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CVD > CVD > Flashcards

CVD Flashcards

1
Q

What are CVDs

A

Dx of heart and blood vessels and covers heart and entire CVS

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2
Q

CVDs comprise

A

CAD-MI and angina
HTN
Stroke
PVD(CV dx outside brain and heart)

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3
Q

What percentage of annual death contributed by CVD

A

Estimated 32%

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4
Q

The basis for most CVD are

A

Endothelial dysfunction
Atherosclerosis

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5
Q

Majority of CVD is caused due to

A

Atherosclerosis

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6
Q

Path of atherosclerosis

A

Fat streaks and inflammatory cells accumulate in vessel wall
Plaque become unstable over time and rupture
Thrombus forms which may occlude vessels

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7
Q

Ethnic/Races can be at higher risk of developing CVD

A

Afro-Caribbean
Asian
Black Race

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8
Q

Risk factors

A

Hypertension
Smoking
Dyslipidemia and Diabetes Mellitus
Inactive/Sedentary lifestyle
Overweight/Obese
Unhealthy eating
Excessive alcohol

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9
Q

Novel Risk factors

A

Homocysteine
Fibrinogen
Impaired fibrinolysis
Increased platelet reactivity
Hypercoagulability
Lipoprotein
Inflammatory-infectious markers
CRP

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10
Q

Definition of HTN

A

Office SBP >_ 140 and or DBP >_ 90 mmHg

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11
Q

BP association with CV risk is extend from low BPs such as

A

SBP > 115 mmHg

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12
Q

Hypertension complications

A

Stroke
MI
Heart Failure
Retinopathy
CKD

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13
Q

Epid in Ghana has shown that the factors that lead to HtN

A

Positive perception of obessity
More sedentary lifestyle
Excessive consumption of high calorie diets
Genetic disposition
High intake of salts

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14
Q

90-95% attibuted to Primary Hypertension

A

True

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15
Q

Strong and independent risk factors assoc with HtN development

A

Central obessity
Age
Family Hx

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16
Q

HTN normally clusters with CV risk factors like

A

Dyslipidemia
Glucose Intolerance

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17
Q

Which system estimates the 10yr risk of first fatal atherosclerotic event

A

SCORE(systemic coronary risk evaluation)

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18
Q

General principles in Hypertension diagnosis

A

Establish disease and grade
Screen for secondary causes
Identify contributing factors, concomitant risk factors and disease
Establish HMOD, early CVD or renal disease

19
Q

Very High risk pt using the SCORE have 10y score of greater than 10%

A

True

20
Q

10yr SCORE of >10% may have any of these

A

Clinical CVD
Unequivocal documented CVD on imaging
DM with End Organ Damage
Sever CKD(eGFR<30)

21
Q

High risk patients have a SCORE value of

A

5-10%

22
Q

High Risk SCORE pt may have

A

Hypertensive LVH
Moderate CKD(eGfR 30-59)
People with DM
Elevation of a single risk factor

23
Q

Moderate and Low Risk SCORE are what values

A

1-5%
<1%

24
Q

Management after established HtN include two well established strategies of BP lowering amongst the ff

A

Lifestyle interventions
Drug treatment
Device based therapy(not yet proven as effective)

25
Q

Reduction of SBP and DBP by 10 and 5 resp has what positive outcomes

A

Reduced major CV event by 20%
Reduced all cause mortality by 10-15%
Reduced stroke by 35%
Coronary events by 20%
Heart failure by 40%

26
Q

Five treatment classes proven to reduce BP

A

ACEIs
ARBs
Beta blockers
CCBs
Duiretics(Thiazides ans Thiazide-like)

27
Q

The treatment options were selected based on

A

Proven BP reduction
Proven reduction of CV events in Placebo controlled studies
Proven broad equivalence in CV mort/morbidity

28
Q

Benefits of ACEIs/ARBs

A

Reduce albuminuria

Delay progression of CKD

Prevent or regress HMOD(LVH,Small artery remodeling)

Indicated post-MI/HFrEF
Reduce LV associated AF

Metabolic neutrality
Anti-atherosclerotic

29
Q

Which treatment class has more stroke reducing benefits than Bp lowering

A

CCBs

30
Q

CCBs are more effective than ACEIs in HFrEF

A

False are less effective generally

31
Q

CCBs are more effective than ACEIs in HFrEF

A

False are less effective generally

32
Q

CCBs are more effective than BB in slowing HMOD like

A

Carotid atherosclerosis
LVH and proteinuria

33
Q

Chlrothalidome and Indapamide are proven to be better than HCTz in

A

Potency in BP reduction
Longer DOA
Lower dose to reduced CV events and mortality

34
Q

Which beta blockers are vasodilatory

A

Labetalol
Carvedilol
Celiprolol
Nebivolol

35
Q

Nebivolol has more favourable benefits on

A

Central BP
Aortic atiffnes
Endothelial dysfunction

36
Q

Classical BB have significant sexual dysfunction SEs except

A

Nebivolol

37
Q

There are level IA evidence on which lifestyle recommendations

A

Salt restriction to <5g per day

Alcohol restriction less than 14:8 units/wk m:w

Increased DASH(veggies, fish nuts not meat high fat etc)

Body wt control

Regular aerobic exercise

38
Q

Evidence class for smoking cessation contributions to Bp control is

A

IB

39
Q

Beta blockers are normally not first line in initial therapy of HtN but must be considered strongly for which specific conditions

A

HF
Angina
Post MI
A-Fib
Reproductive women

40
Q

In uncomplicated HtN initial therapy is with

A

ACEIs + CCB or diuretic(monotherapy is there’s low risk or pt >80yr)

41
Q

Initial therapy of HTN with CAD has what treatment option added

A

ACEIs/ARBs
BB or CCB

BB + Diuretic

CCB+ Diuretic or BB

42
Q

HTN with CKD benefits from treatment with medications for uncomplicated HtN which includes

A

ACEIs/ARBs
CCBs
Diuretics(may use loop diuretics)

Spirinolactone(25-50mg od)addendum in resistant HtN

43
Q

Which treatment option is not to be used in HTN with Hf

A

Non dipine CCBs

44
Q

What is the Bp goal for an over 60 yr old hypertensive

A

<150/90

CVD (2 decks)

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