CV Disease

Question 1

How do you calculate the CVD risk?

Answer 1

• All patients aged between 40-74 years can have a CVD risk check on the NHS
• QRISK - calculates risk of patient having a cardiac event or stroke over the next 10yrs
• If QRISK >/=10% then start 20mg atorvastatin and behaviour health modification

Question 2

What is the alcohol classification in the UK?

Answer 2

• One unit = 10ml or 8g of pure alcohol
• 1 pint = ~500ml
• Alcohol units calculation: strength (ABV) x volume (ml) / 100 = units
• Current guidelines = max 14 units per week for men and women

Question 3

What are the features of taking statins?

Answer 3

• Statins need to be taken for life, each night
• Need to do blood tests before starting statin, then 3 months later, then at 12 months. Checking cholesterol and liver function (statins can affect liver)
• Other medicines and foods e.g. grapefruit can interfere with statins
• Potential side effects - muscle aches and pains - may check CK levels if symptoms persist

Question 4

What is the difference between absolute and relative risk?

Answer 4

• Absolute risk of a disease is the risk of developing a condition over a time period
• Relative risk is used to compare the risk in 2 different cohorts of people e.g. those taking the medication vs those not

Question 5

What are the current guidelines for exercising?

Answer 5

• Strength exercises >/= 2 days per week and 150 mins of moderate activity (increased work of breathing but should still be able to talk) or 75 mins of vigorous activity (fast breathing and difficulty talking), or combination, and to reduce time sitting
• Adults >65 should incorporate balance and co-ordination activities at least twice a week

Question 6

How do you know what BP medication to prescribe?

Answer 6

• If age <55 - ACEi

- If age >55 or Afro-Caribbean - Ca channel blocker

Question 7

What are the risk factors for CVD?

Answer 7

• Male
• Overweight
• Smoking
• FH of CVD
• Increasing age
• Poor diet, rich in fats, sugars and refined foods and lacking in food and vegetables
• Inactivity
• Hypercholesterolaemia
• HTN
• Diabetes

Question 8

What are the values for BMI?

Answer 8

WHO define a BMI of under 18.5 as underweight, overweight if BMI over 25 and normal between these. Obesity is a BMI over 30. Obesity is associated with increased risk of heart disease, stroke, hypertension, diabetes, cancer and osteoarthritis.

Question 9

What advice is given to people at risk of CVD about their diet?

Answer 9

• Reduce their saturated fat intake
• Increase their mono-unsaturated fat intake with olive oil, rapeseed oil or spreads based on these oils and to use them in food preparation.
• Choose wholegrain varieties of starchy food
• Reduce their intake of sugar and food products containing refined sugars including fructose
• Eat at least 5 portions of fruit and vegetables per day
• Eat at least 2 portions of fish per week, including a portion of oily fish
• Eat at least 4 to 5 portions of unsalted nuts, seeds and legumes per week.