NHS Health Check, Cardiovascular risk & case studies- ediitng

• Appreciate the magnitude of cardiovascular disease in the UK

  

• How does the NHS Health Check programme works to identify people most at risk, and how the programme works

  

• Aims for early identification

• How: Target 40-74 years

• Gov initiative to reduce CVD

• Looks to diagnose HD, diabetes, kidney disease stroke

How does NHS identify risk patients

• How it works: HPC Patient history, measurements (heigh, weight, BP, cholesterol, blood sugar tests

  • Calculates CV risk and will either give lifestyle advice and invited back in 5 years or referral point for GP assessment

What might lead to a GP referaal

Raised blood pressure

Raised lipids

High calculated CV risk

Raised blood glucose

What is QRISK

- Assessment tool used to calculate estimation of CV risk

- 3 categories low 10, moderate 10-20, high >20

- However watch out for younger patients with low Qrisk score but high CVD risk factors

- Qrisk increases due to age regardless if nothing else chances

What is Qrisk 3

For people aged 25-84

Predicts CV risk in 10 years

- Not used for T1D, glomerulus filtration <60ml, familial hypercholesterolaemia

• Describe how modifiable CV risk factors may be managed

What is a healthy BMI

18.5-24.9

What factors can influence BMI

• Smoking

• Alcohol

• Physical activity

• Balanced diet e.g. lipoprotein plant based butter-> consider the limitations e.g. price

  Patients can have more than one

  Statins

Treatment for primary prevention

Atorvastatin

Treatment for secondary prevention

Lipid lowering treatment

80mg

Treatment for people with/ without type 2 diabetes

- Atorvastatin 20 mg for patients with 10% more

- Lifestyle advice

Consider factors e.g. age to see if appropriate

Follow up with checking lipid levels

What are the three statin bands

High

Medium

Low

- No longer licensed for primary prevention

- Use in secondary prevention

- Anti-platelet

Be aware of historic prescribing that may lead to inappropriate use