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CARDIOVASCULAR DISEASE (CVD) RISK: DIAGNOSISCardiovascular disease (ischaemic heart disease, peripheral vascular disease, stroke) is preventable and treatable.Identify the patient with established cardiovascular disease:• If patient has or has had chest pain, screen for ischaemic heart disease 15.• If patient has or has had leg pain, screen for peripheral vascular disease 36.• If patient has had sudden weakness of limb/s or face, visual disturbance, difficulty speaking or understanding, dizziness, or severe new headache, screen for stroke 76.Look for risk factors for cardiovascular disease:• Ask about smoking.• Look for hypertension. Hypertension is diagnosed at different BP levels depending on risk factors. Check BP 73.• Check random finger prick glucose for diabetes and interpret result 70.• Calculate BMI (weight (kg)/[height (m) x height (m)]). More than 25 is a risk factor.• Measure waist circumference on breathing out, midway between lowest rib and top of iliac crest. More than 80cm (woman) or 94cm (man) is a risk factor.Calculate the patient’s risk of a heart attack or stroke over the next 10 years:• Plot the patient’s risk on the charts below using age, BMI and systolic BP in the columns for sex and smoking status.• Do not use these charts if the patient is known to have diabetes and/or CVD as s/he is already at high risk.> 140131-140121-130111-120Non-Diabetic ManNon smokerSmoker> 60 yearsRisk of heart attackor stroke over thenext 10 years:> 20%> 140131-140121-130111-120Non-Diabetic WomanNon smokerSmoker> 60 yearsSystolic Blood Pressure171-180161-170151-160141-150131-140121-130111-120171-180161-170151-160141-150≤ 140< 50 years< 20 20-25 26-30 > 30 < 20 20-25 26-30 > 30BMIBMI10-20%< 10%171-180161-170151-160141-150131-140121-130111-12050-60 years 50-60 years171-180161-170151-160141-150≤ 140Manage the CVD risk in the patient with CVD or a CVD risk ≥ 10% and/or CVD risk factors 69.Systolic Blood Pressure< 50 years< 20 20-25 26-30 > 30 < 20 20-25 26-30 > 30BMIBMI68CHRONIC DISEASESOF LIFESTYLE