Cardiovascular health

• Cardiovascular disease (CVD)


  Group of diseases that involve the heart and blood vessels
• Conditions included in CVD


  • Coronary heart disease (including atherosclerosis)
  • Cerebrovascular disease (including stroke)
  • Peripheral artery disease (eg narrowing of arteries in legs due to diabetes or obesity)
  • Atrial Fibrillation and other arrythmias
• CVD is a leading cause of death in Australia
• Non-modifiable CVD risk factors


  • Age
  • Gender
  • Genetic factors/ethnic background
  • Family history
• Modifiable CVD risk factors


  • Blood pressure
  • Plasma lipid levels
  • Fasting glucose
  • BMI
  • Smoking status
  • Dietary factors
  • Exercise level
• Indigenous Australians are more likely to suffer from CVD and the age of onset occurs 10-20 years earlier
• Seven criteria for prevention of CVD (modifiable risk factors)


  • Plasma lipids
  • Blood pressure
  • Fasting glucose
  • Smoking
  • BMI
  • Diet
  • Activity
• Plasma lipids


  Individual targets for cholesterol and triglyceride
• High plasma total and LDL cholesterol


  Increases risk of atherosclerosis
• Hypertension (high blood pressure)


  Puts stress on the endothelium, increases workload of the heart, and increases risk of stroke if untreated
• Blood pressure regulation is complex, involving various mechanisms and medications
• High blood glucose levels


  Increases risk of cardiovascular, vision, renal, nerve and wound healing issues in type 2 diabetes
• Smoking


  Causes damage to endothelium and lipoproteins
• Mechanisms common between smoking, dyslipidaemia and diabetes include oxidation, immune activation, endothelial damage, inflammation and cell death
• Measures of body weight


  • BMI
  • Waist circumference
• Australia has high rates of overweight and obesity in adults
• Dietary factors for CVD prevention


  • Salt
  • Dietary cholesterol
  • Dietary fat incl. trans-fat
  • Weight management
  • Carbohydrate incl. sugar
• The average Australian diet score has gone backwards, with too many discretionary foods consumed
• Increased physical activity has benefits for CVD such as increasing HDL, releasing nitric oxide, lowering blood sugar and leading to weight loss
• Pharmacists can engage in screening, promote non-pharmacological management, help with medication management, and work with patients to address CVD risk factors