1. GORING AND WOODCOTE MEDICAL PRACTICE PATIENT PARTICIPATION GROUP (PPG) Cardiovascular Disease 10 September 2016 Slide 1 Open Meeting

2. Agenda Introductions Healthwacth – Jen Marks Stroke Association – Harriet Hammond Information provided by: British Heart Foundation Heart Disease UK Going Gap Health Walks Cardiovascular disease from the GP perspective – Dr Ed Cap-Bianco Cardiovascular Disease from the consultant’s view - Dr Will Orr Questions Slide 2

3. Dr Ed Capo-Bianco GP

4.  Encompasses the cardiovascular system, including disorders of the Heart, Coronary Arteries, Strokes, Aorta and Peripheral Arteries

5.  In 2011  160,000 deaths due to CVD, around 74,000 due to CAD – UKs biggest killer  Around 103,000 heart attacks a year in UK  152,000 strokes/year, leading to 41,000 deaths Source NHS UK

6.  CHD (inc Heart attacks, Angina) = 317 on register out of 9681 = 3.2%  Strokes/TIA = 223 patients on register = 2.3%  Peripheral Arterial Disease = 51 patients  Hypertension register = 1490 patients

7.  Myocardial Infarction/STEMI/ACS  Blockage to the blood supplying the heart muscle – coronary artery  Angina – restriction in the blood supply to the heart muscle, typical producing chest pain or breathlessness on exertion

9.  2 Main types  Commonest 90% – Blockage to the blood supplying the Brain – called Ischaemic Stroke  10% caused by rupture to a blood vessel – bleed on the brain or Haemorrhagic Stroke  TIA – Transient Ischaemic Attack or ‘Mini- Stroke’ – Symptoms in keeping with a stroke but resolve within 24 hours

11.  Large blood vessel arising from Heart  Runs through abdominal cavity  Can be aneurysmal – enlarged diameter – risk of rupture  Screening programme for Men at age 65yr  Often asymptomatic

13.  Restriction of blood supply (arterial) to peripheries  Most commonly legs/feet affected  Typically presents with pain on walking,  Ulcers and reduced sensation in diabetic patients

15.  Age  Sex  Smoking  Obesity  Hypertension (Raised Blood pressure)  Hypercholesterolaemia  Diabetes  Family History (close relative <60yrs)  Past history of CVD

16.  Stop smoking  Control Weight  Alcohol in moderation new guidelines <14u for men and women/week  Take regular exercise – 30mins for 5 days a week  Balanced diet, reduced fatty meat, oily fish, nuts, wholemeal, 5 Fruit/Veg a day

17.  Good vs Bad  Is it all about cholesterol  Good robust clinical evidence that statins reduce the risk of heart attacks and strokes as primary and secondary prevention  12% reduction all cause mortality, 30% reduction in coronary and 19% reduction cerebrovascular events  Small risk of Side effects, muscle aches etc

18.  Commonest Arrhythmia, 8% of over 75yrs  Irregular heart rate  Increases risk of a Stroke  Reason for thinning blood with warfarin, controlling other risk factors  G&W = 253 in total, 197 over 70yrs

21. GORING AND WOODCOTE MEDICAL PRACTICE PATIENT PARTICIPATION GROUP (PPG) Cardiovascular Disease 10 September 2016 Slide 21 Open Meeting

22. Things to watch out for The Oxfordshire and Sustainability Transition Plan (STP) OCCG are seeking your views on how local GP, community and hospital services should develop so services are of high quality, closer to home, more convenient with better access and can overcome a £200m funding gap by 2020/21. The Big Healthcare Conversation Public consultations this Autumn Slide 22

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