Unit 6 - Cardiovascular system

Question 1

What is cardiovascular disease?

Answer 1

Disease of the circulation
- heart and blood vessels

Includes disorders of coagulation and also problems caused to other organs due to issues with blood supply

Question 2

What are the four main types of CVD?

Answer 2

Coronary heart disease (CHD)
- angina
- myocardial infarction (MI)
- heart failure
Strokes and transient ischaemic attacks (TIA)
Peripheral arterial disease (PAD)
Aortic disease
- most commonly abdominal aortic aneurism (AAA)

Question 3

How many people in the UK are living with heart and circulatory disease?

Answer 3

7 million

Question 4

What percentage of all deaths in the UK are caused by heart and circulatory disease?

Answer 4

25%

Question 5

Out of 152,000 deaths per year, how many are “premature” - before the age of 75?

Answer 5

42,000

Question 6

What percentage of people with CVD have at least one other health condition?

Answer 6

80%

Question 7

What has happened to number of deaths from CVD since 1961?

Answer 7

Halved

- previously 320,000 per year

Question 8

What do primary prevention strategies identify and alter?

Answer 8

Modifiable risks
Modifiable risk factors are behaviours and exposures that can raise or lower a person’s risk of disease. They are modifiable because they can, in theory, be changed.
- reduce incidence in disease-free individuals or in the population

Question 9

What do secondary prevention strategies target?

Answer 9

Individuals with established disease, who have usually had an ‘event’ to reduce morbidity and mortality

Question 10

What are most CVD events?

Answer 10

Most CVD is acquired
- not 'congenital' or inherited
Most events mostly due to lifestyle
- preventable
Influenced by non-modifiable risk factors

Question 11

What is risk stratification in CVD?

Answer 11

Identifying potential patients requiring intervention for primary prevention relies on a strategy in primary care to stratify risk
Estimation of CVD risk should be done regularly for over-40s, using factors recorded in medical notes
A full, formal risk assessment should be carried out where 10 year CVD risk is thought to be 10% or more

Question 12

How is risk stratification in CVD carried out?

Answer 12

Q-RISK 3

Can only give an approximate risk of developing a CVD
- target preventive medication and lifestyle modification

Question 13

What is a Q-risk score of 10% or more classed as?

Answer 13

Higher risk

Question 14

What is a Q-risk score of 20% or more classed as?

Answer 14

May require high intensity therapy

Question 15

Describe primary prevention of CVD

Answer 15

Before offering medication discuss benefits of lifestyle modification and optimise the management of all other modifiable CVD risk factors

• people need support
• incentivise people by repeating CVD risk measurement after a period of lifestyle modification
• pharmacological intervention where necessary

Question 16

What lifestyle factors have an effect on CVD risk?

Answer 16

• smoking
• overweight/obesity
• diet and exercise

Question 17

What proportion of adults in the UK smoke?

Answer 17

1 in 6

Question 18

How many deaths per year are caused by smoking?

Answer 18

100,000

- 20,000 due to CVD

Question 19

What proportion of the UK population or overweight or obese?

Answer 19

1/3 are overweight

1/4 are obese

Question 20

Give three examples of medical risk factors for CVD?

Answer 20

• hypertension
• diabetes
• hyperlipidaemia

Question 21

What percentage of the adult population has high blood pressure?

Answer 21

30%

- about half of these are untreated

Question 22

What percentage of heart attacks and strokes are associated with high blood pressure?

Answer 22

50%

Question 23

How much more likely are adults with diabetes to develop CVD?

Answer 23

2 - 3 times

Question 24

How much more likely are adults with diabetes to die from heart disease or stroke, compared to those without diabetes?

Answer 24

2 times

Question 25

What is a significant risk factor for developing heart and circulatory diseases?

Answer 25

High blood cholesterol

Question 26

How should hypertension be treated?

Answer 26

Start with lifestyle factors

Once confirmed, treat pharmacologially

Question 27

What is necessary when carrying out a HbA1c test?

Answer 27

HbA1c test should be treated to target with antibiotic drugs BUT a full cardiovascular risk profile will be necessary and appropriate medicines should be used concurrently

Question 28

Following a formal risk assessment, which patient groups should be given lipid modification therapy as a primary prevention?

Answer 28

• people aged 84 years and younger if their estimated 10-year risk of CVD using the Q risk assessment tool is 10% or more
• people with type 2 diabetes if their estimated 10- year risk of CVD using the Q risk assessment tool is 10% or more

Question 29

Which patient groups should be given lipid modification therapy as a primary prevention?

Answer 29

• type 1 diabetes
• chronic kidney disease
• familial hypercholesterolaemia
• everyone over 84