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Laboratory Testing For Cardiovascular Risk

1. A fit 20-year old2. A 29-year old with abnormal lipids
3. Routine CV risk assessment4. Persistent adverse risk profile
5. The metabolic syndrome6. A recent MI
7. Gout and cardiovascular risk8. Troponin in atypical chest pain
9. BNP in suspected heart failure10. Testing for newly diagnosed hypertension
11. Cardiovascular screening in the elderly12. Polycystic ovary syndrome
Investigations which are currently not indicated in the routine assessment of CV risk...

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Welcome to this document ‘Laboratory Testing for Cardiovascular Risk’.

This is presented as a series of case scenarios in which a range of clinical situations are commented on. We hope you recognise some of your own patients within these.

This document has been developed with the assistance of our invited panel based on their clinical experience and knowledge of the literature. We are extremely appreciative of this input and we would like to acknowledge their help and expertise:

  • Dr Michael Crooke, Chemical Pathologist, Wellington Hospital and Aotea Pathology, Wellington.
  • Associate Professor Stewart Mann, Department of Medicine, University of Otago, Wellington.
  • Professor Russell Scott, School of Medicine & Health Sciences, University of Otago, Christchurch.
  • Dr Neil Whittaker, General Practitioner, Nelson.

Much of this document references the New Zealand Guidelines Group document ‘The Assessment and Management of Cardiovascular Risk’ which was produced in 2003. In the near future parts of this guideline are to be reviewed. Areas in which changes to the guideline will probably be considered are:

  • How risk is expressed over time. Currently risk is expressed over five years. Many other countries express risk over ten years or even lifetime risk.
  • Reduction of optimum LDL-cholesterol levels to below those currently in the guideline.
  • Increased emphasis on family history in the assessment of risk.

We hope you enjoy this document

The bpacnz team

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