BCACP Cardiovascular Risk Reduction 2 — Questions and Answers
Question 1: A 58-year-old patient with hypertension and CKD (eGFR 35 mL/min) needs antihypertensive therapy. Which agent provides both BP control and renoprotection?
- Amlodipine
- ACE inhibitor (Correct answer)
- Hydrochlorothiazide
- Metoprolol
Correct answer: ACE inhibitor
ACE inhibitors reduce intraglomerular pressure and proteinuria, providing renoprotection in CKD patients with hypertension.
Question 2: According to ACC/AHA guidelines, which 10-year ASCVD risk threshold defines high risk and warrants statin initiation in primary prevention?
- ≥5%
- ≥7.5% (Correct answer)
- ≥10%
- ≥15%
Correct answer: ≥7.5%
A 10-year ASCVD risk ≥7.5% is the threshold for considering statin therapy in primary prevention per ACC/AHA guidelines.
Question 3: A patient on warfarin for atrial fibrillation has a subtherapeutic INR of 1.5. Which dietary change most likely contributed?
- Increased dairy consumption
- Increased green leafy vegetable intake (Correct answer)
- Increased citrus fruit intake
- Increased red meat consumption
Correct answer: Increased green leafy vegetable intake
Green leafy vegetables are high in vitamin K, which antagonizes warfarin's anticoagulant effect and lowers the INR.
Question 4: Which class of medications is preferred for secondary prevention after a myocardial infarction to reduce mortality?
- Calcium channel blockers
- Beta-blockers (Correct answer)
- Alpha-blockers
- Digoxin
Correct answer: Beta-blockers
Beta-blockers reduce mortality after MI by decreasing myocardial oxygen demand, preventing arrhythmias, and reducing reinfarction risk.
Question 5: A 65-year-old male with diabetes and hypertension has a urine albumin-to-creatinine ratio of 450 mg/g. Which agent is MOST appropriate to add?
- Dapagliflozin (Correct answer)
- Glipizide
- Sitagliptin
- Pioglitazone
Correct answer: Dapagliflozin
SGLT2 inhibitors like dapagliflozin have demonstrated cardiorenal protective benefits including reduction of albuminuria and CKD progression.
Question 6: Which lipid parameter is most directly associated with atherogenesis and is the primary treatment target in cardiovascular risk reduction?
- HDL-C
- Triglycerides
- LDL-C (Correct answer)
- VLDL-C
Correct answer: LDL-C
LDL-C is the primary atherogenic lipoprotein and the principal target of lipid-lowering therapy to reduce cardiovascular risk.
Question 7: A patient with heart failure with reduced ejection fraction (HFrEF) asks about dietary modifications. What is the recommended daily sodium limit?
- Less than 1,000 mg/day
- Less than 1,500 mg/day
- Less than 2,000–3,000 mg/day (Correct answer)
- Less than 4,000 mg/day
Correct answer: Less than 2,000–3,000 mg/day
ACC/AHA guidelines recommend limiting sodium to less than 2,000–3,000 mg/day in HFrEF patients to reduce fluid retention and hospitalizations.
BCACP Cardiovascular Risk Reduction 2
A 58-year-old patient with hypertension and CKD (eGFR 35 mL/min) needs antihypertensive therapy.
Which agent provides both BP control and renoprotection?