Cardiovascular Risk

Question 1

What QRISK assessment measuring?

Answer 1

Ethnicity, treated HT, Social deprivation, BMI, Family history other conditions (DM, AF, CKF, RA)

Question 2

What does QRISK 3 also take into consideration?

Answer 2

CKD Stage 3
Migraine
CC
Atypical antipsychotics
Severe mental illness
ED

Question 3

What is a full formal risk assessment?

Answer 3

Use of QRISK3 to assess CV risk for primary prevention for ages 25-84
Use of QRIK3 to assess CV risk in type 2 DM for ages 25-84 yrs

Question 4

When wouldn’t you use QRISK?

Answer 4

Type 1 DM
eGFR <60mL/min
Risk of familial hypercholesterolemia
>78 yrs

Question 5

What lifestyle advice would you give before someone starts statins?

Answer 5

B/H changes
healthy eating
cardioprotective diet
Physical activity
Weight management
Alcohol consumption
Stop smoking

Question 6

What are the baseline assessments you should do before starting statins?

Answer 6

Smoking status
Alcohol consumption
BP
BMI
Lipid profile - Total cholesterol, non-HDL, Cholesterol, HDL & Triglycerides
Diabetes status
Renal Function
LFTs
TSH

Question 7

What is the primary prevention for ppl with type 2 DM?

Answer 7

If QRISK3 score >10% -> Atorvastatin 20mg OD
>78 yrs consider atorvastatin 20mg OD

Question 8

What is the primary prevention for ppl with type 1DM?

Answer 8

Consider Atorvastatin 20mg OD for all type 1 DM
Offer when:
- >40 yrs old
- DM > 10 yrs
- Established nephropathy

Question 9

What is the secondary prevention for ppls with / without Type 1/2 DM?

Answer 9

Atorvastatin 80mg OD
Lifestyle at the same time.

Question 10

What is the primary & secondary prevention for ppls with CKD?

Answer 10

Atorvastatin 20mg OD
- If target reduction not achieved & eGFR >30 then increase dose
- If eGFR <30 then agree on higher dose with renal specialist

Question 11

How much does taking statins reduce your risk that you already have?

Answer 11

40%

Question 12

What are the S/E of statins?

Answer 12

Statin related Muscle Toxicity (SRM):
- Symmetrical pain &/ or weakness
- Large paroximal exercise
- Worsened on exercise
- Evaluated on creatinine kinase
- Resolve with discontinuation

Question 13

What options are there if you become intolerant to statins?

Answer 13

• Take them of the stating then put them back on at a lower dose but same high intensity statin.
• Change statin - (Hydrophilic - rosuvastatin instead of lipophilic statin)
• Consider alternate day/twice weekly dosing
• Consider alternative - Ezetimibe, PCSK9i