19 Inequalities in CVD

Question 1

What does the Global Burden of Diseases Study show?

Answer 1

international study collecting data for risk factors for CVD

shows high systolic blood pressure is the most important risk factor

Question 2

What is a DALY?

Answer 2

Disability Adjusted Life Year

number of years lived in disability, and the number of years lost to premature death

Question 3

What sorts of diseases constitute the most number of DALYs lost?

Answer 3

non-communicable diseases (highest is IHD)

Question 4

How many people do heart and circulatory diseases kill in the UK?

Answer 4

1/4

Question 5

What is the trend in DALYs lost in the UK to CVD?

Answer 5

it has been decreasing for a long time!

appears to be an inflection points at around 2014 though…

Question 6

What is the life expectancy difference between the richest and the poorest?

Answer 6

10 years

Question 7

How does the life expectancy difference differ with disability free life expectancy?

Answer 7

the gradient is even larger

Question 8

Do men or women have a higher risk of CHD?

Answer 8

men

Question 9

Do those in managerial jobs or manual jobs have a higher risk of CHD?

Answer 9

manual

Question 10

Why might there be a little bump in CVD in the neonatal period?

Answer 10

congenital heart defects

Question 11

What constitutes the difference in DALYs lost from CVD between Men and women?

Answer 11

a greater IHD

Stroke is very similar

Question 12

Why might south asians have a higher risk of CVD?

Answer 12

they are at higher risk of DM2, so they present earlier with CVD

Question 13

Do people with severe mental illness have a higher or lower CVD risk?

Answer 13

higher (HR - 1.78 incidence, 1.85 mortality)

Question 14

how do we measure inequality in CVD in the uk?

Answer 14

primary records
health surveys
hospital data
death certificates

Question 15

Name a couple of the points of the NICE Public Health Guidance 2010

Answer 15

Eliminate the use of industrially-produced trans fatty acids for human consumption

prevent marketing which encourages unhealthy diet in children

Question 16

What does the CHA2DS2-VASC score assess?

Answer 16

incidence of stroke in people with AF

this risk could be reduced by starting people on anticoagulants

Question 17

What are the problems associated with NHS health checks?

Answer 17

uptake is lower in those living in the most deprived areas

under half of those invited actually attend

Question 18

What is the most severe type of public health intervention?

Answer 18

eliminating choice

Question 19

What did Geoffrey Rose suggest about public health?

Answer 19

a large number of people at a small risk may give rise to more cases of disease than the small number whoa re at high risk

Question 20

What are the 5 advantages of a high risk strategy?

Answer 20

intervention appropriate to individual
subject motivatino
physician motivation
cost-effective
benefit : risk ratio favourable

Question 21

What are the disadvantages of a high risk strategy?

Answer 21

difficulties and costs of screening
palliative and temporary
limited potential for population
behaviourally innapropriate

Question 22

What are the advantages of the population approach?

Answer 22

radical
large potential for population
behaviourally appropriate

Question 23

What are the disadvantages of the population approach?

Answer 23

small benefit to individual
poor motivation of subject
poor motivation of physician
benefit : risk ration worrisome

Question 24

Are high risk or population approaches to CVD prevention more likely to result in bigger health gains?

Answer 24

population approaches