CHD - risk factors and rehab

Question 1

what are the 6 core components of the BACPR cardiovascular disease prevention program

Answer 1

1. health behaviour change and education
2. lifestyle/risk factor modification
3. psychosocial health
4. medical risk management
5. long-term strategies
6. audit and evaluation

Question 2

modifiable risk factors for CHD (9)

Answer 2

biomedical - diabetes, high cholesterol, hypertension;
lifestyle - smoking, sedentary lifestyle, obesity, alcohol, stress, diet

Question 3

non modifiable risk factors for CHD (4)

Answer 3

age; gender; ethnicity; family history

Question 4

family history risk factor for CHD

Answer 4

↑risk if: first deg female relative <65yro, first deg male relative, familial hypercholesterolemia

Question 5

epidemiology of CHD

Answer 5

higher prevalence in SE Asians, low incidence in japan, there are regional differences within a country itself; risk increases with age

Question 6

what is used to calculates the risk of CHD + what are the categories (10)

Answer 6

QRISK3 CVD score - based on framingham factors
ethnicity; FH; deprevation; blood pressure; mental health; erectile dysfucntion; BMI; rheumatoid arthritis; CKD; AF

Question 7

what are framingham factors

Answer 7

calculates risk of CVD over 10 years: age, gender, total cholesterol, high density lipoprotein cholesterol , smoking habits, and systolic blood pressure

Question 8

what is the secondary prevention for CVD (7)

Answer 8

antiplatelets; B-blockers; statins; ACE inhibitors; lifestyle modification; psychosocial factors; cardiac rehabilitation

Question 9

target systolic BP

Answer 9

130 if tolerates (140 if >70 and 120 if young)

Question 10

what should be recommended for lifestyle change to reduce CVD risk

Answer 10

weight loss; Mediterranean diet; reduced salt in take; physical exercise; moderate alcohol

Question 11

HDLs vs LDLs

Answer 11

HDL - carry cholesterol away from the arteries, towards the liver to be excreted;
LDL - build up in the walls of arteries to form thick, hard deposits that make them less flexible, stored as triglycerides

Question 12

first line therapy for CVD + T2DM

Answer 12

statins

Question 13

what is dysglycaemia

Answer 13

abnormalities in blood glucose levels; including hyperglycaemia, hypoglycaemia, impaired glucose tolerance test

Question 14

what management will improve the lipid profile/glucose metabolism

Answer 14

diet + aerobic exercise + resistance training

Question 15

what is the first line therapy for diabetes/dysglycaemia

Answer 15

metformin - less likley to cause hypoglycaemic episodes

Question 16

what is lifestyle management mostly based on (2)

Answer 16

behaviour change and education

Question 17

effect of smoking on mortality/morbidity

Answer 17

doubles risk of morbidity/mortality; risk is related to the amount + duration smoked

Question 18

effect of nicotine on the CVS

Answer 18

increase BP and HR; so vaping/nicotine patches still bad

Question 19

effect of sedentary lifestyle on CVD death

Answer 19

contributes to 37% of CVD

Question 20

benefits of physical activity

Answer 20

dose-dependent relationship to health; all physical activity has a direct response on CVD; using >1500 calories a week has a direct effect on CVD mortality

Question 21

obesity comorbidities

Answer 21

raised BP; raised LDL/triglycerides; low HCL; impaired glucose tolerance; increased insulin resistance

Question 22

effect of depression on CVD

Answer 22

15-20% of pts have depression post MI; 4x increased risk of mortality post MI; psychiatric medications may increase risk of CHD;

Question 23

what is cardiac rehabilitation and what is it designed to do

Answer 23

comprehensive long-term programs that involve education, prescribed exercise; risk factor modification; counselling etc.; aims to limit the psychological and physiological effects of CVD, control symptoms, reduce the risk of sudden death etc.

Question 24

driving rules after coronary bypass

Answer 24

can’t drive a car for 1 month; can’t drive a lorry for 3 months

Question 25

driving rules post angioplasty (due to MI)

Answer 25

can resume driving after 1 week

Question 26

driving rules post MI w no/unsuccessful angioplasty

Answer 26

can resume driving after 4 weeks