Age-friendly Primary Health Care Centres Toolkit - World Health ...

AGE-FRIENDLY PRIMARY HEALTH CARE CENTRES TOOLKITTable 1 – Important factors influencing prognosis and assessment of CVD risksRisk factors forcardiovascular disease(CVD)Target Organ Damage(TOD)Associated ClinicalConditions (ACC)I Used for riskstratificationSystolic and diastolicblood pressure (mild,moderate or severe) Age>55 (men) >65(women)SmokingTotalcholesterol>6.5mmol/lor TC/HDL ratio>5.0 Diabetes Family history of CVDII Other Factors adverselyinfluencing prognosis- Reduced HDL cholesterol- Raised LDL cholesterol- Microalbuminuria indiabetics- Impaired glucosetolerance- ObesityLeft ventricularhypertrophy (ECG orecho)Proteinuria and/orcreatinine>150 µmol/lAtherosclerotic plaque(X-ray or ultrasoundevidence in carotid,iliac, or femoral arteriesor aorta)CerebrovasculardiseaseIschaemic strokeHaemorrhagic strokeTransient ischaemicattackVascular dementiaCardiovascular diseaseMyocardial infarctionCongestive cardiacfailureRenal diseasePeripheral vasculardiseaseAortic aneurysmRetinopathySource: British Cardiac Society; British Hyperlipidaemia Association; British Hypertension Society; British DiabeticAssociation. Joint British recommendations on prevention of coronary heart disease in clinical practice. Heart. 1998;80(suppl 2):S1–29.Table 2 – Stratification of CVD risk to quantify prognosisBlood pressure (mm Hg)Other riskfactors anddisease historyMild hypertensionSBP 140-159or DBP 90-99ModeratehypertensionSBP 160-179or DBP 100-109No other riskfactorsSeverehypertensionSBP ≥180or DBP ≥110LOW RISK* MEDIUM RISK HIGH RISK1-2 risk factors MEDIUM RISK MEDIUM RISK VERY HIGH RISK3 or more riskfactorsOr TOD orHIGH RISK HIGH RISK VERY HIGH RISK69