Cardiovascular disease Flashcards
Define an atheroma
fatty deposit in an artery wall
Atherosclerosis affects
Medium and large arteries
Stiffening of artery walls causes
hypertension
What co-morbidities increase the risk of atherosclerosis
Diabetes, hypertension, CKD, inflammatory conditions
Non modifiable risk factors for atherosclerosis
Old age, male, family history
What drug class increases the risk of atherosclerosis
atypical antipsychotics
New NICE guidelines suggest that total fat should make up what percentage of total calories
less than 30
total fats should mainly be made up of
monounsaturated and polyunsaturated fats
saturated fat should make up what percentage of total calories
less than 7
according to NICE guidelines how many portions of fish should be eaten a week
2
according to NICE guidelines how many portions of legumes should be eaten a week
4
according to NICE guidelines how much moderate intensity exercise should be done a week
150 minutes
according to NICE guidelines how much vigorous exercise should be done a week
75
according to NICE guidelines strength training activities should be done
twice a week
What score is used to determine if a patient requires primary prevention for cardiovascular disease
QRISK3
What does the QRISK3 score estimate
percentage risk of stroke or MI in 10 years
QRISK3 above what percentage indicates a patient should be commenced on a statin
10
Initial statin for primary prevention
atorvastatin 20mg
What two patient groups should be started on primary prevention regardless of QRISK score
CKD, T1DM for over 10 years or age over 40
how do statins reduce cholesterol production
inhibit HMG CoA reductase
After a statin is introduced when should lipid levels be checked
after 3 months
When checking lipid levels after introduction of a statin what is the goal
greater than 40% reduction
When a statin is commenced LFTs should be checked
at 3 and 12 months
Statins should be stopped if ALT and AST rise
3 times the upper limit of normal
Significant side effects of statins q
Myopathy, rhabdomyolysis, T2DM, Haemorrhagic stroke
Which group of antibiotics interact with statins
Macrolides (clarithromycin and erythromycin)
How does Ezetimibe work
reduces absorption of cholesterol
evolocumab and alirocumab are examples of
PCSK9 inhibitors
PCSK9 inhibitors are given by
s/c injection every 2-4 weeks
4A’s of secondary prevention for cardiovascular disease
Antiplatelet
Atorvastatin
Atenolol
ACE inhibitor
Antiplatelet after MI
Aspirin indefinitely and clopidogrel for 12 months
Antiplatelet of choice post ischaemic stroke
clopidogrel
