between risk factors and disease in tens of thousands of people.¹ Now, this is a very imperfect estimate,² but it is helpful in identifying individuals who are at greater risk,...

Cardiovascular disease is the #1 cause of death in the US, at about 655,000 deaths/year.¹ Even more importantly, it is estimated that nearly of deaths from cardiovascular disease are preventable.²

For this reason, the United States Preventive Services Task Force has made six separate recommendations for clinical preventive services. Two of these recommendations are screenings for risk factors of cardiovascular disease, two are for medications that decrease cardiovascular risk, and then the final two are about behavioral counseling and interventions that also reduce risk.

Let’s start with the two screening recommendations. The first of these is to screen any adult, (any person over the age of 18), for high blood pressure (also known as “hypertension”).³ This condition is very common, with approximately 45% of American adults affected.⁴ It’s also a very sneaky condition, as most of the time hypertension doesn’t cause any symptoms. It is...

When it comes to smoking, we have both some good news and some bad news to discuss. 

Let’s start with the bad news: 42.1 million Americans still smoke regularly.¹ Tobacco use remains the largest preventable cause of disease, disability, and death in the United States, and there are over 480,000 premature deaths annually that are related to tobacco use. This means that around one out of every five deaths that occur each year in the United States is related to smoking._²

Now for some good news: people are smoking less and less all the time. Between 2005 and 2016, the percentage of US adults who smoke has decreased from 20.9% to 15.5%.³ In adults who have ever used cigarettes, 59% have quit as of 2016, which has increased from 50.8% in 2005. Going back even further in time, there were more than twice as many smokers (as a percentage) in 1965 compared to today.³

Although the change is happening gradually and slowly, this is a war that we appear to be...

An abdominal aortic aneurysm (often abbreviated as AAA) is a “ballooning” of the aorta below the diaphragm. The aorta is the largest artery in the body. When your heart beats, it pumps a large amount of blood from the heart’s left ventricle directly into this blood vessel. All other arteries in the body branch off of the aorta. An aneurysm develops as a result of weakening of the wall of the artery, causing it to stretch and create the “ballooning“ effect. As you could imagine, if this balloon were to burst, it would instantly become a life-threatening issue. Up to 81% of all people who experience a rupture of an AAA do not survive.¹

The most important risk factors for development of an AAA include male sex, a history of smoking, older age, and having a first-degree relative with a history of AAA.² The other risk factors of lesser importance include high blood pressure, high cholesterol, atherosclerosis, history of aneurysms, coronary artery disease,...