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1

What is the definition of CVD?

CVD is a wide variety of heart and blood vessel diseases

2

What are the types of CVD?

1. Coronary heart disease (CHD) + Ischemic heart disease (IHD) + Myocardial infarction (MI) 2. Cerebro-vascular disease + Cerebral infarction (stroke) 3. Hypertensive heart disease 4. Peripheral arterial disease (PAD) 5. Congenital heart disease (type of structural heart disease) 6. Heart failure 7. Arrhythmias 8. Coronary artery disease + Coronary vascular disease

3

Explain the cause of CHD, IHD, and MI (heart attack)?

These all take place when the blood vessels supplying the heart become diseased

4

Explain cerebro-vascular disease or cerebral infarction (stroke)

This is disease of the blood vessels supplying the brain with blood

5

Explain hypertensive heart disease

Diseases that are caused due to high blood pressure

6

Explain Peripheral arterial disease

Disease of blood vessels supplying arms and legs

7

Explain congenital heart disease

It’s the malformation of the heart since birth. A type of structural heart disease (the other type being aquired after birth)

8

Explain Heart failure

Occurs after the heart is damaged or weakened ~ usually by heart attack or high blood pressure

9

Explain Arrhythmias

Disorder that causes the heart to beat too fast or too slow

10

Explain Coronary artery disease and Coronary vascular disease

This disease causes the arteries/vessels to become hardened

11

Where is CVD in terms of mortality Canada/WW?

WW: #1 cause of death
Canada: #2 (cancer is #1)

12

What countries have a high rate of CVD mortality? And Why? Is mortality increasing or decreasing?

Most deaths due to CVD occur in low and middle income countries.

The reason is increase exposure to 1. risk factors, and 2. lack of prevention and 3. treatment

Mortality is decreasing because of improved access to prevention/treatment

13

What is CVDs economic impact on Canada?

Huge impact on our budget: In 2000, cost us aprox. 20 billion

14

How much more likely are people with past of IHD, who survived a heart attack and have heart failure, to die prematurely?

3 times, 4 times, 6 times more likely

15

Is the rate of incidence and prevalence of IHD and MI/Heart failure?

Sex: Males more affected than females

16

Is the mortality rate from MI greater for men or women? Why?

Greater for women. This because 1. More comorbidity 2. Chest pain absent; misdiagnosis or under diagnosis so get treatment too late 3. Live longer so likely happen later in life; greater risk for mortality

17

What groups are most at risk for CVD?

- men
- poor: less access to prevention and treatment
- less educated: less access to prevention and treatment
- minorities: language barrier, taken less seriously
- family history of MI or Stroke: similar life style choices, genetics

18

Explain the trend of incidence, mortality and prevalence, of IHD in Canada?

Incidence: Decrease
Mortality: Decrease
Prevalence: Slight increase before a slow decrease

>> Better prevention awareness and better treatment

19

Explain the incidence, mortality, and prevalence of Heart failure?

Incidence: decrease
Mortality: decrease
Prevalence: aprox equal

20

Explain the incidence, mortality and prevalence of MI

Incidence: slight decrease
Mortality: slight decrease
Prevalence: aprox same/ slight decrease

21

What are the modifiable risk factors for CVD, what are prevention methods you recommend?

- High blood pressure/Hypertension: less salt in the diet, a more balanced diet, cessation of nicotine
- High blood cholesterol: Diet that includes foods with less trans fat like less processed foods
- Smoking: cessation of smoking asap
- Physical inactivity: Atleast 60 minutes of heart rate increasing activity per week
-Obesity: circumference of the waist above allotted amount
- Poor diet: A diet high in carbs, sugar, trans fats etc
- Diabetes: Diet high in carbs and sugar
-Depression

22

What are the economic disadvantages of CVD? The personal level disadvantages?

Economic: Loss of productivity, Cost to health care system

Personal/Community: Premature mortality, Comorbidity, Depression and Disability

23

What are the 5 Key prevention methods for CVD?

Key prevention:

1.Stop smoking: carcinogens cause inflammation and nicotine causes narrowing of pathways

2. Lower Blood Cholesterol: causes build up of plaque in arteries and increases LDLs

3. Managing weight and diet, through better nutrition and physical activity: can cause comorbidity of diabetes & obesity worsening consequences

4. Managing stress: causes an overall decline in health and hypertension/heart arrhythmias etc

5. Early detection

24

What are the ABCs of stroke prevention?

1. Aspirin
2. Hemoglobin A: monitor blood glucose
3. Blood pressure: prevent and control high blood pressure
4. Cholesterol: Prevent and control high LDL-cholesterol
5. Smoking: Stop or prevent smoking

25

Define Hypertension. What are the parameters?

A condition where the blood vessels have consistently raised pressure.

Parameters: Diastolic pressure > 89mmHg and Systolic pressure > 139mmHg

26

What influences blood pressure? How can we modify it?

1. Cardiac output*: how much blood your heart pumps out (heart & central nervous system)
2. Total blood volume*: (kidneys)
3. Blood viscosity*: thickness of blood, can modify this through pharmacological avenues (kidneys)
4. Resistance of blood vessels: is it flexible or no?

27

What are the symptoms of hypertension? Why is hypertension called a ‘silent killer’?

1. Hypertensive heart disease, MI, Congestive heart failure
2. Hypertensive neuropathy
3. Hypertensive nephropathy (kidney failure)
4. Hypertensive retinopathy (retina problem)

Silent killer: usually asymptomatic ^^ these symptoms rarely manifest

28

What are the 2 types of hypertension? Explain them (cause, risk factors)

1. Essential/ Primary Hypertension: no cause (genetics), obesity and poor lifestyle choices (smoking,alcohol, stress, diet high in salt, and cholesterol)

2. Secondary Hypertension: caused by hormonal disorders (hyperthyroidism etc), kidney disease. Same risk factors

29

What is pre-eclampsia? What are the complications?

Hypertension in pregnant women. Can progress into eclampsia which is life threatening and IUGR in the baby

30

What are the complications and consequences of hypertension?

Arteriosclerosis and Arteriolosclerosis + heart damage, retinal damage, kidney damage and even brain damage