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. QRISK®2-2014 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?
Recommended
