CVD risk

Question 1

Stages of HTN

Answer 1

Stage 1: clinic BP >/=140/90, ABPM/HBPM average >/= 135/85

Stage 2: clinic BP >/=160/100, ABPM/HBPM average >/= 150/95

Stage 3: clinic BP >/= 180/110

Question 2

When to use drug treatment in HTN

Answer 2

• IMMEDIATELY in severe HTN (no ABPM/HBPM)
• all stage 2
• stage 1 if: QRISK >20%, DM, or organ damage

Question 3

1st line HTN Mx

Answer 3

<55y or diabetic: ACEi (or ARB)

>55y or black: CCB (or thiazide-like diuretic)

Question 4

Which antihypertensives should be avoided in heart failure?

Answer 4

CCB

Question 5

Examples of thiazide-like diuretics

Answer 5

• indapamide

- chortalidone

Question 6

Examples of ARBs

Answer 6

• candesartan

- losartan

Question 7

Who should have statins?

Answer 7

• QRISK >/=10%
• CKD
• DM

Question 8

1st line statin

Answer 8

atorvastatin 20mg

Question 9

When should statins be stopped?

Answer 9

CK >5x normal

LFTs (transaminases) >3x normal

Question 10

Monitoring on statins

Answer 10

• LFTs before, at 3 months, and at 12 months

- CK if myalgia

Question 11

Pharmacological secondary prevention of MI

Answer 11

1. ACEi once haemodynamically stable
2. dual antiplatelet therapy for 12m (aspirin + clopidogrel/ticagrelor), then 75mg aspirin indefinitely
3. beta blocker once haemodynamically stable for 12m, or indefinitely if LV systolic dysfunction
4. atorvastatin 80mg