Cardiovascular And Cerebrovascular Disease

Question 1

What are CHD

Answer 1

Group of disease of the heart and blood vessels

• heart failure
• stroke
• rheumatic heart disease
• congenital heart disease
• coronary heart disease
• cerebrovascular disease
• peripheral artery disease

Question 2

What are some risk factors of CHD

Answer 2

• family history
• diabetes and metabolic syndrome
• hypertension
• dyslididaemia
• obesity and physical activity
• cigarette smoking

Question 3

Family history that has an impact of CHDs

Answer 3

Unmodifiable
Male 1st degree relative experiencing CHD<45yrs
Female 1st degree relative experiencing CHDs <55yrs
Familial hypercholesterolaemia
High TC , high LDL-C

Question 4

Effects of diabetes

Answer 4

Relatives or absolute insulin deficiency

Congenital or acquired

Type 1 or type 2

Leading to glucose metabolic problems

Greater risk for CHD, stroke , chronic kidney dx and PVD

Depending on type-modifiable/unmodifiable risk

Question 5

Hypertension

Answer 5

Elevated arterial blood pressure

Defined:SBP>/=140mmHg , DBP>/=90mmHg

Normal SBP <120 , DBP <80

Pre-hypertension SBP 120-139
, DBP 80-89mmHg

Increased risk to develop HPT in future

Primary or secondary in aetiology

Question 6

Dyslipidaemia

Answer 6

Increased Total Cholesterol (TC)

Increased LDL-C

Optimal <100mg/dL

Low risk 100-130 , intermediate 130-160mmHg

High risk 160-190mg/dL

Low HDL-C

• <40mg/dL men , <50mg/dL in women
• regardless of TC , strongly associated with CHD risk

Question 7

Smoking

Answer 7

• risk increases with number of cigarettes
• risk increases with number of years smoking
• including second hand smoking
• Tobacco smoking

Question 8

Obesity and inactivity

Answer 8

• other CVD risks linked to obesity and inactivity
• HOT , Oyslipidaemia , Type 2 DM , Obstructive , sleep apnaea

Physical inactivity
-increased SBP and DBP

OBESITY
BMI >30kg/m2

Question 9

Metabolic syndrome

Answer 9

Associated with greater risk of DN AND CVD
consist of at least 3 of the following :
-abdominal obesity (F>89cm/M >115cm abdominal circumference)
-HDL-C <40mg/dL
-fasting triglycerides 150mg/dL and above
-elevated BP
-impaired fasting glucose or on hypoglycemia therapy

Question 10

Risk factors for stroke

Answer 10

Elevated BP
Diabetes 
Cardiac arrhythmias 
Low HDL-C
Cigarette smoking 
Family history 
Chronic kidney disease

Question 11

Risk factors of heart failure

Answer 11

Hypertension (VI)
Preceding MI
Increased B type natriuretic peptide levels
Increased albumin: creative ration

Question 12

Risk factors for PVD

Answer 12

Cigarette smoking 
Diabetes 
High cholesterol 
Hypertension 
Obesity (BMI>30m2) 
Family history 
Increased age (especially >50 years)
Similar to CHD

Question 13

Primary Preventions of risk factors of DM HOT Obesity Dyslipidaemia

Answer 13

Modification of risk factors

Prevention of clinical manifestations

Question 14

Secondary preventions

Answer 14

Already had a disease
Aggressive control of risk factors
Prevention of disease recurrence