cardiovascular disease Flashcards
when is CVS preventative treatment initiated?
- elevated QRISK2 score
- particularly high risk factor
- presence of certain other risk factors e.g. diabetes
- target organ damage
pharmacotherapy for stopping smoking
- Nicotine replacement (patches, gums, sprays- can use combos)
- Bupropion: 8 week course stop smoking 1-2weeks into course- use with NRT
- Varenicline- reduces craving and reward with smoking but more side effects
NICE definition of hypertension
Stage 1- clinic BP >140/90 and home >135/85
Stage 2: clinic >160/100 and home >150/95
severe hypertension >180/110
what lifestyle advice is given
stop smoking- cessation service
increase exercise >150 mins moderate intensity of >75 mins high intensity & muscle strengthening exercise >2/7
reduce salt intake <6g/day
reduce alcohol intake <21 units for men and <14 for women
when should drug treatment be started for hypertension
immediately is bp >180/110
all stage 2 hypertension
stage 1 hypertension if elevated QRISK
see notes for which drugs
what are secondary causes of dyslipidaemia
- excess alcohol
- uncontrolled diabetes
- hypothyroidism
- liver disease
- nephrotic syndrome
when do you consider specialist assessment for dyslipidaemia
total cholesterol >7.5 and FH of prem disease
total cholesterol >9
triglycerides >10
triglycerides >4.5 and cholesterol >7.5
when is primary prevention of cholesterol considered
10 year CVS risk 10%
diabetes
chronic kidney disease
side effects of statin
GI upset- if felt to be that cause consider lower dose or milder statin (Simva)
myopathy
abnormal liver function
secondary prevention after MI
- Aspirin 75mg- lifelong
- ace inhibitors-
- beta blocker- lifelong if LVF otherwise 12m
- statin- atorvastatin 80mg
safe to drive after MI?
Not recommended for 4 weeks (6 weeks in bus/lorry drivers)
