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NHS Health Check - Vascular Disease Flashcards

1
Q

What are the aims of the service?

A
  • Targets 40 to 74 year olds to increase their awareness of their vascular risk and how to minimise it.
  • Improve health outcomes + quality of life
  • To prevent diabetes
  • To sustain increase in life expectancy
  • To reduce health inequalities
  • To improve convenience + accessibility
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2
Q

What are the most common vascular diseases?

A
  • Coronary heart disease
  • Stroke
  • Diabetes
  • Kidney disease
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3
Q

What are the signs of a stroke?

A 
FAST
Face - drooped on 1 side
Arms - not able to lift, weak/numb in 1
Speech - slurred, not able to talk at all
Time - call 999 immediately
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4
Q

What are the signs of a heart attack?

A 
Chest Pain - pressure, tightness
Pain in other parts of body
Feeling dizzy
Sweating
Shortness of breath
Feeling sick
Coughing/wheezing
Overwhelming sense of anxiety
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5
Q

What is a cardio-protective diet?

A
  • Total fat intake = <30% of total energy intake
  • Saturated fat = <10% of total energy intake
  • Dietary cholesterol = <300mg/daily
  • Saturated fats replaced by mono/polysaturated fats
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6
Q

What is the potential relationship between infection and vascular disease?

A

Poor oral health - endocarditis

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7
Q

List the 5 modifiable risk factors for vascular disease.

A
  1. Smoking
  2. Physical inactivity/sedentary lifestyle
  3. High BP
  4. Raised cholesterol levels
  5. Obesity
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8
Q

What is the difference between a fixed and a modifiable risk factor?

A

A fixed factor cannot be change whereas a modifiable one can.

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9
Q

List the 4 main fixed risk factors for vascular disease

A
  1. Age
  2. Gender
  3. Family history of vascular disease
  4. Ethnicity
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10
Q

What is the purpose of the QRISK3-2018 calculator?

A

To identify areas in which a patient is at highest risk and to identify the likelihood of a heart attack/stroke occurring in the next 10 years based on the data provided

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11
Q

How do I calculate BMI?

A

weight of a person (kg) / their height (m^2)

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12
Q

What is the ideal BMI range?

A

18.5-24.9 kg/m2

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13
Q

What other BMI measurements are there?

A 
<18.5 = underweight
>24.9 = overweight
>30 = obese grade 1
> 35 = obese grade 2
> 40 = morbidly obese grade 3
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14
Q

What is the ideal BP measurement?

A

90/60mmHg to 120/80 mmHg

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15
Q

What is low BP?

A

Less than 90/60mmHg

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16
Q

What is high BP?

A

More than 140/90 mmHg

17
Q

What is the normal total cholesterol measurement?

A

5.0mmol/L or less

18
Q

What is the normal LDL cholesterol measurement?

A

3.0mmol/L or less

19
Q

What is the normal HDL cholesterol measurement?

A

1.2mmol/L or more

20
Q

What is the normal TChol/HDL ratio?

A

4.5 or less

21
Q

What is the normal blood glucose measurement when FASTING?

A

4 to 6 mmol/L (72 to 108 mg/dL)

22
Q

What is the normal blood glucose measurement 2 HOURS AFTER EATING?

A

7.8 mmol/L (140 mg/dL)

23
Q

Who might be prescribed statins?

A

People with >10% risk of developing CVD in next 10 years

24
Q

What statins might be prescribed?

A

Atorvastatin 20mg ONCE DAILY

25
Q

What do statins do?

A

Inhibit 3-hydroxy-3-methylglutaryl co-enzyme A (HMG CoA) reductase, an enzyme involved in cholesterol synthesis.
This reduces LDL cholesterol levels by slowing production in the liver, increasing liver’s ability to remove the LDL.

26
Q

What interactions with statins are there?

A

LOTS

  • Cytochrome P450 enzyme inhibitors lead to increased conc. of statins = inc. risk of myopathy or rhabdomyolysis
  • Oral fusidic acid = fatal rhabdomyolysis (breakdown of damaged skeletal muscle)
27
Q

What interactions with atorvastatin are there?

A
  • Potent CYP3A4 inhibitors (ending with -in, -ol, -azole)
  • HIV protease inhibitors (-avir)
  • Ciclosporin, telaprevir, tipranavir with ritonavir, DO NOT EXCEED 10mg daily
  • Erythromycin + clarithromycin = Lower max dose of atorvastatin and monitoring
28
Q

What is classed as high risk in the QRISK-2018 calculator?

A

Score >20%

2 in 10 chance of CVD in next 10 years

29
Q

What is classed as moderate risk in the QRISK-2018 calculator?

A

Score 10% - 20%

30
Q

What is classed as low risk in the QRISK-2018 calculator?

A

Score <10%

31
Q

What is the course of action taken if high or moderate risk?

A
  • Treatment w medicines usually advised (statins for cholesterol or BP medicine)
  • Advice to tackle any lifestyle issues given
  • Signposting to relevant support
  • ALL HIGH RISK REFERRED TO GP FOR FURTHER INVESTIGATION
32
Q

What advice should be given to high or moderate risk patients?

A
  • Cardio-protective diet
  • Exercise 3 x 45/60 mins a week
  • Reduce alcohol consumption, spread over 3 days, no more than 14 units a week
  • 5 fruit + veg at least a day
33
Q

Why is postcode taken into account in the QRISK-2018 calculator?

A

Provides a geographical measure of deprivation + socio-economic factors

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