Cardiovascular risk assessment

Introduction

• Wash hands, introduce self, check patient ID
• Explain/introduce consultation and gain consent

Risk Assessment

Basically a focused history based on CVS risk factors

• Ask about demographics i.e. age, (sex), (ethnicity),
  • The other non-modifiable risk factors include family history and personal history
• Move on to current/modifiable risk factors i.e.
  • Current medical history
    • Hypertension- control, medications etc
    • Diabetes- control, medications, duration, etc
    • Lipids/cholesterol (if known)- again- any medications?,
    • Other conditions to consider include kidney disease; thyroid disease; AF etc
  • Social factors
    • Diet
    • Exercise
    • Occupation (both for stress and activity)
    • Smoking
    • Alcohol intake

Behaviour modification/Risk Reduction

• Give feedback on risk
• Where there is time
  • Assess how willing the patient is to change high risk behaviour
    • If so, give some advise as to methods of doing this e.g. smoking cessation aids, easy ways of increasing activity etc
• Ask about ideas, concerns and expectations and try to address these

Investigations/Follow-up

• Measure BP and take bloods for cholesterol/lipids
  • Treat where appropriate
• There are cardiovascular risk calculators which can be used e.g. QRISK, ASSIGN score

Ending

• Summarise the consultation and any decisions made
• Thank the patient
• (Wash hands)