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Chronic condition

Chronic conditions require ongoing medical attention. This includes heart disease, diabetes, lung disease, and cancer. 

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Heart failure

There are now three types of left heart failure: 


  • Heart Failure with reduced ejection fraction (HFrEF): LVEF less than or equal to 40%

  • Heart Failure with mildly reduced ejection fraction (HFmrEF): LVEF of 41% to 49% and evidence of increased LV filling pressures

  • Heart Failure with preserved ejection fraction (HFpEF): LVEF equal to or greater than 50% and evidence of increased LV filling pressures.

Recommended pharmacological treatment for HFrEF includes four classes of medications, in addition to diuretics:

  1. angiotensin receptor-neprilysin inhibitors or, if not feasible, angiotensin-converting enzyme inhibitors

  2. mineralocorticoid receptor antagonists

  3. beta-blockers

  4. SGLT-2 inhibitors

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There are three types of statin: low-dose, moderate-dose, and high-dose statin. 

High-intensity statins are recommended for patients with clinical atherosclerotic disease such as coronary artery disease, peripheral arterial disease, and ischemic stroke or if the patient has diabetes and an ASCVD risk score is more than 7.5%. 

Moderate-intensity statins are recommended for patients with diabetes and an ASCVD risk score of less than 7.5%. 

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Lifestyle changes include: 


Weight loss

Exercise for at least 30 minutes a day, most days

Avoid or reduce alcohol use

Stop smoking 

Reduce salt in your diet

DASH diet


Blood pressure has two measurements: 


Systolic pressure is the top number. This is the pressure in the arteries produced when the heart contracts. 


Diastolic pressure is the bottom number and refers to the pressure between heartbeats during relaxation. 

Common medications started are the following for hypertension: 

ACE-inhibitor (Lisinopril) 

Angiotensin receptor blockers (Losartan) 

Calcium channel blockers (Amlodipine)

Diuretic (Hydrochlorothiazide, Chlorthalidone)

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