Epidemiology of CV disease Flashcards

1
Q

What are the first and second leading causes of death in females worldwide?

A
  • 1st: stroke
  • 2nd: ishaemic heart disease
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2
Q

What are the first and second leading causes of death in males worldwide?

A
  • 1st: ischamic heart disease
  • 2nd: stroke
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3
Q

Describe the worldwide distribution of age at death

A

Lower and middle income countries: more deaths in children (0-14 years) and adults (15-69 years) than in high income countries where the majority of deaths occur in those aged 70 and above.

Life expectancy increases with increasing economic affluence.

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4
Q

Which is the largest risk factor for death worldwide?

A

Hypertension

Is the highest risk factor for cardiovascular disease which is the leading cause of death worldwide.

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5
Q

What are the 4 highest risk factors for death worldwide?

A
  • Hypertension
  • Obesity
  • High blood glucose
  • High cholesterol
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6
Q

What are the 2 leading causes of disability in developed countries?

A
  1. Tobacco use
  2. Hypertension
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7
Q

What are the 2 leading causes of disability in developing countries?

A
  1. Alcohol consumption
  2. Hypertension
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8
Q

Describe the demographic transition

A

As countries go through the demographic transition, death rates decline along with birth rates.

Population growth slows

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9
Q

Describe the epidemiological transition of CVD

A

As levels of affluence, acculturation and urbanisation increase:

  • increase in CV disease across the stages of demographic transition

HTN rises first due to society with low smoking, moderate fat and salt intake.

Atherosclerosis rises second due to a society with moderate smoking, fat and salt intake.

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10
Q

Describe primordial prevention of disease

A

Focuses on the causes of unequal distribution of health damaging exposures, susceptibilities and health protective resources.

Focuses on social organisation and prevents the appearance of the mediating risk factor in the population.

Addresses why socioeconomic position is related to health

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11
Q

Describe primary disease prevention

Give an example in the context of CVD

A

Reduction of incidence of disease by:

  • Removing primary causative agent
  • Interrupting transmission of an infective agent
  • Protection from environmental hazards
  • Improving host resistance

E.g. Reduction in population salt intake

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12
Q

Describe secondary disease prevention

A
  • Early detection of pre-clinical case (screening)
  • Treatment to prevent progression or recurrence
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13
Q

Describe tertiary disease prevention

A

Treatment of established disease to prevent complications and/or relieve distress.

E.g. palliative care

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14
Q

What is a population strategy in reducing disease?

A

It aims to reduce the risk factors of a particular disease across a whole population, in the knowledge that a small reduction in the risk factor will reduce the risk in everyone across the distribution of the risk factor.

By the implementation of this strategy the proportion of people in the upper end of the distribution (eg. Diseased) will also be reduced, hence reducing both the incidence and the prevalence of the condition.

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15
Q

What is a ‘high risk’ strategy in reducing disease?

A

Treating those with a defined disease status (e.g. diabetes, HTN) to prevent the development of CVD. It will have a small impact on the burden of CVD as these people are not many in the population.

This strategy does not reduce ‘incidence’ of the disease as it does not address the causes but deals with the consequences and manifestations

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16
Q

What are the advantages and disadvantages of the ‘population’ strategy?

A

Advantages:

  • Attempts to control the determinants of incidence rather than cases
  • Population based
  • More radical
  • More permanent

Disadvantages:

  • More expensive?
17
Q

What are the advantages and disadvantages of a ‘high risk’ strategy?

A

Advantages:

  • Extension of traditional clinical approach

Disadvantages:

  • It does not produce lasting population changes
  • It needs to be repeated from generation to generation
18
Q

What are the 3 connections to CVD?

A
  • Dietary intake
    • Shift from simple to processed foods
    • Rise of fat production and consumption
    • Rise in soft drink consumption
  • Physical activity (inactivity)
    • Increase in car ownership
    • Increased rates of obesity
  • Culture
    • Supermarketisation
    • Lifestyle
    • Advertising