General Flashcards
CVD modifiable risk factors (8)
Diet Physical inactivity Smoking Dyslipidaemia Hypertension Obesity Thrombogenic factors Excessive drinking
CVD unmodifiable risk factors (4)
Personal CVD history
Family CVD history
Age
Gender
Risk factor modifications (7)
Lose weight Limit alcohol intake Increase physical activity Reduce salt intake Stop smoking Limit food intake rich in fats and cholesterol Anti platelet therapy
Clinical appearance of high cholesterol levels (4)
Xanthomata – Yellow deposit appearing around the body
Xanthelasmata – Yellow deposit below skin on eyelids
Corneal arcus senilis – Yellow ring around cornea
Milky blood/serum
What lipids are measured in practice (5)
Total cholesterol HDL cholesterol Triglycerides - Normal is <4.5mmg/L Total/HDL cholesterol ratio LDL cholesterol - Normal is >2mmol/L
Why is simvastatin prescribed
Good potency and evidence
Why is pravasatin prescribed
Good evidence and interactions
Why is atorvastatin prescribed
Good evidence and efficacy
Why is fluvastatin prescribed
Good safety - Weakest statin
Why is rosuvastatin prescribed
Good efficacy, interactions and evidence
Why are women dying of CVD more than men although with treatment improvements (6)
Knowledge gaps Trials under represented (<30%) Evidence-based CV medicine biased to men Publication bias False assumptions Lack of awareness
Reasons of worse CV outcomes in women (6)
Atypical and delayed presentation and diagnosis Lack of awareness of risk and symptoms Assessment bias Treatment bias Biological bias Higher procedural complication rate
Structural features of CAD in women (4)
Smaller size
Increased stiffness
More diffuse disease
In younger women more plaque erosion and less obstructive disease
Functional features of CAD in women (3)
Endothelial dysfunction
Smooth muscle dysfunction
Inflammation
Plague in women tends to be distributed or clumped?
Distributed causing subtle pressure drop where angiographic studies are misinterpreted
Emerging risk factors in women (6)
Preterm delivery Hypertensive disorders of pregnancy Gestational diabetes Autoimmune disease Early menopause Depression
Prevention of CVD in women (3)
Behavioural changes
Education to raise awareness on risk and symptoms
Importance of lifestyle choices on long term risk and outcomes
Pre-menopausal management of CVD risk (2)
Lifestyle - Metabolic syndrome
Pregnancy - Post partum referral if Gaucher’s disease or HBP
Post-menopausal management of CVD risk (5)
Exercise Lose weight/ avoid gain Optimise BP Lower cholesterol Manage depression/anxiety
