CVD Risk Reduction Flashcards

(31 cards)

1
Q

What are the non-modifiable risk factors for CVD?

A

Personal history of CVD
Family history of CVD
Age
Gender (women > men)

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2
Q

What are some modifiable risk factors for CVD?

A
Smoking
Alcohol
Hypertension
Dyslipidaemia
Diabetes
Obesity
Physical activity
Thrombogenic factors
Deprivation?
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3
Q

How do you assess someones CVD risk and what is involved?

A

ASSIGN score:

  • age
  • sex
  • smoking
  • systolic BP
  • total cholesterol
  • HDL cholesterol
  • family history of premature CVD
  • diabetes
  • rheumatoid arthritis
  • deprivation
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4
Q

What is the aim of primary prevention?

A

To reduce incidence in a population

before disease

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5
Q

What is the aim of secondary prevention?

A

Detection and treatment of pre-symptomatic disease

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6
Q

What is the aim of tertiary prevention?

A

Reduce incidence/recurrences of chronic incapacity among those with symptomatic disease

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7
Q

What are the SIGN key recommendations for overweight/obesity?

A

Target with interventions, aiming to reduce weight by 3 kg

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8
Q

What is the recommended amount of dietary saturated fat?

A

Men < 30g per day

Women < 20g per day

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9
Q

What is the recommended amount of dietary fish?

A

Twice per week, 1 of which is oily fish

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10
Q

What is the recommended amount of dietary salt?

A

< 6g per day

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11
Q

Which type of diet is recommended for CVD health?

A

Mediterranean

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12
Q

What is the recommended amount of physical activity per week?

A

150 mins moderate exercise OR 75 mins vigorous
Resistance training at least twice per week
Minimise time spent sedentary

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13
Q

Is there a role for anti platelet therapy in primary prevention of CVD?

A

Not recommended for primary prevention

If atherosclerosis –> 75mg aspirin daily

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14
Q

When should lipid lowering drugs be considered for primary prevention of CVD and what should be offered?

A

If at high risk and no evidence of CVD
Offer statin following discussion of risks/benefits
–> Atorvastatin 20mg/day

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15
Q

How might hyperlipidaemia manifest clinically?

A

Xanthomata
Xanthelasma
Corneal arcus
Milky blood/serum

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16
Q

Apart from CVD, what are high triglycerides a risk factor for?

A

Acute pancreatitis

17
Q

How are cholesterol and triglycerides transported in the blood?

A

Lipoproteins e.g. HDL and LDL

18
Q

Which pattern of lipoproteins is associated with CVD?

A

High LDL

Low HDL

19
Q

Which type of cholesterol is ‘bad’ and why?

A

LDL

assist in the production of atheromatous plaques

20
Q

Which cholesterol is ‘good’ and why?

A

HDL

key role in removing excess cholesterol from cells by transporting it to the liver

21
Q

How is cholesterol removed from the body?

A

Only liver has capacity to remove cholesterol from the body

–> secreted into bile or used to synthesise bile salts

22
Q

How do statins work?

A

Inhibit HMG-CoA reductase

–> reduce total and LDL cholesterol

23
Q

How are statins taken?

A

Orally at night

24
Q

What are some side effects of statins?

A

GI upset
Myositis
Rhabdomyolysis (rare)

25
Which drugs are first line for patients with very high triglyceride levels?
Fibrates
26
Which other drugs can be given when statin alone does not control cholesterol?
Ezetimibe | PCSK9 inhibitors e.g. alirocumab, evolocumab
27
How does Ezetimibe work?
Reduces cholesterol absorption in duodenum
28
What are some side effects and contraindications to ezetimibe?
SE: diarrhoea, abdominal pain CI: breastfeeding
29
Which genetic disorder causes high cholesterol and what is its pattern of inheritance?
Familial hypercholesterolaemia | Autosomal dominant
30
Which lipid reducing drug and dose should be prescribed for secondary prevention?
Atorvastatin 80mg
31
What needs to be checked before starting a statin?
LFTs