Familiarity with prescription medications dispensed by U.S. community pharmacies provides an insight into prevailing disease trends in the U.S. population. The top 200 prescription drugs also closely mirror the medications taken by patients in oral healthcare settings. Based on their mechanisms of action, the most common cardiovascular problems include hypertension, coronary artery disease, cardiac arrhythmias, heart failure, and thromboembolic complications.
Before treating a patient with risk factors for or known CVD, estimate the patient’s perioperative risk for MACE. If the combined procedure- and patient-specific variables predict low- or elevated-risk for MACE, but the patient’s functional capacity is ≥4 METs the patient may not need any further preoperative evaluation. If the functional capacity is < 4 METs, before initiating any elective dental care, the patient should undergo medical evaluation and risk modification.