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Ailments and Diseases
Published in James Sherifi, General Practice Under the NHS, 2023
The working hypothesis of the Framingham group was that hypertensive and arteriosclerotic cardiovascular disease did not have a single cause but was rather the culmination of multiple factors. Their published work in 1961 detailed a list of preconditions, hypertension, hyperlipidaemia, obesity, arrhythmia, and smoking (exercise was identified as decreasing risk) that became the ‘cardiovascular risk factors,’ the basis of all cardiovascular consultations. All these elements were subsequently refined into the Framingham cardiovascular risk score, the common tool for predicting cardiovascular morbidity in the NHS before the introduction of more UK-specific population algorithms, such as QRISK.23
Human Immunodeficiency Virus and Opportunistic Infections
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Bone health and cardiovascular health in HIV patients are again areas of concern; incidents occur more frequently and at an earlier age than the general population, either due to medication, inflammation, the HIV itself or lifestyle factors, so active screening via tools such as the FRAX score or QRISK are imperative.
Knowledge and evidence
Published in Jane Wilcock, Grace Mutton, General Practice Today, 2017
We will now look further in depth at the CVD risk score programme based on populations from England and Wales, QRISK2, in order to widen our thinking about risk factors. It can also be used in Scotland, N. Ireland, and internationally, though NHS Scotland also recommends ASSIGN, a Scottish population-derived risk tool. QRISK is integrated into the computer systems of all the major GP systems.
Cardiovascular complications of acute respiratory infections: current research and future directions
Published in Expert Review of Anti-infective Therapy, 2019
Jennifer A. Davidson, Charlotte Warren-Gash
While prevention of ARIs themselves is likely to result in the greatest clinical and public health benefit, treatment during the acute phase of infection could also prevent cardiovascular complications. A better understanding of the cardiovascular effects of antivirals is needed, e.g. from RCTs with the primary outcome of cardiovascular complications. Some observational studies have investigated whether other drugs including statins, corticosteroids and antiplatelet agents may potentially reduce risk of CVD events during acute infections [25–27]. Further research is needed on the effectiveness, timing and target populations for any such treatments. Observational research suggests cardiac biomarkers provide one method to identify patients with ARI who are at high risk of cardiovascular complications [28]. This cohort study identified hospitalized CAP patients who had blood samples taken at several time points during the first 30 days of admission and showed multiple biomarkers were higher among patients who had a cardiovascular event. People with high overall vascular risk score, such as Framingham or QRISK, are another group who could be targeted for early intervention.
What are medical students’ attitudes to clinical risk-scoring tools? An exploratory study
Published in Education for Primary Care, 2019
Fiona Tomlinson, Thomas A Willis
This study offers the first insight into medical students’ attitudes towards clinical risk-scoring tools. Participants reported a good understanding of the tools, including their practical application and the advantages, enablers and barriers to their use. They appeared to trust the tools and their evidence base, believing they have the potential to be advantageous to practice. First, they can help to support clinical decision making, ensuring safe practice within medicine. This is particularly helpful for junior doctors with limited experience, to help refine their history-taking skills, to prevent them forgetting important questions and to justify their clinical decisions to seniors, patients and if required for legal purposes. Second, they may provide an effective way of communicating clinical risk to patients, which has been cited as a major advantage of risk-scoring tools, such as QRISK®2 [18,19]. Finally, risk-scoring tools may have a novel role in undergraduate medical education, as they complement learning about risk factors, history-taking and risk stratification. This area is yet to be explored and could benefit from further research.
When are the cardiovascular and stroke risks too high? Pharmacotherapy for stroke prophylaxis
Published in Expert Opinion on Pharmacotherapy, 2018
Antonio Gómez-Outes, Mª Luisa Suárez-Gea, Jose Manuel García-Pinilla
The QRISK 3 algorithm is a general CV risk score that has been developed and intended for the United Kingdom’s (UK) population [14]. Equation is based on cohort study in primary care including several million patients and more than 100,000 CV events (Table 1). The online risk calculator available gives an estimate of the 10-year CV risk of CHD [angina and myocardial infarction (MI)], stroke, or TIA (Table 1), but no advice is given depending on the risk. One of the main limitations is that it has not been calibrated for countries outside the UK.