Public Health (Cardiovascular) Flashcards
Is incidence of coronary heart disease increasing or decreasing?
Decreasing.
What is thought to be the biggest reason for the decline in CHD?
Decline in smoking rates
Has CHD decreased more in more deprived areas or less deprived areas?
Less deprived areas.
Define primary, secondary and tertiary prevention in managing CVD risk factors?
Primary: reduce incidence in popn.
Secondary: detection and treatment of pre-symptomatic disease.
Tertiary: reducing incidence/recurrences of chronic incapacity among those with symptomatic disease.
What is the difference between systematic reviews and guidelines?
Systematic reviews: all trials on a specific treatment.
Guidelines: review large body of evidence, synthesis evidence with clinical experience.
How are the guidelines produced?
A group of experts look at systematic reviews, primary papers and their own clinical experience. They come up with a consensus on management.
What are risk scores useful in?
Assessing or estimating risk and in prioritising treatment on an equitable basis.
What individuals are given higher priority clinically in prevention of CVD and why?
High risk individuals, they have the most to gain from risk factor modification.
When should asymptomatic individuals be considered high risk for CVD?
If they are assessed as having 20% or higher risk of a first cardiovascular event within ten years.
Is antiplatelet therapy recommended for primary prevention?
No.
Give some examples of place-based population interventions.
Planning, licensing, marketing, active transport (no idea what she means by this), health workplace, schools etc.
Give some examples of national action and population interventions.
Political, legislative, commercial, partnership.
What is the best way to reduce healthcare inequlities?
Policy.
Give 2 examples of initiatives to help increase healthy eating?
- Healthyliving award. 2. Community food and health Scotland.
What report is designed to advise policy makers on physical activity?
Start active, stay active.
What document tells pregnant women how they can exercise?
The physical activity for pregnancy document.
Why is alcohol buying from off-trade worse than on-trade?
It is cheaper and people can drink at home unsupervised.
What are the most effective strategies for decreasing alcohol consumption?
Targeting marketing, availability and affordability.
Why are there challenges in determining the effect of a public health intervention?
It is difficult to design studies which evaluate entire cities/regions/countries, there are unreasonable expectations about speed of change, behaviour change is often erratic or slow, impact of upstream influences e.g. policy.
Give 2 examples of secondary prevention of CVD?
NHS diabetic eye screening programme and NHS abdominal aortic aneurysm screening.
How often can diabetics get their eyes screened on the NHS?
Yearly for people with diabetes aged 12 or over.
At what age are men screened for an abdominal aortic aneurysm?
65.
What are the sizes of small, medium and large AAAs?
Small: 3-4.4cm. Medium: 4.5-5.4cm. Large: >5.5.
What are the treatment plans for the different sizes of AAAs?
Small: repeat scan yearly. Medium: repeat scan every 3 months. Large: referral to vascular surgery to discuss options.
Why are men given lots of information before deciding whether to get screened for an AAA or not?
The surgery contains risks.
What tertiary prevention is there for CVD?
Specialist commissioning of tertiary care services (equality of access across Scotland).
