Risk factors for Coronary Heart Disease Flashcards
What is meant by Primary and Secondary prevention or Coronary Heart Disease?
Primary - Aims to reduce incidence of coronary heart disease by identifying high-risk groups and effective ways of lowering risk
Secondary - Aims to halt or retard progression of the disease in those already with CHD.
What is a independent risk factor?
Risk factor for CHD that occurs without the presence of other risk factors.
What are the 5 independent risk factors for CHD?
Smoking Hyperlipidemia Obesity Hypertension Inactivity
What are the 4 Non-modifiable risk factors of CHD?
1) Age (Increase with age)
2) Gender (Men until post-menopause)
3) Family history (First-degree relative)
4) Ethnic origin (Bangladeshi/Pakistani)
What are the 9 Modifiable risk factors of CHD?
1) Smoking
2) Hyperlipidemia
3) Hypertension
4) Inactivity
5) Obesity
6) T2DM
7) Fibrinogen levels
8) Alcohol
9) Psychological factors
What are the 3 acute/immediate effects of smoking that damage the coronary vessels?
1) Increased heart rate and blood pressure
2) Vasospasm of coronary arteries
3) Reduction in the oxygen-carrying capacity of the blood
What are the 4 chronic/long term effects of smoking that can lead to CHD? What is the overall effect of this?
1) Reduced HDL
2) Damage lining of coronary arteries
3) Increase platelet stickiness and therefore thrombus formation
4) Loss of oestrogen with menopause occurring 2-3 years earlier
Smokers have 2-3x increased risk of developing CHD than non-smokers
How much does cessation of smoking reduce the risk of premature death or further MI?
50%
How does increased blood pressure increase the risk of CHD?
- High blood pressure means the heart has to work harder to eject blood into the systemic circulation
- The heart will become enlarged/thickened over time
- Heart rate requires more oxygen due to increased effort/size
- O2 demand may not be met particularly in those already with CHD leading to angina
What are the 7 ways to reduce blood pressure?
1) Antihypertensive medication
2) Regular exercise
3) Stop smoking
4) Reduce weight to appropiate level
5) Reduce salt intake
6) Avoid excess alcohol intake
7) Practice stress management
Who is most susceptible to hypercholesterolaemia?
People with genetic condition called hypercholesterolaemia - cholesterol production does not reduce in response to intake
What are the british guidelines for cholesterol concentration?
Total cholesterol >4.0mmol/l HDL <1.0mmol/l LDL >2.0mmol/l Triglyceride >1.7mmol/l Total cholesterol:HDL, 3:1 more desirable
What is the cholesterol threshold limit for treating people with a statin in the UK?
Total cholesterol >4.0 mmol/l
LDL >2.0 mmol/l
What are the 7 secondary prevention methods for lowering lipid?
1) Reduce intake of fat intake and saturated fat
2) Increase intake of fire
3) Increase intake of oily fish
4) Participate in more exercise
5) Control weight
6) Stop smoking
7) Moderate alcohol intake
What are the 4 methods by which physical activity contributes towards reduced CHD risk?
1) Decreased total cholesterol and LDL with increased HDL
2) Reduced total body fat and intraabdominal fat
3) Improved insulin sensitivity
4) Reduced systolic and diastolic blood pressure
