Cardiovascular Flashcards
(42 cards)
What are the 2 main risk factors for CV disease?
- Smoking
- Genetics
What are some irreversible CV risk factors?
- age - risk increases with age
- sex - males generally higher risk than females
- family history - genetic risk
What are some reversible CV risk factors (patient)?
- smoking
- obesity
- diet
- exercise
What are some reversible CV risk factors (medical)?
- hypertension
- hyperlipidaemia (high cholesterol)
- diabetes
What are the key parts of risk modification?
- patient centres and controlled
- information
- belief
- motivation
- behavioural change
What are the 2 types of prevention?
- primary prevention
- secondary prevention
What does primary prevention for CV involve?
- exercise, diet and not smoking
- assess total risk - medical treatment if high risk
What does secondary prevention for CV involve?
- exercise, diet and not smoking
- medical treatment to reduce risk
What is primary prevention?
- stopping a disease before it happens
- looking at patient’s life style, risk factors, family history etc
What is secondary prevention?
stopping a second incident e.g. preventing a patient from having a second heart attack
What can be used to assess a patient’s risk for CV (primary prevention)?
opportunistic approach
* family history
* diet
* smoking
* test cholesterol
* test blood pressure
* test for diabetes (type 2)
What are 4 approaches to the prevention of CV disease?
- lifestyle changes
- control total cholesterol
- statin treatment
- reduce cholesterol <5.0mmol/L or 25%
- control hypertension
- moderate hypertension
- mild hypertension with evidence of CV disease
- reduce blood pressure to target of <140/85
- anti platelet drugs - aspirin
- when identified CV disease
- when high risk with no identified disease
Why do the dental team have a role in cardiac prevention?
- dentists see “well” patient regularly - doctors see you only occasionally when you are sick
- opportunity foe dentist to deliver general health education messages as oral health education messages
- opportunity for dentist to look at diet and lifestyle and offer advice and referral to support services - smoking cessation in particular
What is hypertension?
raised blood pressure
* systolic >140mm Hg
* diastolic >90mm Hg
sitting and rested for at least 15 minutes
What are known risk factors for hypertension?
- age
- race
- obesity
- alcohol
- family history
- pregnancy
- stress
- drugs
- non steroidal
- corticosteroids
- oral contraceptives
- sympathomimetics
What is the highest risk of uncontrolled hypertension?
CVA (stroke)
In coronary heart disease, why won’t treating the hypertension have little effect to the patient’s risk?
CHD is a slowly progressing disease - reversing high HP won’t reverse the atherosclerotic changes that have built up in the vessels over years of high BP
In congestive heart failure does treating hypertension have a large effect to the patient’s risk?
Yes, has a large effect - reduces the work load of the heart, making the muscle more able to cope
What are the outcomes from hypertension?
- accelerated atherosclerosis
- myocardial infarction
- stroke
- peripheral vascular disease
- renal failure - which will then make hypertension worse
What are common triggers for hypertension?
- NONE usually found (essential hypertension)
- likely genetic failure of autoregulation control of blood vessel wall constriction
What are rare triggers for hypertension?
- renal artery stenosis
- endocrine tumours
- Phaeochromocytoma (adrenaline)
- Conn’s syndrome (aldosterone)
- Cushing’s syndrome (cortisol)
Why does increases adrenaline, aldosterone and cortisol increase blood pressure?
- adrenaline - vasoconstrictor
- aldosterone and cortisol - increases circulating blood volume
What are the signs and symptoms of hypertension?
- usually NONE
- may get headache
- more common in ‘malignant hypertension’ - where BP is rapidly accelerating
- may get Transient Ischaemic Attacks
- TIA’s are ‘mini strokes’
- full neurological return in 24hrs
What are the indications for further investigations of hypertension?
- young patient
- resistant hypertension despite ‘adequate’ treatment
- accelerated hypertension
- ‘unusual history’
