cardiovascular intro Flashcards
what are the risk factors of CVD?
modifiable and non-modifiable?
modifiable:
High blood pressure (hypertension) Physical inactivity Smoking Diet and weight Diabetes Cholesterol Stress(?)
non-modifiable
Age/Sex
Family history
Race/ethnic background
what are non-pharmacological preventions of CVD?
Prevention is better than treatment!
Regular exercise
Recommended 30 min moderate exercise 5 days per week
Well balanced diet
E.g. the eat well plate, 5-a-day etc
Other lifestyle choices e.g.
Give up smoking
Moderate alcohol
Sleep
what are the risk assessments which takes place for CVD
Should be assessed + reviewed on an ongoing basis after age 40
If estimate a 10 year risk factor >10% full formal risk assessment should be considered
For formal risk assessment use a standardised risk tool e.g. Qrisk2 not all risk tools are appropriate for all patients
what are the types of cardiovascular diseases?
Cardiovascular disease is caused by disorders of the heart and blood vessels
Coronary Heart Disease (CHD) - disease of the blood vessels supplying the heart muscle
Cerebrovascular disease - disease of the blood vessels supplying the brain
Peripheral arterial disease - disease of blood vessels supplying the arms and legs
Rheumatic heart disease damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria
Congenital heart disease malformations of heart structure existing at birth
Deep vein thrombosis and pulmonary embolism- blood clots in the leg veins, which can dislodge and move to the heart and lungs.
what is coronary heart disease?
Coronary Heart Disease (CHD) - disease of the blood vessels supplying the heart muscle
what is Cerebrovascular disease
Cerebrovascular disease - disease of the blood vessels supplying the brain
what is Peripheral arterial disease
Peripheral arterial disease - disease of blood vessels supplying the arms and legs
what is Rheumatic heart disease
Rheumatic heart disease damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria
what is Congenital heart disease
Congenital heart disease malformations of heart structure existing at birth
what is Deep vein thrombosis and pulmonary embolism-
Deep vein thrombosis and pulmonary embolism- blood clots in the leg veins, which can dislodge and move to the heart and lungs.
how does a healthy heart work?
- deoxygenated blood enters via the vena cava into the right atrium
- passes through tricuspid valves into the right ventricle
- pumped through pulmonary valve to the pulmonary artery
- it takes deoxygenated blood to the lungs
- the oxygenated blood enters via the pulmonary vein
- into the left atrium through the mitral valve into the left ventricle
- which pumps through the aortic valve into the aorta
- into the body
what are the three types of blood vessles?
- artery
- vein
- capillary
what are the differences between the three blood vessles
ARTERY VEIN. - lumen - lumen -medial layer consisting of smooth muscle cells -covered by adventitia (connecting tissues and nerves) -Thicker -Thinner walls walls -h Pressure -low systems pressure
capillary
- single layer of endothelial cells
- nucleus of endothelial cells
Age and progression of vascular disease
Plaque tends to grow with HBP and cholesterol
it can increase with age aswell
plaque restricts the blood flow to the heart/organs
Healthy - Normal
Fatty streak -Normal
plaque -High blood pressure and cholesterol
obstructive plaque with core - chest pain + above
ruptured plaque -angiogram/abnormal ECG - heart attack + above
thrombus - heart attack + above
what is hypertension
high blood pressure
what is primary hypertension?
causes
risk factor
Primary (essential) Hypertension 90-95%
Classed as an “asymptomatic” syndrome
High blood pressure with no apparent individual cause
Recent evidence suggest inflammatory/immune responses may be involved*
risk factors similar to those for CV disease N.B.:
Age
(35-50 in men; following menopause in women)
Race
1 in 3 African/Caribbean’s
what are the causes of secondary hypertension?
Secondary hypertension
Adrenal gland disorders
Cushing’s syndrome (see PM3A-inflammation), hyperaldosteronism (Chronn’s syndrome), pheochromocytoma (rare tumour)
Kidney diseases
polycystic kidney disease, kidney tumor, kidney failure
Drugs
anti-inflammatory corticosteroids (e.g. prednisone);
birth control pills (esp. containing estrogen);
cold medicines (e.g. containing pseudoephedrine, phenylephrine)
Pregnancy
what is clinical BP?
in a clinical setting (for example, an outpatient clinic), blood pressure is measured by the auscultation method using a mercury or aneroid sphygmomanometer, or using an automatic sphygmomanometer that has been calibrated by the auscultation method, and maintaining the arm-cuff position at the heart level.
what is ABPM?
Ambulatory monitoring of blood pressure (AMBP) is a non-invasive exam (i.e., it does not require opening the patient) that records blood pressure over a period of 24 hours
what is HBPM?
The main difference between ABPM and HBPM is that ABPM assesses daytime and nighttime blood pressure during routine daily activities typically during one 24-hour period, whereas HBPM assesses blood pressure at specific times during the day and night over a longer period of time while the patient is seated and resting.
what is the normal BP?
<120/80
The 1st value is Systolic BP
The 2nd is Diastolic BP
what is the clinical BP?
Hypertension is defined as a clinic BP >140/90
explain the classification of hypertension
(clinical) under 140/90 - check BP at least every 5 years
(ABPM + HBPM)- under 135/85
140/90 - 179/119 - offer ABPM/HBPM
- investigate for target organ damage
- assess cardiovascular risk
180/120 +
assess organ damage ASAP
consider drug treatment without ABPM/ HBPM is there is a target organ damage
repeat clinical BP in 7 days if there is no target organ damage
refer to same day specialist review - if there is any life threatening symptoms, or hemorrhage
what is hypertensions treatment strategy ( NICE guideline)
HYPERTENSION WITH TYPE 2 DIABETIES + AGEE <55 AND NOT BLACK AFRICAN OR AFRICAN CARABEIAN FAMILY WITHOUT DIABETIES TYPE 2
1) ACEi or ARB
2) ACEi or ARB and CCB or thiazide like diruetics
3) ACEi or ARB + CCB + thiazide like diruetics
4) seek experts advice
HYPERTENSION WITHOUT TYPE 2 DIABETES , AGE 55 OR OVER , BLACK AFRICAN OR AFRICAN CARABIEAN FAMILY ORIGIN
1) CCB
2) CCB and ACEi or ARB or thiazide like diruetics
3) ACEi or ARB + CCB + thiazide like diruetics
4) seek experts advice
