case 2 - clinicalriskfactors for IHD Flashcards
What are the three principal epicardial arteries?
Right Coronary Artery (RCA), Left Anterior Descending Artery (LAD), Circumflex artery (Cx)
What is the source of myocardial blood supply?
The myocardial blood supply arises from the aorta via coronary sinuses.
When does coronary blood flow occur?
Coronary blood flow occurs during cardiac diastole.
Define clinical risk factor
A risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury
How to deal with clinical risk factors of heart disease?
Predict disease onset
Be biologically plausible
what are the TYPES of clinical risk factors of IHD?
Types of risk factor
▪ Acquired behaviour (smoking)
▪ Inherited (familial hyperlipidaemia)
▪ Complex disorder (hypertension/type 2 diabetes mellitus)
▪Laboratory biomarker (hsCRP)
Traditional risk factors for IHD?
▪ Age
▪ Sex
▪ Smoking history
▪ Hypertension
▪ Hyperlipidaemia
▪ Metabolic syndrome and T2DM (type 2 diabetes mellitus)
name future challenges of smoking
Electronically vaporized nicotine (e-cigarettes)
Air quality and IHD risk - if you improve air quality, you’ll reduce the risk of IHD
chronic inflammatory disease: non-traditional risk factors for IHD?
Rheumatoid arthritis
Chronic obstructive
pulmonary disease (COPD)
What is considered Stage 2 high blood pressure?
A blood pressure of 140/90 is considered Stage 2 high blood pressure (hypertension).
What is considered Stage 1 high blood pressure?
A blood pressure of 130/80 is considered Stage 1 high blood pressure.
What is the relationship between arterial pressure and mortality?
The relationship is quantitative; the higher the arterial pressure, the worse the prognosis.
Stage 1 treatment of hypertension - Treat if < 80 years of age and if one or more of the following are
present:
If one or more of the following are present:
- Target organ damage
- Cardiovascular disease
- Renal disease
- Diabetes mellitus
- 10-year CVD risk > 20%.
what should you do with stage 2 or severe hypertension?
Treat
What effect does treatment with commonly-used regimens have on major cardiovascular events?
It reduces the risk of total major cardiovascular events.
How does blood pressure reduction relate to cardiovascular risk?
Larger reductions in blood pressure produce larger reductions in risk of CVD.
What is the effect of a 1 mmHg decrease in blood pressure on MI risk?
Every decrease in blood pressure by 1 mmHg decreases MI risk by 2 – 3 %.
regarding hypertension treatment, what should you give to patient who is aged under 55 years or has T2DM?
ACE inhibitor or low-cost angiotensin II
receptor blocker (ARB)1
regarding hypertension treatment, what should you give to patient who is Aged over 55 years or a black person of
African or Caribbean family origin of any
age?
Calcium-channel blocker (CCB)
regarding hypertension treatment, what should you give to a patient who has heart failure?
Thiazide-like diuretic
Each 1% reduction in HbA(1c) reduces the risk of the following, from the lowest decrease in % to highest decrease in %, is as follows:
MI - lowest decrease in risk
Risk of any end point related to diabetes (type 2)
Death related to diabetes (type 2)
Microvascular complications - highest decrease in risk
Each 10 mm Hg decrease in systolic blood pressure was associated with reductions in risk of:
any complication related to diabetes
deaths related to diabetes (type 2)
myocardial infarction
microvascular complications
