(Solved): NTR-218 Heart Disease Case Study Mr. R is a 52 year old accountant who is being seen for a routine ...

NTR-218 Heart Disease Case Study Mr. R is a 52 year old accountant who is being seen for a routine physical exam. He has been in relatively good health, is not on any medications and has not seen a physician for the past 2 years. Mr. R is recently separated and has one daughter who is away at college. Mr. R's family history is positive for heart disease. His father had a fatal heart attack at age 48 and his older brother had a stroke at age 50. Mr. R attributes a 12 pound weight gain over the past 2 years (since his last physical) to a sedentary, stressed lifestyle. He works long hours and reports high stress levels both at home and on the job. He typically eats three meals per day, most in restaurants or take-out meals. Mr. R drinks two cups of coffee every morning and three alcoholic drinks (beer or wine) most evenings. Mr. R has been a smoker for 30 years, but has recently been successful at cutting back his smoking from one pack to one-half pack of cigarettes per day. On this visit, the following measurements are recorded: Height: 5'10" Weight: 212 lbs Waist: 44 inches Blood Pressure: 160/90 Fasting Glucose: 88 mg/dL Total Cholesterol: 245 mg/dL HDL: 38 mg/dL LDL: 160 mg/dL Mr. R reports the following 24 hour food intake: Breakfast (stops at Burger King) 1 Burger King biscuit with sausage, egg and cheese Coffee, 12 oz. with 2 Tbsp. Half & Half Mid-Morning (office) 1 jelly filled doughnut Coffee, 12 oz. with 2 Tbsp. Half & Half Lunch 2 slices Pepperoni Pizza Soda (Cola type), 12 oz. After Work 2 oz. cheddar cheese 5 Ritz crackers Beer, 12 oz. Dinner (Take out) Vegetable Egg Rolls (2) Moo shi pork, I cup White Rice, 1 cup Red wine, 2 glasses (5 oz. each) Vanilla Ice Cream, 1 cup 1. List ALL of the CHD risk factors that Mr. R has. For each modifiable risk factor, recommend a SPECIFIC diet or lifestyle change that could decrease his CHD risk. 2. Using the ACC/AHA heart attack Risk Assessment calculator (see on-line lecture B), calculate Mr. R's 10 year risk of having a heart attack. 3. What are the TLC recommendations for total fat, saturated fat and cholesterol intake? How do you think Mr. R's diet compares to those recommendations and explain your answer. 4. Suggest 5 tips to help Mr. R. change his diet so that it more closely aligns with the TLC recommendations. Your suggestions should be specific and actionable.