Prevention of CVD

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prevention of common cardiovascular diseases

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  • Prevention of Cardiovascular

    diseases

    Shelan Karim

  • By the end of this session you should be able

    to understand

    What the term cardiovascular disease (CVD) mean?

    How are the CVD linked?

    What are the risk factors to developing CVD?

    Health advice to avoid CVD.

  • What has been covered so far.

    Year One Hypertension

    Arrhythmias

    Year Two Acute Coronary Syndrome (ACS)

    Stable angina

    Therefore, this session will concentrate on health advice to avoid CVS diseases.

  • What is Cardiovascular disease?

    The term cardiovascular disease means all the diseases of the heart and circulation, including Angina

    Heart failure

    Congenital heart disease

    Stroke

    In 2011, almost 160,000 people died in the UK from CVD. 74,000 of these deaths were caused by coronary heart

    disease.

  • How are CVS diseases linked?

    Main cause for stroke, angina, and MI is atherosclerosis.

    Atherosclerosis

    Narrowing of the arteries by a gradual build-up of atheroma within the walls and thrombosis.

  • Risk Factors

    Fixed risk factors

    Family history

    Male

    Age

    Ethnicity

    Treatable/ Partly treatable risk factors

    High blood pressure

    High cholesterol

    High triglycerides

    Diabetes

    Kidney diseases

  • Risk factors

    Preventable risk factors

    Smoking

    Lack of exercise

    Obesity

    Excess alcohol

    Diet

  • Cardiovascular risk asessment

    Two tools are available for use

    1. QRISK2-2014 cardiovascular disease risk calculator

    www.qrisk.org This calculator can be used to work out the risk of having a heart

    attack or stroke over the next ten years by answering some simple

    questions. It is suitable for people who do not already have a diagnosis

    of heart disease or stroke.

    2. Cardiovascular risk calculator

    http://www.patient.co.uk/doctor/cardiovascular-risk-

    calculator

  • The prevention of CVD

    Diet

    What recommendations can you make

    as pharmacists to the public?

  • The prevention of CVD

    Alcohol

    What is the maximum alcohol intake for

    women and men?

  • The prevention of CVD

    Exercise and weight management

    The recommendation for adults is 30 minutes of moderate-intensity aerobic exercise every day at least

    five days a week.

  • The prevention of CVD

    Smoking

    Smokers are at twice risk of developing CVD compared to non-smokers.

    How does smoking cause CVD?

    Causes damage to the lining of the arteries

    Reduce the amount of oxygen in blood

    Causes high blood pressure

    Risk of developing clots

  • The prevention of CVD

    Tips to quit smoking Set a give up date

    Make a plan

    Get support

    Stay busy

    Treat yourself

    Also: NHS stop smoking service

    Quit kit

    Nicotine replacement therapy (NRT)

  • Case study 1

    Mr. Smith is a 65 years old retired engineer who went to see his GP complaining of headache for

    the past week that was not resolved with pain

    killers. He usually smokes 15 cigarettes a day.

    His only regular medication is Metformin 500mg TDS for diabetes.

    It was noted that his blood pressure was 160/98

  • Case study 1

    What risk factors does Mr.Smith have for

    developing CVD?

  • Some revision for management of

    hypertension

    What is the target blood pressure for a person aged less than 80 years old?

    140/90mmgHg

    What is the target blood pressure for a person aged more than 80 years old?

    150/90mmHg

  • Case study

    GP decides to start patient on medication as this is the second visit where his blood pressure is

    raised.

    What medication would you recommend?

    How will you counsel the patient?

  • NICE guidelines: Management of

    hypertension

  • Case study

    Mr. Smith was prescriber Amlodipine. He brought the prescription to the community pharmacy you

    work at and he explains this is a new medication,

    and would like some information about it.

    What information will you tell the patient?

  • Case study 2

    Mrs. Jones is a 44 years old teacher who was admitted to the hospital for elective total knee

    replacement.

    During her stay, it was noted that he blood sugar levels were raised and the doctors advised her to

    change her diet to control her diabetes before

    speaking to the GP to consider medication.

    You see her in the ward, and she asks you about what she can do to manage her diabetes?

    What advice will you give her?

  • References/Useful resources

    National Institute for Health and Clinical Excellence. NICE public health guideline 25: Prevention of Cardiovascular disease. June

    2015.

    National Institute for Health and Clinical Excellence. NICE clinical guideline 127: Hypertension. Clinical management of

    primary hypertension in adults. National Institute for Health and

    Clinical Excellence, London. August 2011.

    NHS choices: Preventing cardiovascular disease in adult, www.nhs.uk

    The British Heart Foundation- Cardiovascular disease. www.bhf.org.uk

    www.nhs.uk/smokefree

    www.patient.co.uk

    www.qrisk.org

  • The end

    Any questions?