How is co-infection with coronary heart disease and ischemic stroke assessed? Take a look at the latest expert consensus

Cardiovascular and cerebrovascular diseases have become the most important diseases that endanger the health and life of Chinese residents, and are also the main diseases
that cause the loss of life expectancy, poverty due to illness, and return to poverty due to illness.
The Expert Consensus on the Co-Existing Management of Primary Coronary Heart Disease and Ischemic Stroke focuses on evidence-based medical evidence
for coronary heart disease and ischemic stroke (comorbidity) and the management of coexisting risk factors and/or comorbidities.
Regarding the co-morbid assessment of coronary heart disease and ischemic stroke, the consensus mainly involves the following
.

Coronary heart disease and ischemic stroke co-assessment is to prevent the recurrence of cardiovascular events in patients with cardio-cerebral comorbidities, and primary medical institutions should focus on the patient's condition assessment and risk assessment of recurrent cardiovascular events, and the problems found should be referred
in time.

Assessment of coronary heart disease

(1) Stable angina chest pain symptom assessment: The severity of angina pectoris is divided into 4 levels
.
Level 1: general physical activity (walking and ascent) is not restricted, but angina occurs when strong, fast, or sustained exertion; Level 2: Mild restriction of physical activity in general, angina pectoris in rapid walking, after meals, cold, mental stress, and several hours after waking up, and angina pectoris occur when walking more than 200 meters on the ground or climbing the first floor of the building under normal circumstances; Level 3: General physical activity is obviously limited, generally walking within 200 meters of flat ground or climbing the 1st floor of the building to develop angina; Level 4: Angina can occur with light activity or rest
.

(2) Recurrent unstable angina / myocardial infarction: stable angina, myocardial infarction and unstable angina are in the stable stage after drug treatment, PCI treatment, coronary artery bypass transplantation and patients with one or more of the following conditions can consider recurrent unstable angina or myocardial infarction: (1) Frequent angina pectoris in the past 1 month; (2) (spontaneous) angina at rest; (3) Chest pain lasts longer, the degree is severe, and it is not easy to be relieved
by nitroglycerin.

(3) Treatment decision-making: stable angina chest pain assessment of grade 3 or 4 and recurrence of unstable angina or myocardial infarction patients are recommended to be referred to a higher hospital, to clarify the degree and diagnosis of coronary artery disease, and to take further treatment measures
.

Assessment of ischemic stroke

(1) Ischemic stroke stage: divided into acute stages according to the course of the disease: within 1 month after the onset of the disease, the condition is the most serious and requires timely and correct treatment; Recovery period: 2 to 6 months after the onset of the disease, through treatment, secondary prevention and TCM physiotherapy, TCM rehabilitation and other measures, the symptoms of acute neurological dysfunction are improved; Sequelae phase: more than 6 months after the onset of the disease, vital signs are stable, signs and symptoms are no longer progressing, and there may be a certain degree of sequelae
.

(2) Recurrent stroke: patients with a history of previous stroke should consider recurrent stroke if one or more of the
following conditions suddenly occur.
(1) Weakness or numbness of the newly emerging limb (with or without face); (2) Numbness or crooked corners of the mouth in the newly emerging side; (3) Unable to speak clearly or have difficulty understanding language; (4) Gaze to one side with both eyes; (5) Loss or blurring of vision in one or both eyes; (6) Vertigo with vomiting; (7) Rare severe headache and vomiting; (8) The above symptoms are accompanied by impaired consciousness or convulsions
.

(3) Treatment decision-making: For patients with acute or convalescent period with ischemic stroke history within 3 months, it is recommended to carry out standardized treatment and rehabilitation in a higher-level hospital, and those suspected of recurrent stroke are recommended to be referred to a higher-level hospital for clear diagnosis and further treatment measures
.

Risk assessment for cardiovascular events with cardio-cerebral comorbidities

Patients with cardiocerebral comorbidities were identified as ultra-high-risk patients with atherosclerotic cardiovascular disease, and treatment decisions and risk factor control goals
were determined on this basis.
Failure to follow treatment, substandard risk factor control, and unhealthy lifestyles all increase the risk of
recurrent cardiovascular events.

1.
Treatment adherence

Cardiocerebral comorbidities have standardized secondary preventive drug treatment and play a key role in factor control and long-term prognosis
.
Primary medical institutions should often assess the patient's medication compliance, and remind and help the patient to take the medication
according to the doctor's instructions.
Treatment adherence assessment includes the type of drug, the dose of the drug, the time of administration, the number of medications, and the
duration.

2.
Risk factor control

The following risk factors are strongly associated with recurrent cardiovascular events, including: (1) diabetes; (2) Hypertension; (3) High levels of low-density lipoprotein cholesterol (LDL-C); (4) Chronic kidney disease stage 3 or 4; (5) Smoking
.
Patients should be assessed for concomitant risk factors and controls, as shown in the original text
.

3.
Other cardiovascular health influencing factors

Including reasonable diet, physical activity, healthy psychology, healthy weight, hyperhomocysteinemia, coagulation factors, oral contraceptives, etc
.

Diagnosis and evaluation process of coronary heart disease and ischemic stroke are co-existent