Cardiovascular disease

Question 1

Describe the primary prevention of cardiovascular disease

Answer 1

Starting a statin in a person with a QRISK3 score of 10% or greater

Question 2

What is QRISK3?

Answer 2

QRISK3 estimates the risk of a person having a stroke or myocardial infarction in the next 10 years

Question 3

Describe the secondary prevention of cardiovascular disease

Answer 3

The 4 A’s:

• Aspirin
• Atorvastatin
• Atenolol (or another beta blocker)
• ACE inhibitor, e.g. ramipril

Question 4

What are the risk factors for developing cardiovascular disease? How can these be classified?

Answer 4

Non-modifiable:

• Older age
• Family history
• Male

Modifiable:

• Obesity
• Smoking

Question 5

Which other medical conditions increase the risk of cardiovascular disease?

Answer 5

• Diabetes
• Hypertension
• CKD

Question 6

You are starting a statin in a patient with a QRISK3 score of 15%.. Current NICE guidelines suggest starting which drug? At what dose?

Answer 6

Atorvastatin 20 mg

Question 7

Give 2 side effects of statins

Answer 7

• Mild transaminitis (statin does not need to be stopped if rise in AST and/or ALT is less than 3x upper limit of normal)
• Myopathy