Singapore medical journal
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Singapore medical journal · Jul 2016
ReviewStatin-centric versus low-density lipoprotein-centric approach for atherosclerotic cardiovascular disease prevention: a Singapore perspective.
The link between cholesterol levels and atherosclerotic cardiovascular disease (ASCVD) is well-established. In Singapore, there is an increasing prevalence of risk factors for ASCVD. Like many Asian countries, Singapore's population is rapidly ageing and increasingly sedentary, which predisposes individuals to chronic health problems. ⋯ Furthermore, it is widely believed that the responses of Asians (both patients and physicians) to statin therapy are different from those of their Western counterparts. Experts convened in 2014 to determine the impact of current guidelines on clinical practice in Singapore. This review summarises the key findings and recommendations of these guidelines, and presents key principles to aid clinicians to manage the cardiovascular risk of their patients more effectively.
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The treadmill electrocardiogram (ECG) stress test is widely used to screen for obstructive coronary artery disease (CAD). The presence of STsegment changes, either depression or elevation, on the ECG during the treadmill test often suggests presence of CAD and warrants further management. We herein present three cases, with evidence of ischaemia on the treadmill ECG stress test. In addition, we discuss the use of the treadmill ECG stress test, including its indications, contraindications, reasons for termination and interpretation of the ST-segment changes, heart rate, as well as blood pressure responses to exercise.