Epidemiology of CHD

Question 1

Define public health.

Answer 1

The science and art of preventing disease, prolonging life, and promoting health through the organised efforts of society

Question 2

What elements are included in individual determinants?

Answer 2

Gender
Beliefs
Motivation
Age
Skills

Question 3

What elements are included in social environment?

Answer 3

Social cohesion
Culture
Income
Equity
Social support

Question 4

What elements are included in built environment?

Answer 4

Urban design
Green space
Transport
Land-use patterns

Question 5

What elements are included in natural environment?

Answer 5

Air
Water
Weather
Topography

Question 6

What is at the centre of the roots of CHD?

Answer 6

Physical activity and active living

Question 7

What type of study describes the health status of a population?

Answer 7

Descriptive study (time, place and person)

Question 8

What type of study understands the natural history of a condition?

Answer 8

Longitudinal study

Question 9

What type of study identifies the causes of medical problems?

Answer 9

Observational study

Question 10

How can evaluation and action on medical and health promoting interventions be undertaken?

Answer 10

Monitoring through routine data and observational studies

Intervention through experimental studies

Question 11

What are the 3 steps to ‘achieving the correct diagnosis’?

Answer 11

Define numerator (clinical condition) and denominator (who makes up at risk population)
Dig out good sources of information
Describe what the data shows and interpret

Question 12

What are some examples of good and reliable sources of data?

Answer 12

scotpho. org
isdscotland. org
bhf. org

Question 13

What are the 6 stages of a disease, starting with onset and ending in outcome?

Answer 13

Onset
Symptoms
Seek care
Diagnosis
Treatment
Outcome
   ---> cure
   ---> control
   ---> disability

Question 14

The Framingham Study definition of ‘risk factor’ can be split up into 4 aspects and based on 2 pieces of evidence. Define it.

Answer 14

Aspect of ...
• personal behaviour
• lifestyle
• environmental exposure
• genetic trait,
Which on the basis of epidemiological evidence...
• is associated with a health-related condition
• considered important to prevention

Question 15

What does ‘pathogenic’ mean?

Answer 15

Linked to disease state

Question 16

What does salutogenic mean?

Answer 16

Linked to health

Question 17

What does ‘interactive’ mean?

Answer 17

Two factors that together increase risk

Question 18

What are the 3 different types of risk factor?

Answer 18

Marker of risk (associates, not causal)
Causal risk factor (associated and causal)
Modifiable risk factor (causal but can be modified by intervention)

Question 19

What was the objective of the Framingham Heart Cohort Study?

Answer 19

To identify the common factors or characteristics that contribute to CVD by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke

Question 20

What were the key risk factors for CHD as shown by Framingham study?

Answer 20

High systolic BP

High total to high density cholesterol ratio

Question 21

How can performance monitoring be carried out?

Answer 21

Quality Outcomes Framework data
Data from smoking cessation services
Lifestyle surveys
Data about the outcomes for individual clinicians

Question 22

What should performance monitoring target?

Answer 22

Prevention
Treatment
Rehabilitation

Structure
Process
Outcome

Question 23

“….. potentially modifiable risk factors account for ……% of acute MI”

Answer 23

9

90

Question 24

What are these 9 potentially modifiable risk factors?

Answer 24

Smoking
Hypertension
Lipids
Abdominal obesity
Diabetes
Fruit & Veg intake
Alcohol
Exercise
Psychosocial

Question 25

What are the 4 approaches to CVD epidemiology?

Answer 25

Describe
Understand
Identify causes
Evaluate medical and health promoting interventions