cardiovascular disease Flashcards
(53 cards)
what is cardiovascular disease?
group of heart conditions that affect heart and blood vessels caused by atherosclerosis and thrombosis eg coronary heart disease, MI, stroke etc
who is at high risk of cardiovascular disease? [4]
men
ethnicity eg south asians
ppl with family history of CVD
ppl aged over 50 and risk increases with age
what are the 9 modifiable risk factors for cardiovascular disease?
hypertension abnormal lipids obesity smoking excess alcohol poor diet diabetes psychosocial eg anxiety and depression low exercise
give examples of some risk calculators?
what do these do?
QRISK 2, QRISK 3, JBS3, ASSIGN
predict likelihood of cardiovascular event and deciding whether statins should be prescribed or nor
what drug is given when there is a 10 year cardiovascular risk?
primary prevention drug normally atorvastatin
what risk factors does the QRISK 2 and JBS3 tools use to assess CVD risk? [12]
gender age ethnicity smoking BMI lipid profile systolic BP chronic kidney disease social status family history of CVD rheumatoid arthritis atrial fibrilliation
there are certain pt at high risk of CVD that using a risk calculator could underestimate their score. it is unsafe to use a risk calculator for these pt. who are these high risk patients? [6]
type 1 diabetes established CVD chronic kidney disease familial hypercholesterolemia risk increases with age [more than 85 years old] 10 year risk of CVD more than 10%
are aspirins recommended for primary prevention of cardiovascular disease?
when are antihypertensives recommended for primary prevention of CVD?
no
only for those who have a BP higher than 140/90
which drugs are recommended for primary prevention of CVD?
lipid lowering drugs
eg atorvastatin
why is atorvastatin preferred over high dose simvastatin for SECONDARY prevention of CVD?
bc high dose of simvastatin increases risk of myopathy [muscle weakness]
what drugs are recommended for SECONDARY prevention of CVD?
LOW dose aspirin, clopidogrel, dipyridamole
are antihypertensives used in SECONDARY prevention of CVD? and when?
yes but when blood pressure higher than 140/90
define hyperlipidaemia
high cholesterol, high triglycerides or both
what are the causes of hyperlipidaemia? [6]
HYPOthyroidism family history lifestyle [smoking, diet] liver/renal impairment drugs [eg corticosteroids, immunosuppressants] diabetes
which patients are at high risk of developing hyperlipidaemia and should be given a statin regardless of serum cholesterol levels? [6]
type 1 diabetics type 2 diabetics only if they have a CVD risk greater than 10% chronic kidney disease familial hypercholesterolemia risk increases with age [over 85 yo] 10 year risk of cvd greater 10%
what is step 1 and step 2 for management of primary prevention of cardiovascular disease?
step 1: lifestyle
step 2: statins
what is step 1 and step 2 for management of SECONDARY prevention of CVD?
step 1: address secondary causes of hyerplipidaemia eg uncontrolled diabetes, hypothyroidism
step 2: statins again should be offered to everyone including elderly
what is a high intensity statin?
a statin that reduces LDL cholesterol by more than 40%
what strengths of atorvastatin are classed as high intensity?
20mg, 40mg, 80mg
what strengths of rosuvastatin are classed as high intensity?
10mg, 20mg, 40mg
what strength of simvastatin is classed as high intensity?
80mg
which statin is recommended for all patients with secondary prevention of CVD?
atorvastatin
what must be monitored and checked 3 months after a patient starts statins?
lipid profile [total cholesterol, HDL and LDL and triglycerides]
what is the amount of total cholesterol in mmol/L that warrants a diagnosis for HYPERlipidaemia?
more than 6mmol/L
