CHD - risk factors and rehab Flashcards
what are the 6 core components of the BACPR cardiovascular disease prevention program
- health behaviour change and education
- lifestyle/risk factor modification
- psychosocial health
- medical risk management
- long-term strategies
- audit and evaluation
modifiable risk factors for CHD (9)
biomedical - diabetes, high cholesterol, hypertension;
lifestyle - smoking, sedentary lifestyle, obesity, alcohol, stress, diet
non modifiable risk factors for CHD (4)
age; gender; ethnicity; family history
family history risk factor for CHD
↑risk if: first deg female relative <65yro, first deg male relative, familial hypercholesterolemia
epidemiology of CHD
higher prevalence in SE Asians, low incidence in japan, there are regional differences within a country itself; risk increases with age
what is used to calculates the risk of CHD + what are the categories (10)
QRISK3 CVD score - based on framingham factors
ethnicity; FH; deprevation; blood pressure; mental health; erectile dysfucntion; BMI; rheumatoid arthritis; CKD; AF
what are framingham factors
calculates risk of CVD over 10 years: age, gender, total cholesterol, high density lipoprotein cholesterol , smoking habits, and systolic blood pressure
what is the secondary prevention for CVD (7)
antiplatelets; B-blockers; statins; ACE inhibitors; lifestyle modification; psychosocial factors; cardiac rehabilitation
target systolic BP
130 if tolerates (140 if >70 and 120 if young)
what should be recommended for lifestyle change to reduce CVD risk
weight loss; Mediterranean diet; reduced salt in take; physical exercise; moderate alcohol
HDLs vs LDLs
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
first line therapy for CVD + T2DM
statins
what is dysglycaemia
abnormalities in blood glucose levels; including hyperglycaemia, hypoglycaemia, impaired glucose tolerance test
what management will improve the lipid profile/glucose metabolism
diet + aerobic exercise + resistance training
what is the first line therapy for diabetes/dysglycaemia
metformin - less likley to cause hypoglycaemic episodes
what is lifestyle management mostly based on (2)
behaviour change and education
effect of smoking on mortality/morbidity
doubles risk of morbidity/mortality; risk is related to the amount + duration smoked
effect of nicotine on the CVS
increase BP and HR; so vaping/nicotine patches still bad
effect of sedentary lifestyle on CVD death
contributes to 37% of CVD
benefits of physical activity
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
obesity comorbidities
raised BP; raised LDL/triglycerides; low HCL; impaired glucose tolerance; increased insulin resistance
effect of depression on CVD
15-20% of pts have depression post MI; 4x increased risk of mortality post MI; psychiatric medications may increase risk of CHD;
what is cardiac rehabilitation and what is it designed to do
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.
driving rules after coronary bypass
can’t drive a car for 1 month; can’t drive a lorry for 3 months
driving rules post angioplasty (due to MI)
can resume driving after 1 week
driving rules post MI w no/unsuccessful angioplasty
can resume driving after 4 weeks
