Lecture 18: Introduction to cardiovascular disease Flashcards

1
Q

how do we classify CVD?

A

classify CVD using International Classification of disease 11th revision

large variety of disease in the circulatory system which contributes to CVD

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2
Q

what are the most globally prevalent CVDs?

A

ischaemic heart disease/coronary heart disease (lack of oxygen in heart)

cerebrovascular disease (stroke) - lack of blood supply in parts of the brain

Hypertension - high blood pressure

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3
Q

what are other important heart conditions?

A
  • rheumatic heart disease, other heart valve disorders
  • cardiomyopathy
  • abdominal aortic aneurysm
  • heart failure
  • congenital heart disease
  • peripheral vascular disease
  • venous thromboembolism
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4
Q

what are the definitions of risk factors? which one is used in public health?

A
  1. an aspect of personal behaviour or lifestyle, an environmental exposure, or an inborn or inherited characteristic that, on the basis of scientific evidence, is known the be associated with meaningful health-related conditions (implies there is an association, not cause)
  2. an attribute or exposure that is associated with an increased probabiity of a specified outcome such as the occurence of a disease. not necessarily a causal factor: may be a risk marker (might mean a higher risk of heart disease, but not a cause of heart attack)
  3. a determinant that can be modified by intervention, therby reducing the probability of occurence of disease or other outcomes. it may be reffered to as a modifiable risk factor and logically must be a cause of the disease. (use this definition in the course)
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5
Q

what are the non-modifiable risk factors for cardiovascular disease?

A
  • age
  • sex
  • family history premature CVD
  • personal history of CVD
  • atrial fibrillation/conduction disorders
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6
Q

what are the modifiable risk factors in primary care?

A
  • smoking
  • elevated blood pressure
  • diabetes
  • metabolic syndrome/impaired CHO metabolism/insulin resistance
  • dyslipidaemia
  • obesity
  • physical activity (sedentary behaviour)
  • poor diet
  • inflammation
  • gender?????
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7
Q

what are the modifiable risk factors of CVD in public health?

A
  • smoking
  • elevated blood pressure
  • diabetes
  • metabolic syndrome/impaired CHO metabolism/insulin resistance
  • dyslipidaemia
  • obesity
  • physical activity (sedentary behaviour)
  • poor diet
  • inflammation
  • gender?????
  • low socioeconomic status - especially in childhood
  • depression, social isolation and lack of social support
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8
Q

what is atherosclerosis?

A
  • happens in arteries and primary pathological events that happens in CVD, build up of fatty depositions in the inner walls
  • risk factors: cholesterol, BP, inflammation combine to form atherosclerosis
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9
Q

what is IHD, CHD, CAD and what can it lead to?

A

ischaemic heart disease, coronary heart disease and coronary artery disease

atherosclerosis in the vessel wall lead to narrowing of BV and reduces nutrients being delivered to heart wall

  • can lead to angine (chest pain) and acute heart attack (myocardial infarction)
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10
Q

what are the 2 types of cerebrovascular disease/stroke?

A
  • ischaemic (blockage of blood vessels)
  • haemorrhagic (rupture of blood vessels)
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11
Q

what is elevated blood pressure?

A
  • increase pressure in arteries

Hypertension
Systolic, diastolic blood pressure (mmHg)

important risk factor but can lead to direct problems

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12
Q

what is systolic and diastolic BP?

A

systolic
- occurs when the ventricles contract to pump blood into the circulatory system

diastolic
- occurs when the ventricles relex and the heart refills with blood before the next contraction

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13
Q

what is congenital heart disease?

A

many different types
e.g. abnormailities of valves, heart muscle, septum (atrial/ventricular), arrangement of major blood vessels

  • important for child health
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14
Q

what is rheumatic heart disease?

A

Rheumatic fever - autoimmune reaction to throat infection

Rheumatic heart disease - repeated episodes of RF affects heart valves

High gradient of deprivation (e.g. Maori, Pacific, Indigenous australians)

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15
Q

what is heart failure?

A

heart not pumping well

  • but is NOT a heart attack

May be due to:

  • ischaemic heart disease
  • hypertension
  • cardiomyopathy
  • heart valve abnormalities
  • diabetes
  • excess alcohol
  • viral infection of heart
  • thyroid disease
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16
Q

what is abdominal aortic aneurysm? AAA

A

Hearts pumps high pressure blood through thoracic aorta then to abdominal aorta, if there is weakness in wall, you can get ballooning of aorta in thorax or abdomen.

Walls become thinner and becomes larger but weaker

Clot collects in these areas

Can rupture and all the blood goes to the abdomen and you can die from it very quickly unless you get it surgically repaired.

17
Q

what is peripheral vascular disease?

A

Atheroscleroisis In the legs - top or leg or further down. Impairs blood flow to feet, end up ischaemia in the legs. Less oxygen and nutrients in feet. Left untreated can require amputation.

Smoking is important for this one.

18
Q

what is an arrythmia?

A

irregular heart beat.

  • affects blood pressure and ability to pump blood around
  • ventricular arrythmias are common after myocardial infarction and need to be treated with defibrilator
  • higher rates in maori and pacific
19
Q

what is a venous thrombeomolism?

A

veins are not as muscular as arteries and are more flexible.

can have a deep vein thrombosis in legs which can break off and travel to lungs and cause a pulmonary embolism.

20
Q

what are the non-modifiable and modifiable risk factors for venous thromboembolism?

A

non-modifable:
- inheritied clotting problems (thrombophilias)

modilable (partly modifiable):

  • obesity
  • surgery
  • pregnancy
  • cancer
  • injury
  • immobility
  • long-distance air travel
  • oral contraceptives
  • hormone therapy
  • antipsychotics
  • other drugs
21
Q

what preventions are best use for CVD?

A

primary and secondary preventions

22
Q

which health determinants should be focused on to prevent CVD?

A
  • individual lifestyle factors (age, sex etc)
  • social and community networks
  • general socioeconomic, cultural and environmental conditions (education, work environment, water and sanitation, health care, housing etc)