Cardiovascular Reviews

Cardiovascular disease (CVD) includes several conditions which affect the heart and circulatory system. These include high blood pressure, angina, heart attacks and stroke / TIA amongst others.

There are several risk factors for CVD

  • Smoking
  • Alcohol
  • Hypertension (high blood pressure)
  • High cholesterol levels
  • Diabetes
  • Being physically inactive
  • Being overweight / obese

 

Within Affinity Care anyone with established cardiovascular disease will have at least an annual review to discuss the following:

  • Any symptoms you are experiencing.
  • The medications you are prescribed to check for side effects and ensure the combination and dosing is optimal for your conditions.
  • Advice on any lifestyle modifications which may be needed and signposting to relevant healthcare providers.
  • A discussion on self-care and ways to manage your conditions at home.

An annual review will include an appointment to check height, weight, pulse and blood pressure alongside any investigations (e.g blood tests, urine tests, ECG) that may be required, followed by a planned telephone review.

These reviews are undertaken by our Long Term Conditions clinical teams, which is a multidisciplinary team of healthcare professionals including Pharmacists, Nurses, Advanced Clinical Practitioners (ACP) and GPs, along with the support of the practice Healthcare Assistants.

If a problem is identified that the Long Term Conditions team cannot manage, then you will be referred to our clinical access teams (GPs and ACPs) to decide on further management.

By bringing a mixture of healthcare professionals together, we can ensure your long term condition reviews are being managed in the most holistic manner, covering multiple angles and ensuring you are receiving the most up to date care.

 

What is a normal blood pressure reading?

A normal blood pressure reading is below 140/90, but if you have heart or circulatory disease, diabetes or kidney disease, your blood pressure should ideally be less than 130/80.

If you want to monitor your blood pressure at home, it can be a good idea to get a blood pressure machine that lets you keep a track of your blood pressure readings at times that are suitable for you.

How to check your blood pressure using a blood pressure machine

  1. In order for it to be an accurate reading it’s important that you’re resting and that you’re not feeling anxious or stressed.
  2. Sit upright in a chair, your back against the back of the chair, and place your feet flat on the floor.
  3. Rest your arm on a table if you have one and just make sure your hand and arm are relaxed on the table. It’s important that you don’t clench your fist when you’re taking your blood pressure.
  4. Place the cuff over your upper arm and tighten the cuff over your arm, making sure you can fit two fingers underneath the cuff. You want the cuff to be over the upper part of your arm with the tubing leading down the centre or slightly to the right of your arm.
  5. When you check your blood pressure, don’t talk and just relax. Press the on button, and then press the start button.
  6. You’ll feel the cuff inflate quite rapidly. It may temporarily be a bit tender or uncomfortable for,  as the cuff inflates and deflates automatically, but this will only be for a short period of time. If it is too tender/uncomfortable you can just press the ‘Stop’ button and the cuff will instantly deflate.
  7. Once you get your reading, make a note of the reading.
  8. A few minutes after you’ve taken your blood pressure, it’s a good idea to check it again, to make sure the readings are similar and accurate.
  9. If you’ve been asked by the practice to check your blood pressure, take it twice a day – morning and evening – recording the lowest of the 2 readings over the course of a week to generate 14 readings.

Treating high cholesterol

There is lots you can do to help lower your cholesterol:

If lifestyle changes are not enough to lower your high cholesterol, we may suggest medication. If you are diagnosed with high cholesterol, you will be invited for a blood test every year to check your levels and adjust your treatment if necessary.

Statins are the main type of medicine used to reduce cholesterol. But there are other treatments available. The team will let you know if you need to take any other drugs which help control your cholesterol levels

What causes obesity or weight gain?

The causes of obesity include many things such as:

  • portion sizes
  • medical conditions and medications
  • our genes
  • stress and lack of sleep
  • junk food advertising
  • food labelling
  • the fat and sugar content of every day foods
  • the calorie content of food and drink served in restaurants and cafes

We know managing your weight can be difficult. A good place to start is to know about calories. The amount of energy in food or drink is measured in kilocalories (kcal), you may hear them called calories. You bring energy (calories) into your body by eating and you burn calories by being active. When you eat and drink more calories than you use up, your body keeps the excess calories as body fat. If you regularly eat more calories than you use up, you will start to gain weight.

If you’re concerned about your weight and you would like help to start managing it, you can speak to the team

How do I know if I have excess weight or obesity?

There are three measurements that are helpful to work out if you have excess weight or obesity:

  • Body Mass Index (BMI)
  • waist circumference and
  • Waist: height ratio

How to work out your BMI

The first step to calculating your BMI is to measure your height and weight. The practice can do this for you if you can’t do this at home.

Using your height and your weight, you’ll be able to work out your BMI.

Your BMI score will place you into one of these categories: underweight, healthy, overweight or obese.

  • Underweight: BMI below 18.5
  • healthy weight: BMI 18.5 to 24.9
  • overweight: BMI 25 to 29.9
  • obesity class 1: BMI 30 to 34.9
  • obesity class 2: BMI 35 to 39.9
  • obesity class 3: BMI 40 or more

There are lots of resources online to help you eat more healthily and lose weight by recognising unhealthy foods and sticking to healthier recipies

https://www.bhf.org.uk/informationsupport/support/taking-control-of-your-weight

Why should I exercise?

It’s well-known that exercise is good for your health. When it comes to your heart, it can reduce your risk of heart and circulatory diseases by up to 35% – giving you peace of mind and a longer life. Getting active can also help you:

  • control your weight
  • boost energy and improve sleep
  • improve mental health
  • improve symptoms of heart and circulatory conditions like angina pain in the long-term – making everyday life easier and letting you do more
  • reduce blood pressure and cholesterol, which lowers your risk of getting heart and circulatory diseases like heart attacks, strokes and vascular dementia
  • reduce feelings of stress.

How much exercise should I do?

It’s recommended that you do at least 150 minutes of moderate intensity exercise per week. Moderate exercise is when you feel warm and comfortably breathless like when walking or pushing a lawn mower. Intense exercise is when you breathe hard and fast like when running, swimming or cycling.

What one person finds moderate may be intense to another. That’s why it’s helpful to do the ‘talk test’ while you’re exercising to find the right level for you. The talk test:

  • if you can comfortably talk while being active
  • feel warm and are breathing a little more heavily than normal
  • you’re moving at the right pace.

Whether it’s walking or weights, it’s important to start low and slow and to ‘listen’ to your body. A session could be as little as five or 10 minutes. Even the smallest changes can have great results.

It’s best to spread your exercise evenly over the week, making sure you have some rest days to ensure your body recovers. Recovery can be just as important for improving your fitness as the exercise itself. Being active is about living a happier, healthier life and should fit into it how you live.

What are the benefits of quitting smoking?

You will notice benefits sooner than you think:

  • your heart rate and blood pressure will begin to return to normal after 20 minutes
  • your sense of smell and taste will begin to improve after 2-3 days
  • your breathing will begin to improve, and exercise may be easier after 2-12 weeks
  • your risk of a heart attack is half that of a smoker after 1 year.

Quitting smoking also has other benefits like:

  • you will have fresher breath and whiter teeth
  • your skin might look younger and age less quickly
  • you might have more energy, feel less tired and get less headaches
  • your immune system will find it easier to fight off colds and flu
  • your sex drive may increase, and it can improve your fertility
  • you will protect the health of your children, family and friends.

It’s never too late to benefit from stopping smoking. On average, men will add 10 years to their life if they quit by the age of 30. Many people will add 3 years to their life if they quit by the aged of 60. Being a non-smoker can also improve your chances of being more physically active and healthier as you get older.

How can I quit smoking?

If you quit smoking, you will greatly improve your health and the health of everyone around you. It may feel hard to resist the temptation to smoke sometimes. But you can make small changes to make it easier to stick to it:

  • Try to think positively – even if you’ve tried to quit before and didn’t manage it, don’t let it put you off trying again.
  • Set a date to quit and tell your family, friends and colleagues so they can help you stick to it.
  • Plan how you will deal with your cravings when you’re at events and times where you would usually smoke.
  • If you usually smoke after meals, eat foods that can make cigarettes taste bad like cheese, fruit and vegetables. Or change your routine to keep your mind busy when you would usually smoke, like washing the dishes straight after eating.
  • Cravings usually last around 5 minutes. Plan things you can do in 5 minutes to stay busy for when you get cravings.
  • When you’re out, hold your drink with the hand that used to hold cigarettes and use a straw. This will help to keep your hands and mouth busy.
  • When you get a craving, remind yourself of why you’re quitting. You may want to carry a picture of your family with you to look at if you’re tempted to smoke.

You are not alone. Aside from your family and friends, you can get support from healthcare professionals, stop smoking programmes and nicotine replacement therapy.

How does alcohol affect my health?

For your health, it’s important to try to stay within the recommended guidelines of no more than 14 units of alcohol per week. That’s because drinking too much alcohol (more than the recommended 14 units) on a regular basis can cause:

  • abnormal heart rhythms
  • damage to your heart muscle
  • diseases such as stroke, liver problems, vascular dementia and some cancers
  • high blood pressure
  • palpitations (when you suddenly become aware of your heartbeat pounding or beating more quickly than usual)
  • weight gain from the calories in alcohol and unhealthy food choices when drinking.

How much can I safely drink?

There’s no completely safe level of drinking. If you drink alcohol, it’s important to keep within the guidelines to lower your risk of harming your health by:

  • not drinking more than 14 units of alcohol each week
  • having several alcohol-free days each week.

These guidelines apply whether you drink regularly, or only occasionally.

Most people don’t drink alcohol every day – but if you do, you should aim to have some days off. Just make sure you don’t increase the amount you drink on the other days. If you do drink as much as 14 units per week, spread this our evenly over three days or more.

Drinking large amounts of alcohol in one go – binge drinking – can have a serious impact on your short and long-term health. It can put you at greater risk of falls, accidents, anti-social behaviour, alcohol poisoning and affect your mood and memory.

In the long term, it can increase your risk of becoming dependent on alcohol, alcohol-related cancer and heart disease. Binge drinking is considered drinking:

  • more than 6 units of alcohol for women
  • more than 8 units of alcohol for men.

That’s equivalent to drinking about four pints of normal strength beer (4% ABV) for men and three pints for women in one go!

How much is one unit of alcohol?

How many units of alcohol do you consume each week? It’s a hard question to answer when you visit the surgery. We usually count by the number of drinks we’ve had, but units are how alcohol is properly measured.

The number of units in a drink is based on the size and its alcohol strength (ABV). The ABV (alcohol by volume) figure is the percentage of alcohol in the drink. So, units are an easy way to tell you how strong your drink is.

The ABV strength of some alcohols are:

  • 4% – a pint of ‘regular’ lager, beer or cider
  • 5% – a pint of ‘strong’ or ‘premium’ lager, beer or cider
  • 12-13% – a standard glass of wine (175ml)
  • 20% – a glass of liqueur (50ml)
  • 40% – a single pub measure of spirits (25ml).