Cardiovascular

Health Diary
Your cardiovascular health diary
This diary is specially designed to help you keep track
of your medication and avoid confusion.
Your Patient Health Diary is also
a useful record of your health.
As you will see, the diary contains
recording sections for medication
and for measurements, such as
blood pressure, so at any time you
and your doctor can see how you
are responding to treatment.
While cardiovascular disease is
common in Australia, there have been
important improvements in treatment
in recent years. As a result, death
rates from cardiovascular disease
have fallen significantly.5 This book
should help ensure that you receive
the maximum benefit from your
treatment.
How to use this book
Take it with you whenever you
see your doctor or fill a prescription
from a pharmacist. Ask your
doctor or specialist to record
any measurements taken in the
appropriate section. Make sure that
your pharmacist completes the
dispensing section: If your pharmacist
substitutes a generic drug for the
prescribed drug it is important that
this change is recorded.
Managing multiple
medications
This book will help you keep track
of the medications you take, their
strengths and any changes to
medication that your doctor or
pharmacist makes.
In a recent survey, up to one in four
Australians reported taking four or
more prescription medications5. When
prescribed a number of medications,
there is always the possibility of not
always taking the correct medication
at the correct time. To avoid this
possible confusion, keep this book
up-to-date at all times, and get rid of
any medications that are no longer
current for you. If you have any doubts
about your medication, take this book
with you and ask your doctor or
pharmacist to clarify the situation.
Please note: The information within
this diary is intended as a general
introduction and is not meant to
substitute for your doctor’s or
healthcare professional’s advice.
All care is taken to ensure that the
information is relevant to the reader.
If further information is required,
please discuss with your doctor or
healthcare professional.
Lifestyle recommendations
In addition to taking the medications prescribed by your doctor,
you can take an active part in your treatment by implementing
lifestyle changes that have been shown to support your
prescribed medications and improve your quality of life1.

Smoking cessation Speak to your doctor about advice

on healthy eating. You may also be
Smoking has been shown to referred to a dietician for further
increase the risks associated advice on healthy eating.
with coronary heart disease and
stroke and as such it is highly
recommended that as a part of your
treatment that smoking be ceased.
There are a number of programs
available to assist you to stop
smoking. Talk to your doctor or
pharmacist about which program
is best for you.

Healthy eating
Healthy eating that comprises
mainly plant based foods with
moderate amounts of lean meats,
fish and reduced fat dairy products
with moderate amounts of poly-
unsaturated and monounsaturated
(good) fats has been shown to
reduce the likelihood of coronary
heart disease and the risks of
heart attack and stroke.
Alcohol consumption
Moderate alcohol consumption
(up to 2 standard drinks per day
for men and 1 standard drink per
day for women) is recommended
to support your treatment of
cardiovascular disease.

C a rd i ova s c u l a r H e a lth Diary  

Physical activity
Regular exercise (total of 30 minutes
per day) of moderate intensity on
most days of the week can assist in
the prevention of cardiovascular
disease and reduce the risk of
coronary heart disease and stroke.
Regular exercise can be as simple
as taking a daily walk. Talk with your
doctor about what physical activities
are best for you.

Healthy weight
Maintaining a healthy weight through
healthy eating and physical activity
can assist with the prevention of
cardiovascular disease. A healthy
weight is measured either by Body
Mass Index (BMI) which is calculated
by dividing body weight (kg) by
[height in metres)2 or by waist
circumference usually measured
at the navel.
It recommended that your
BMI should fall in the range of
18.5–24.9, or your waist should
measure less than or equal to
94cm for men or less than or
equal to 80cm for women.
Speak with your doctor or
pharmacist if you are having
difficulty maintaining a healthy
weight.

 Cardiovascular Health Diary

Understanding cardiovascular disease
One disorder, many related conditions.
Cardiovascular disease affects
almost one in five Australians5.
Cardiovascular disease includes
all diseases and conditions of the
heart (cardio) and blood vessels
(vascular). The most common
diseases and conditions include
hypertension (high blood pressure),
heart attack, heart failure, coronary
heart disease, stroke and chronic
kidney disease.
There are a number of risk factors
for cardiovascular disease.1,3 These
include:
• Age – as you age the risk
increases
• Gender – men are more at risk
• Family history of cardiovascular
disease
• Hereditary factors such as race
• Depression
• Chronic health conditions
associated with cardiovascular
disease such as high blood
pressure, high cholesterol
and diabetes.
C a rd i ova s c u l a r H e a lth Diary 
People with cardiovascular disease
may take a number of different
medications to reduce present
conditions, eg. high blood pressure;
and reduce the risk of future events,
eg. stroke or heart attack.
High blood pressure
High blood pressure, medically
known as hypertension, is a
condition that affects over two
million Australians6. High blood
pressure means that your blood
is pumping with more force than
normal through your arteries and
over time, this extra work and
pressure can cause gradual damage
to many organs in your body.
While there are usually no symptoms,
high blood pressure is one of the
causes of stroke, heart disease, and
kidney failure. If not controlled, high
blood pressure can accelerate the
silting of arteries with fatty plaques
(cholesterol). This condition is called
atherosclerosis.

High blood pressure (cont.)
Atherosclerosis contributes to
many illnesses, such as heart attack
and stroke. Other risk factors for
atherosclerosis include cigarette
smoking and high blood cholesterol.
In the blood pressure recording
section, two measurements are
taken. The first, higher number is the
systolic pressure and represents the
pressure in the artery when
the heart is beating. The lower
number is the diastolic and
represents the pressure when
the heart is resting between beats.
The systolic pressure is always
stated first and the diastolic
second, eg. 140/90 (“140 over 90”).

The National Heart Foundation
recommends the following blood
pressure ranges1:
• A blood pressure of <130/85 mmHg
is recommended for adults less
than 65 years; adults with renal
insufficiency (kidney insufficiency)
and/or diabetes and/or proteinuria
0.25 – 1.0g/day (protein in the
urine).
• A blood pressure of <140/90 mmHg
is recommended for adults
65 years or older unless they have
diabetes and/or renal insufficiency
and/or proteinuria
≥ 0.25g/day.
• A blood pressure of <125/75mmHg
is recommended for adults with
proteinuria greater than 1g/day.
Coronary heart
disease/angina
Coronary heart disease (also known
as ischaemic heart disease) is a
condition in which the heart does
not get enough blood (ischaemia),
usually as a result of atherosclerosis
in blood vessels. When the blood
supply to the heart is suddenly
cut off by a blood clot, the result
is a heart attack.
Cardiovascular Health Diary
When the blood supply to the heart
is temporarily restricted, angina pain
can result. When the blood supply to
the brain is cut off by a blood clot,
the result is an ischaemic stroke.
For patients with a history of
coronary heart disease, there are
a number of tests and procedures
that can be used to monitor the
condition. Most commonly, the
heart is assessed using an
electrocardiogram, or ECG,
sometimes in combination with
exercise or stress testing. Your
doctor will use an ECG tracing to
look for “ST segment elevation”
or “T wave changes”.
Apart from heart assessment,
pain from blood supply restriction
to the heart (angina pain) is
commonly reported from exertion.
If reported, medications for
temporary relief and reduction
of associated risk may be
recommended.
If you are diagnosed with
coronary heart disease or angina,
your doctor will advise what
management options are most
appropriate for you.
C a rd i ova s c u l a r H e a lth Diary 
Cholesterol and
triglycerides
Like high blood pressure, high
levels of cholesterol or triglycerides
can increase the risk of heart attack,
stroke and other cardiovascular
diseases.
Cholesterol is an essential type
of fat manufactured in the liver
and found in all tissues (in foods,
only animal products contain
cholesterol). Cholesterol is carried in
the bloodstream in particles called
lipoproteins and these are described
by how big they are. Two commonly
reported lipoproteins are: Low
Density Lipoproteins (LDL); these
are medium sized particles and High
Density Lipoproteins (HDL); these
are the smallest particles.
Like cholesterol, triglycerides are
a type of fat found in your fat cells
and your blood. Triglycerides are
the main form of fat stored in the
body. They result from the digestion
of fats from food, and provide you
with the energy to undertake your
daily activities.
Raised levels of cholesterol in the
blood and a high proportion of LDL can
increase the risk of atherosclerosis.
Eventually, atherosclerosis can
clog arteries and cause a heart
attack or angina, so it is important
to reduce the total cholesterol level
and increase the level of HDL.

Cholesterol and triglycerides (cont.)
Similarly, raised levels of
triglycerides are often part of what
is known as “metabolic syndrome”,
a condition that increases your risk
of cardiovascular disease. A person
with metabolic syndrome will have
excess weight around the waist and
at least two of the following:
• high blood pressure;
• raised levels of triglycerides;
• low levels of high-density
lipoprotein (HDL) cholesterol; or
• an abnormal fasting blood
glucose.
Whilst high cholesterol levels
are recognised and well known
as a risk factor, researchers are
increasingly recognising that raised
triglycerides can by themselves
increase your risk of cardiovascular
disease — even if your cholesterol
levels are normal.
To measure cholesterol and
triglycerides, a blood sample is
taken and analysed. While a number
of different measures of cholesterol
can be reported (eg. HDL
cholesterol), two common
measurements reported are the
ratio of HDL to LDL and the level
of triglycerides.

Apart from healthy eating, medication
may be of benefit in reducing high
cholesterol. The National Heart
Foundation recommends aiming
for the following cholesterol and
triglyceride levels1:
• LDL < 2.0 mmol/L
• HDL > 1.0 mmol/L
• Triglycerides < 1.5 mmol/L
Diabetes
The most common type of diabetes
found in Australia is Type 2 diabetes.
It is usually diagnosed during middle
or later life and is both a condition
in its own right and a risk factor for
cardiovascular disease. Many people
with diabetes also have other
cardiovascular risk factors, such
as high blood pressure and/or
high cholesterol. For people with
a clustering of risk factors, good
control is critical. The goal of
diabetes treatment is to
reduce blood glucose and
keep it at a reduced level.
The blood glucose level is
monitored by checking
the blood usually prior
to breakfast and is
commonly described
as the fasting
plasma glucose
or blood
sugar
level.
Cardiovascular Health Diary
In analysing blood for glucose,
a key measure is glycosylated
haemoglobin, commonly
abbreviated as ‘HbA 1 c’.
The measurement of fasting
blood glucose level and if required,
the HbA1c percentage, are two
measures that your doctor may
record in this diary.
The National Heart Foundation
recommends maintaining an optimal
blood sugar or glucose level (BSL)
of a HbA1c level ≤ 7%1.
Chronic kidney disease
Chronic kidney disease is called the
“silent disease” as there are often
no warnings. It is possible to lose
up to 90% of your kidney function
before getting any symptoms.
Maintaining kidney health is
important because of their role
in helping to regulate and maintain
your body’s chemical balance.
By making hormones that cause
the expansion and contraction
of blood vessels,
stabilising the
acid level and
balancing a
number of
minerals and
salts, the
kidneys
play
C a rd i ova s c u l a r H e a lth Diary 
an important role in the functioning
of your body. If your kidneys are not
functioning properly, your blood
pressure, heart and blood vessels
can be affected increasing your risk
of cardiovascular disease.
Measuring the level of kidney
functioning can be via a blood test or
urine test. Measuring blood pressure
is important because high pressure
can be a result of kidney disease or
cause kidney disease. Additionally,
measuring your iron level in your
blood may be required as chronic
kidney disease can cause anaemia.
The results from the blood or
urine tests may report on a number
of clinical values including creatinine
level in the blood, Glomerular
Filtration Rate (GFR) and protein
in the urine are described as
microalbuminuria or proteinuria.
Your doctor will explain what
the results indicate and what the
next steps are to support your
kidney health.
References: 1. National Heart Foundation of
Australia and the Cardiac Society of Australia and
New Zealand. Reducing risk in heart disease 2007.
2. Kidney Health Australia. Chronic Kidney Disease,
revised May 06 3. Kidney Health Australia. Heart
Disease and Chronic Kidney Disease, revised Oct 05
4. CSIRO. Cholesterol Facts (www.csiro.au/
resources/ accessed 17.4.08) 5. Australian Institute
of Health and Welfare. Medicines for cardiovascular
health: are they used appropriately? Cardiovascular
disease series no. 27, May 2007 6. Australian
Institute of Health and Welfare. Indicators for chronic
diseases and their determinants. Feb 2008

Measuring your cardiovascular health
Blood Cholesterol Fasting blood
Factor: Triglycerides
pressure HDL:LDL glucose level
Target: /

Date: Actual: Actual: Actual: Actual:

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 Cardiovascular Health Diary

 BMI/waist or Other
Factor: HbA1c Proteinuria
Hip:Waist parameter
Target: /

Date: Actual: Actual: Actual: Actual:

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C a rd i ova s c u l a r H e a lth Diary  

Tracking your medications
Medication: Dose: Time/frequency:

10  Cardiovascular Health Diary

 Dr/Pharm
Date initiated: For the treatment of: Date ceased:
signature:

C a rd i ova s c u l a r H e a lth Diary  11

 If found, please return to:

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Instructions to doctor Instructions to pharmacist

Whilst this patient health diary is primarily
focused upon cardiovascular health, other
health parameters can be included that may
need to be measured regularly. Space is
included for recording of another parameter
or if more than one, the parameters included
that are not appropriate for your patient can
be deleted and updated to the additional
health parameter.
Please fill in the parameters for your patient,
as applicable, and record the actual patient’s
levels below these targets. Regular review of
these parameters and the target with your
patient can assist in your patient being
consistent in the implementation of lifestyle
changes and medication compliance.
This patient health diary is primarily focused
upon cardiovascular health but other health
parameters may be included by the patient’s
doctor. Supporting regular reviews of the
health parameters for the patient and
medication compliance can help improve
health outcomes for the patient.
With any change in medication, including
titration and substitution, please note the date
of this change in the ‘Date Ceased’ column,
and fill in a new line with the details of the
titrated/new drug. Please initial the ‘Initiated
By’ section of the Diary for each cessation,
titration or substitution of medication, and
strike a line through this discontinued
product.

Please note the name and dose of the Pharmacy details:

medication being prescribed in the
‘Medication’ and ‘Dose’ columns. Please note
frequency and timing of medication.

Additional space is included to allow the

recording of a number of medications
including those for conditions other than
cardiovascular disease.

With any change in medication, including

titration, please note the date of this change
in the. ‘Date Ceased’ column, and fill in a new
line with the details of the titrated/new drug.
Further copies of the Patient Health Diary are
available via your Aspen representative.
Please see your pharmacist for a copy
of the Consumer Medicine Information
(CMI) for your medications.

12  Cardiovascular Health Diary

A patient resource provided by:
Aspen Pharmacare Australia Pty Ltd ABN 51 096 236 985
For further patient information, please go to: www.aspenpharma.com.au
FD80526