Inequalities in Cardiovascular Disease

Question 1

What is the relationship between income inequality and index of health and social problems?

Answer 1

Income inequality is positively correlated with index of health and social problems.

Question 2

List the 3 most common causes of death among men in the UK.

Answer 2

1 - Cancer.

2 - Coronary artery disease.

3 - Respiratory diseases.

Question 3

List the 3 most common causes of death among women in the UK.

Answer 3

1 - Cancer.

2 - Respiratory diseases.

3 - Coronary artery disease.

Question 4

List 4 behavioural risk factors for cardiovascular disease.

Answer 4

1 - Poor diet.

2 - Physical inactivity.

3 - Tobacco use.

4 - Alcohol consumption.

Question 5

List 5 non-controllable risk factors for cardiovascular disease.

Answer 5

1 - Age.

2 - Family history.

3 - Postmenopause.

4 - Race (e.g. Pakistani, Irish, Caribbean).

5 - Diabetes.

Question 6

List 8 dimensions of inequalities.

Answer 6

1 - Geography.

2 - Age.

3 - Gender.

4 - Socioeconomic status.

5 - Ethnicity.

6 - Religion.

7 - Disability.

8 - Sexual orientation.

Question 7

List 2 biological measures of cardiovascular disease risk.

Answer 7

1 - Blood pressure.

2 - Plasma cholesterol.

Question 8

Define population attributable risk.

What is it used for?

Answer 8

• The proportion of the incidence of a disease in the population (exposed and unexposed to risk factors) that is due to exposure.
• Used to quantify the contribution of a risk factor to a disease.

Question 9

What is Interheart?

Answer 9

• A case control study of potentially modifiable risk factors for acute myocardial infarction across 52 countries.
• The primary outcome is to determine population attributable risk.

Question 10

What were the outcomes of Interheart?

Answer 10

9 factors account for >90% of the risk for 1st myocardial infarction:

1 - Smoking.

2 - Lack of fruit & veg.

3 - Physical inactivity.

4 - Alcohol consumption.

5 - Hypertension.

6 - Diabetes.

7 - Abdominal obesity.

8 - Psychosocial factors.

9 - Lipid intake.

Question 11

What is the British Regional Heart Study?

Answer 11

• A prospective study of wider outcomes of diagnosed cardiovascular disease.
• The focus was on blood cholesterol, blood pressure and smoking.

Question 12

What is Interstroke?

Answer 12

A case control study of risk factors for stroke across 22 countries.

Question 13

What were the outcomes of Interstroke?

Answer 13

10 risk factors contribute to stroke, including:

1 - Hypertension.

2 - Smoking.

3 - Waist:hip ratio.

4 - Diet.

5 - Physical inactivity.

6 - Diabetes.

7 - Alcohol consumption.

8 - Psychosocial factors.

9 - Depression.

10 - Apolipoproteins.

Question 14

What is NICE’s public health guideline 25 concerning the treatment of cardiovascular disease?

Answer 14

There should be a shift towards taking population approaches to cardiovascular disease prevention rather than individual approaches.

Question 15

List 10 ways, according to NICE, in which cardiovascular disease can be treated on a population level.

Answer 15

1 - Reduce population consumption of salt.

2 - Reduce population consumption of saturated fats.

3 - Reduce population consumption of trans fats.

4 - Marketing and promotion to children.

5 - Transparency in commercial deals.

6 - Product labelling.

7 - Health impact assessments.

8 - Common agricultural policies.

9 - Physically active travel.

10 - Public sector catering guidance.

Question 16

List the factors that are assessed in a cardiovascular risk assessment.

Answer 16

1 - Age.

2 - Gender.

3 - Smoking status.

4 - Physical activity.

Question 17

What is the difference between a population-wide approach and a community-level approach?

Answer 17

• A population-wide approach aims to change the risks from the social, economic, material and environmental factors that affect an entire population.
• A community-level approach targets groups of people who are at high risk of a disease.

Question 18

How do population-wide approaches differ from community-level approaches in how they achieve their aims?

Answer 18

• Population-wide approaches achieve their aims through regulation, legislation, subsidy and taxation.
• Community-level approaches achieve their aims through changing health behaviours.