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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
What do statins do?
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
What interactions with statins are there?
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
What interactions with atorvastatin are there?
- 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
What is classed as high risk in the QRISK-2018 calculator?
Score >20% | 2 in 10 chance of CVD in next 10 years
29
What is classed as moderate risk in the QRISK-2018 calculator?
Score 10% - 20%
30
What is classed as low risk in the QRISK-2018 calculator?
Score <10%
31
What is the course of action taken if high or moderate risk?
- 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
What advice should be given to high or moderate risk patients?
- 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
Why is postcode taken into account in the QRISK-2018 calculator?
Provides a geographical measure of deprivation + socio-economic factors

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