2- cardiovascular risk factors & management Flashcards
what groups of people have increased risk for CVD?
- deprived communities
- black, asian, minority ethnic background
- people with severe mental illness
- also increases with older age & more common in males
what is incidence?
number of new cases in a defined population during a defined period of time, reflects the risk of disease
- good for things that are short lived e.g. MI
what is prevalance?
total number of individuals in a population who have a disease or health condition at a specific time period, usually expressed as a % of population
good for chronic disease e.g. heart failure
what is standardization?
a technique to enhance comparability of rates for different populations over time by making adjustments for the confounding effects of differences in age & sex structure
what gender is more likely to be at risk for strokes?
females have a higher mortality than males for stroke (even though incidence is higher in males) →unusual pattern
what has been the trend in CVD epidemiology?
general decrease in CVD incidence/mortality but recent years plateau
(it’s been leading cause of morbidity, disability & mortality)
what are modifiable risk factors of CVD?
- smoking
- inadequate physical activity
- obesity
- excess alcohol consumption
what are non-modifiable risk factors for CVD?
- age
- gender
- ethnic background
- family history of CVD
what are comorbidities that increase risk of CVD?
- High blood pressure (hypertension)
- High or abnormal cholesterol levels
- Irregular heartbeat (atrial fibrillation)
- High blood glucose levels
- Diabetes
- Chronic Kidney Disease
- Inflammatory conditions such as rheumatoid arthritis
- Atypical antipsychotics
what is cohort study?
group who are exposed to risk factor & group not exposed to risk factor, they are followed over period of time to determine occurrence of disease - the incidence of disease in each group is compared and relative risk is used to assess whether exposure & disease are causally linked
what is primordial prevention?
seeks to prevent at a very early stage, often before a risk factor is established e.g. population strategies to prevent smoking/smoking exposure
- at population level
what is primary prevention?
prevention of disease through control of risk factors for CVD e.g. weight control, smoking cessation, diet
what is secondary prevention?
prevention of further events through appropriate treatment & interventions
what is tertiary prevention?
application of measures to reduce or eliminate long term impairments and disabilities and improve quality of life e.g cardio rehabilitation therapy
what are examples of primary/primordial prevention?
- smoking most important preventable cause of ill-health & premature death in scotland
- food & diet
- physical activity
what is scottish strategy for food & diet primordial prevention?
- decrease access & availability of unhealthy option
- increasing access of availability & affordability of healthy options
what are the most effective strategies for targeting alcohol?
targeting: marketability, availability, affordability
what is a risk tool you should use?
- QRISK 3 calculator - recommended by NICE
= calculates cardiovascular risk - just estimate so clinical judgement still required
what is risk calculator recommendation?
statin treatment should be offered for primary prevention of CVD to people with estimated 10 year CVD risk of 10% or more if lifestyle interventions not proved effective
what are limitations of risk calculator?
- can’t perfectly predict absolute risk
- not all risk factors included
- not for all patient groups especially those already with high risk of CVD
what is example of tertiary prevention?
cardiac rehabilitation
what should you do in secondary prevention?
optimise management of comorbidities (diabetes, hypertension, atrial fibrillation)
