CVD

Question 1

Most common global CVD causes of Death: MALES FEMALES RISK FACTORS

Answer 1

Males: IHD, stroke, COPD Females: Stroke, IHD, LRTIs RFs: HTN, tobacco, ^ cholesterol

Question 2

DEMOGRAPHIC TRANSITION MODEL STAGE 1 Consists of Why

Answer 2

^ birth rates ^death rates Population = stable Why? Limited contraception Poor healthcare *LECDSs

Question 3

DEMOGRAPHIC TRANSITION MODEL STAGE 2 consists of Why

Answer 3

Stable birth rate Decr death rate Pop growth = rapid Why? Improving healthcare * developing countries

Question 4

DEMOGRAPHIC TRANSITION MODEL STAGE 3 consists of Why

Answer 4

Decr BR Decr DR pop= slower growth Why? Access to contraception ^ education ^ LE

Question 5

DEMOGRAPHIC TRANSITION MODEL STAGE 4 consists of Why

Answer 5

Decr BR Decr DR pop=stable Why? ^focus on careers Smaller families MEDCs

Question 6

DEMOGRAPHIC TRANSITION MODEL STAGE 5 (population projection) consists of Why

Answer 6

Decr/- BR decr DR *ageing population

Question 7

Epidemiological Transition for CVD: Stage 1- Pestilence and Famine Description LE % deaths from CV Dominant CVDs

Answer 7

-malnutrition -infectious diseases LE:35yrs <10% deaths from CVD Dominant CVDs: Infectious (RHD) Nutritional

Question 8

Epidemiological Transition for CVD: Stage 2- Receding pandemics Description LE % deaths from CV Dominant CVDs

Answer 8

Improved nutrition and public health Chronic disease HTN LE:50yrs 10-35 % deaths from CVD Dominant CVDs: Infectious (RHD) Haemorrhagic stroke

Question 9

Epidemiological Transition for CVD: Stage 3 - degenerative and man-made diseases Description LE % deaths from CV

Answer 9

High fat and caloric intake Tobacco use Chronic diseases > infectious, malnutrition LE:>60yrs 35 -65% deaths from CVD Dominant CVDs: IHD Haemorrhagic stroke, ischaemic stroke

Question 10

Epidemiological Transition for CVD: Stage 4- delayed degenerative diseases Description LE % deaths from CV

Answer 10

Leading causes of mortality CV and cancer deaths Prevention and treatment delays onset LE:>70 yrs %deaths from CV: 40-50 Dominant CVDs: IHD, ischaemic stroke, CHF

Question 11

Primordial prevention strategies- CVDs

Answer 11

Focus on the reason for inequalities and social organisation

Question 12

Primary prevention strategies-CVD

Answer 12

Reducing the incidence amongst healthy population

Question 13

Secondary prevention strategies - CVDs

Answer 13

Screening for preclinical/early disease (prevents progression)

Question 14

Tertiary prevention strategies - CVDs

Answer 14

Treatment of established disease & prevention of complications

Question 15

WHOs Global Action Plan for NCD

Answer 15

• reducing population alcohol intake -reducing prevalence of insufficient physical activity -reducing population salt intake -reducing prevalence of tobacco use -halt rise in obesity and diabetes -

Question 16

CVD prevention strategies -

POPULATION strategies vs HIGH RISK strategies

Answer 16

Population strategies Reduce risk factors e.g. blood pressure in all + more permanent - at risk individuals may not gain benefit

-High risk strategies target those with risk factors (HTN/DM) + those affected +may reduce mortality of those already affected

Question 17

Drivers of CVD

Answer 17

-diet: processed/fatty food, fizzy soft drinks -inactivity: obesity, transport - cultural

Question 18

Drivers reducing CVD mortality

Answer 18

-antihypertensives -statins -MI & stroke treatment e.g. stenting & thrombolytics

Question 19

The nutrition transition : Populations eat more…. and not enough…. What must we do

Answer 19

Populations eat more: meat, fat, sugar, salt Not enough: fruit, veg, fibre, water We must reduce salt intake

Question 20

Strategies for reducing the populations salt intake: What strategies are most and least effective?

Answer 20

COMMUNICATION- public awareness campaigns REFORMULATION- setting targets, industry engagement/corporate responsibility, voluntary vs regulatory MONITORING- dietary surveys, urinary sodium, salt content of foods, attitudes & behaviours RESEARCH- nutrition, public health, policy Mandatory reformulation most effective, nutrition labelling lease effective