CARDIAC RISK ASSESSMENT
Cardiovascular diseases are caused by the build up of small fatty deposits, called atheroma inside the lining of arteries, which can reduce the blood flow. Small bits of atheroma plaque can break off the artery wall and block the artery further down and blood clots then form around this to produce a thrombosis. Depending on the site of the atheroma this causes include heart attack, angina, stroke, and peripheral vascular disease.
Cardiovascular risk assessment should be carried out on all adults over 40, especially those with a strong family history. This means a father or brother who developed heart disease or a stroke before they were aged 55, or in a mother or sister before they were aged 65. It is also important if there is a family history of very high cholesterol.
We will ask you about risk factors like smoking, obesity, a poor diet, lack of physical activity, and drinking excessive alcohol. We will take blood tests to measure your cholesterol profile, kidney function and glucose level. Your blood pressure will be measured. A score is then calculated based on several of these risk factors as well as your age and sex. This will tell how high your risk is of developing heart disease and helps us to give you specific, personal advice on prevention.
The risk calculation is given as a percentage. So, for example, if your score is 20% this means that you have a 20% chance of developing a cardiovascular disease within the next 10 years. Risk groups are divided into:-
High risk – if your score is 20% or more. This usually needs significant lifestyle change and may need medication for cholesterol or blood pressure
Moderate risk – if your score is 10-20% This may respond to significant lifestyle change
Low risk – if your score is less than 10% This may need little or no lifestyle change
Erectile dysfunction (ED) or impotence means that you cannot get and/or maintain an erection. Most men have occasional times when they cannot get an erection if they are stressed or tired. However, some men have persistent ED. It can occur at any age, but becomes more common with increasing age. About half of men between the ages of 40 and 70 have ED. About 7 in 10 men aged 70 and above have ED.
In many cases it is due to an underlying physical condition. Reduced blood supply to the penis, caused by narrowing of the arteries is the commonest physical cause and this can be due to Diabetes, smoking and high blood pressure; high cholesterol; and increasing age. Some medications can contribute to ED and occasionally some neurological or hormonal causes can also contribute to the problem Common psychological causes can include anxiety & stress, depression relationship difficulties. Alcohol and drug misuse can also cause ED.
We can carry out a full assessment to see if you have an underlying medical cause and can prescribe medication if appropriate. Medication to help with erectile dysfunction is usually very effective for most men.
SEXUALLY TRANSMITTED DISEASES
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Prostate cancer is a serious condition which is responsible for 2% of deaths in men. Prostate assessment includes a review of any urinary symptoms and family history, a digital rectal examination of the prostate gland and a PSA blood test.
However, the PSA test, which can give an early indication of prostate cancer, has both advantages and disadvantages as a screening test. Experts disagree on how useful the PSA test is and this is why there is no national screening programme for prostate cancer in Ireland. We can discuss this as part of an overall assessment and help you decide if PSA screening is right for you.
The prostate gland often gets bigger in older men. This prostate gland enlargement is called benign prostatic hyperplasia (BPH). It can cause problems with passing urine, like slowing of the stream, having to get up at night to pass urine, and urinary frequency during the day.
Symptoms are often mild and may not cause much bother. If symptoms become troublesome or distressing they can often be improved by medication.
We can offer you information, advice and help when you are actively thinking of stopping smoking. Various medicines are available which can increase your chance of quitting. These include Nicotine Replacement Therapy (NRT) which comes as various forms. You can buy NRT without a prescription. A medicine called varenicline (trade name ‘Champix) can also help and these are available on prescription.