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Moderate Risk Example
Read through the following 3 cases to see various ways you might use the risk assessment tool in different situations.
Moderate Risk Case 3
Susan is a female patient aged 47 with 167/83 mm Hg blood pressure, total serum cholesterol of 6.3 mmol/L, HDL cholesterol of 0.9 mmol/L, with no history of diabetes or family CVD. She is overweight with a BMI of 27, smokes 1 cigarette a day and is not willing to take drugs because blood pressure medication made her get vertigo in the past, and she has heard bad media reports about statins.
Feedback
The risk is moderate (14%), so medication is not recommended in the guidelines, unless there are additional risk factors or lifestyle change has been ineffective after 3-6 months.
Some patients may be very anti-medication, as a general attitude or because of side-effects experienced in the past. In this case the risk calculator can be used to show how they can achieve similar changes to CVD risk with lifestyle changes to diet (e.g. following a Mediterranean diet) and physical activity (e.g. increasing the number of walks per week to meet national guidelines). Some GPs also use the concept of medication as a way to motivate lifestyle change – if the patient can achieve enough change in blood pressure and cholesterol, then they may avoid reaching the medication threshold.
Once you’ve explained to them their risk most of them understand very well where they’re going and what they need to do and they always, most of them are pretty keen on the lifestyle modification – Doc if I do that do you think it will come down, I don’t have to take a tablet
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Peer discussion
Moderate Risk Case 3
Susan is a female patient aged 47 with 167/83 mm Hg blood pressure, total serum cholesterol of 6.3 mmol/L, HDL cholesterol of 0.9 mmol/L, with no history of diabetes or family CVD. She is overweight with a BMI of 27, smokes 1 cigarette a day and is not willing to take drugs because blood pressure medication made her get vertigo in the past, and she has heard bad media reports about statins.
Feedback
The risk is moderate (14%), so medication is not recommended in the guidelines, unless there are additional risk factors or lifestyle change has been ineffective after 3-6 months.
Some patients may be very anti-medication, as a general attitude or because of side-effects experienced in the past. In this case the risk calculator can be used to show how they can achieve similar changes to CVD risk with lifestyle changes to diet (e.g. following a Mediterranean diet) and physical activity (e.g. increasing the number of walks per week to meet national guidelines). Some GPs also use the concept of medication as a way to motivate lifestyle change – if the patient can achieve enough change in blood pressure and cholesterol, then they may avoid reaching the medication threshold.