scholarly journals Cardiovascular risk assessment: Audit findings from a nurse clinic – a quality improvement initiative

2009 ◽  
Vol 1 (3) ◽  
pp. 226
Author(s):  
Sarah Waldron ◽  
Margaret Horsburgh
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Community Support ◽  
Lipid Lowering ◽  
Quality Improvement Initiative ◽  
Cvd Risk ◽  
Retrospective Audit ◽  
Prescribing Trends

BACKGROUND AND CONTEXT: Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice. METHOD : A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average). RESULTS: Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had a five year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period. STRATEGIES FOR IMPROVEMENT: The recently available ‘heart health’ trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends. LESSONS: Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health. KEYWORDS: Cardiovascular disease risk assessment; nurse clinics; audit

scholarly journals Cardiovascular disease risk assessment in diabetes and metabolic syndrome patients with and without non-alcoholic fatty liver disease

2015 ◽  
Vol 2 (4) ◽  
pp. 91 ◽  
Author(s):  
Mohammed Alim ◽  
Rakesh K. Sahay ◽  
Nuwairah Hafiz ◽  
B. Prabhakar ◽  
Mohammed Ibrahim
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Fatty Liver ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Recently non-alcoholic fatty liver disease (NAFLD) has been suggested as independent cardiovascular (CVD) risk factor and many studies have shown strong links between NAFLD and CVD but NAFLD has not been related to cardiovascular mortality independently on a long term follow up. Inflammation and oxidative stress is well recognized factors for NALFD which lead to many interrelated factors contributing to cardiovascular risk. Aim: To study the cardiovascular disease risk in diabetes and metabolic syndrome patients with and without NAFLD using different risk assessment calculators.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This was a single center, prospective cross sectional study. 62 patients with diabetes and metabolic syndrome attending the endocrinology &amp; gastroenterology clinics of Osmania General Hospital were enrolled in to the study with 31 patients in group A (NAFLD) and 31 patients in group B (Non-NAFLD). Patients were diagnosed with fatty liver by ultrasound examination.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The groups were individually evaluated for cardiovascular risk assessment by PROCAM risk score, atherosclerotic cardiovascular disease (ASCVD) score and atherosclerosis Index. The means ± standard(%) deviation of Procam risk score for NAFLD group was 6.00 ± 1.00 and for Non NAFLD group it was 10.00 ± 2.00 (p=0.039). ASCVD risk score shows 5.11 ± 1.12 for NAFLD and Non NAFLD group showed 8.25 ± 2.18 (p=0.235). The Atherosclerosis index for NAFLD group was 0.24 ± 0.03 and Non NAFLD 0.18 ± 0.04 (p=0.785). The QRsik2 score for NAFLD and Non-NAFLD patients was 13.16 ± 7.56 and 17.45 ± 10.36.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>There was no difference in CVD risk assessment when assessed with different calculators in this population.</p>

scholarly journals Protocol for the WARM Hearts study: examining cardiovascular disease risk in middle-aged and older women - a prospective, observational cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044227
Author(s):  
Alexandra V Rose ◽  
Kevin F Boreskie ◽  
Jacqueline L Hay ◽  
Liam Thompson ◽  
Rakesh C Arora ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cohort Study ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Observational Cohort Study ◽  
Moderate Intensity ◽  
Cvd Risk ◽  
Non Invasive ◽  
Observational Cohort

IntroductionCardiovascular disease (CVD) is a leading cause of death in women. Novel approaches to detect early signs of elevated CVD risk in women are needed. Enhancement of traditional CVD risk assessment approaches through the addition of procedures to assess physical function or frailty as well as novel biomarkers of cardiovascular, gut and muscle health could improve early identification. The Women’s Advanced Risk-assessment in Manitoba (WARM) Hearts study will examine the use of novel non-invasive assessments and biomarkers to identify women who are at elevated risk for adverse cardiovascular events.Methods and analysisOne thousand women 55 years of age or older will be recruited and screened by the WARM Hearts observational, cohort study. The two screening appointments will include assessments of medical history, gender variables, body composition, cognition, frailty status, functional fitness, physical activity levels, nutritional status, quality of life questionnaires, sleep behaviour, resting blood pressure (BP), BP response to moderate-intensity exercise, a non-invasive measure of arterial stiffness and heart rate variability. Blood sample analysis will be used to assess lipid and novel biomarker profiles and stool samples will support the characterisation of gut microbiota. The incidence of the adverse cardiovascular outcomes will be assessed 5 years after screening to compare WARM Hearts approaches to the Framingham Risk Score, the current clinical standard of assessing CVD risk in Canada.Ethics and disseminationThe University of Manitoba Health Research Ethics Board (7 October 2019) and the St Boniface Hospital Research Review Committee (7 October 2019) approved the trial (Ethics Number HS22576 (H2019:063)). Recruitment started 10 October 2020. Data gathered from the WARM Hearts study will be published in peer-reviewed journals and presented at national and international conferences. Knowledge translation strategies will be created to share our findings with stakeholders who are positioned to implement evidence-informed CVD risk assessment programming.Trial registration numberNCT03938155.

scholarly journals Cross-sectional survey describing general practitioners’ absolute cardiovascular disease risk assessment practices and their relationship to knowledge, attitudes and beliefs about cardiovascular disease risk in Queensland, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e033859
Author(s):  
Kim Greaves ◽  
Anita Smith ◽  
Jason Agostino ◽  
Kuhan Kunarajah ◽  
Tony Stanton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Assessment Practices ◽  
Attitudes And Beliefs ◽  
Sufficient Time ◽  
Cross Sectional Survey ◽  
Cvd Risk ◽  
Cross Sectional

ObjectivesTo describe general practitioners’ (GPs’) absolute cardiovascular disease risk (ACVDR) self-reported assessment practices and their relationship to knowledge, attitudes and beliefs about ACVDR.DesignCross-sectional survey with opportunistic sampling (October–December 2017).SettingSunshine Coast region, Queensland, Australia.Participants111 GPs responded to the survey.Primary and secondary outcome measuresProportion of GPs reporting a high (≥80%) versus moderate (60%–79%)/low (<60%) percentage of eligible patients receiving ACVDR assessment; proportion agreeing with statements pertaining to knowledge, attitudes and beliefs about ACVDR and associations between these factors.ResultsOf the 111 respondents, 78% reported using the Australian ACVDR calculator; 45% reported high, 25% moderate and 30% low ACVDR assessment rates; >85% reported knowing how to use ACVDR assessment tools, believed assessment valuable and were comfortable with providing guideline-recommended treatment. Around half believed patients understood the concept of high risk and were willing to adopt recommendations. High assessment rates (vs moderate/low) were less likely among older GPs (≥45 vs ≤34 years, age-adjusted and sex-adjusted OR (aOR) 0.36, 95% CI 0.12 to 0.97). Those who answered knowledge-based questions about the guidelines incorrectly had lower assessment rates, including those who answered questions on patient eligibility (aOR 0.13, 95% CI 0.02 to 1.11). A high assessment rate was more likely among GPs who believed there was sufficient time to do the assessment (aOR 3.79, 95% CI 1.23 to 11.61) and that their patients were willing to undertake lifestyle modification (aOR 2.29, 95% CI 1.02 to 5.15). Over 75% of GPs agreed better patient education, nurse-led assessment and computer-reminder prompts would enable higher assessment rates.ConclusionsAlthough the majority of GPs report using the ACVDR calculator when undertaking a CVD risk assessment, there is a need to increase the actual proportion of eligible patients undergoing ACVDR assessment. This may be achieved by improving GP assessment practices such as GP and patient knowledge of CVD risk, providing sufficient time and nurse-led assessment.

scholarly journals Cardiovascular Disease Risk Assessment in Diabetes

2021 ◽  
Vol 22 (3) ◽  
pp. 168-173
Author(s):  
Jin Hwa Kim
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Disease Risk ◽  
Vascular Inflammation ◽  
Cardiovascular Disease Risk ◽  
Arterial Disease ◽  
Cvd Risk ◽  
Glycation End Products ◽  
Peripheral Arterial ◽  
Include Heart Failure

Diabetes has become an increasing issue in the last century and even more pressing in the last few decades due to the exponential rise of obesity and has become one of the leading causes of death worldwide. Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in people with diabetes. Hyperglycemia, insulin resistance, and excess fatty acids increase oxidative stress, disrupt protein kinase C signaling, and increase advanced glycation end-products that result in vascular inflammation, vasoconstriction, thrombosis, and atherogenesis. Compared to non-diabetics, those with diabetes carry a higher mortality risk from CVD across ethnicity and sex. The most common cardiovascular manifestations in those with diabetes include heart failure, peripheral arterial disease, and coronary heart disease. CVD risk assessment in diabetes can present an opportunity for preventive strategies and decreased mortality for people with diabetes.

scholarly journals Hot Flashes and Cardiovascular Disease Risk Indices Among Women With HIV

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Mabel Toribio ◽  
Evelynne S Fulda ◽  
Sarah M Chu ◽  
Zsofia D Drobni ◽  
Magid Awadalla ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
General Population ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hot Flashes ◽  
Cvd Risk ◽  
Hot Flash ◽  
Risk Indices ◽  
Women With Hiv

Abstract Women with HIV (WWH) transitioning through menopause have heightened cardiovascular disease (CVD) risk. In the general population, hot flash burden relates to CVD risk indices. We found higher hot flash burden among women with vs without HIV. Further, among WWH, hot flash burden related to select CVD risk indices. ClinicalTrials.gov Registration NCT02874703.

scholarly journals Consumption of dairy products and cardiovascular disease risk: results from the French prospective cohort NutriNet-Santé

2021 ◽  
pp. 1-37
Author(s):  
Laury Sellem ◽  
Bernard Srour ◽  
Kim G. Jackson ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dairy Products ◽  
Disease Risk ◽  
Heart Diseases ◽  
Cardiovascular Disease Risk ◽  
Dietary Intakes ◽  
Cvd Risk ◽  
Dairy Consumption ◽  
Fermented Dairy ◽  
The Impact

Abstract In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for cardiovascular disease (CVD) prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥ 18 years from the NutriNet-Santé cohort (2009–2019). Daily dietary intakes were collected using 24h-dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n=1,952) included cerebrovascular (n=878 cases) and coronary heart diseases (CHD, n=1,219 cases). Multivariable Cox models were performed to investigate associations. This analysis included n=104,805 French adults (mean age at baseline 42.8 years (SD 14.6)), mean follow-up 5.5 years (SD 3.0, i.e. 579,155 persons years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared to intakes below 57 g/d (HR=0.81 [0.66-0.98], p-trend=0.01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomized controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.

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