6 Cardiovascular Disease Flashcards
Q: Where are more deaths caused by CVD? Developing or developed?
Differences in prevalence of CHD in different countries is mainly due to what?
A: Developing
environmental factors.
Q: What are top 2 for cause-specific mortality worldwide?
A: coronary heart disease (CHD) then Stroke (1st and 2nd)
Q: Why are there more CVD patients but less deaths? (2)
A: Due to demographic (population ageing) and epidemiological transitions burden of disease from non-communicable diseases in developing countries likely to rise
Q: What are the discrepancies in incidence and mortality from coronary heart disease (CHD)? (4)
A: – Low rates in Japan
– Increasing in UK and other western countries
– High rates in the Middle East
– At all ages rates higher in men than women, though gap shrinking in some countries
Q: What do the epidemiological patterns (rising and declining rates within countries, large differences across countries which lessen or disappear with migration) in CVD indicate?
A: that environmental rather than genetic factors underlie much of the variation in cardiovascular disease risk worldwide
Q: Name 5 established risk factors of CHD related to diet and lifestyle (and therefore modifiable)? Where is the burden of disease attributable to these risk factors high?
A: high blood pressure tobacco smoking serum cholesterol levels Body weight (BMI>27 can increase risk by over 30%) Reduced physical activity
in the developing as well as the developed countries
Q: Worldwide trends in obesity will increase what?
A: the burden of non-communicable disease including metabolic disorders and diabetes
Q: How does age affect the number of deaths from CHD ?
A: increases with age but decreases after about 80 years old (less people in these age groups as they have passed away)
Q: How does ethnicity affect death rates from CHD?
A: Higher death rates from CHD in black males compared to white in US
Q: Describe serum cholesterol as a risk factor for CHD. Marker? Measurements? Prognostic validity? Ability to discriminate between cases and non-cases of heart disease and why?
A: • Cholesterol is a good predictive marker
• Well–measured, so that a single measure characterises the population reasonably well
• Longitudinal studies show prognostic validity
• poor ability (this is because not only Cholesterol levels cause CHD as this is a multifactorial disease)
Q: Describe blood pressure as a risk factor for CHD. How does age affect? explained by? Gradual/steep? Hypertensive risk and age? Ethnicity? Gender?
A: – Lifestyle factors , especially diet , key in explaining differences between populations in the rise in BP with age and the consequent prevalence of high BP at older ages.
- The risk is increasing in a gradiential way
- Hypertensive risk increases with age
- Blood pressure also varies with ethnicity and gender.
- The same goes for systolic blood pressure as blacks are more hypertensive than whites
Q: Describe smoking as a risk factor for CHD. Evidence? Smoking rates over time in UK? Developing countries rate?
A: • Has one of the most evidence that supports it to be a huge risk factor of CHD
• The rates of smoking have decreased overtime, in the UK, in particular but the decrease is still slow
• However, this is not mirrored in the rates of developing countries; they are increasing and by 2025, 85% of smokers will be distributed across developing countries
Q: Describe obesity as a risk factor for CHD. Prevalence? Promotes?
A: – Obesity rates increasing in many countries though especially in the US.
– Promotes diabetes
Q: Describe physical activity as a risk factor for CHD. Global rates? explanation (2)?
A: • This is actually seen worldwide, with rates of inactivity in Africa only being slightly lower than those in Europe
• This could be explained by increased modernisation in terms of transport, in effect making populations lazier
• The sedentary lifestyle and social culture also contributes towards inactivity
