Lesson 1Adapting communication and plans for low-literacy, low-income patients: teach-back, pictorial aids, low-cost medication choicesThis section describes adapting counselling and care plans for low-literacy, low-income patients in Ghana, using teach-back, pictorial tools, simple regimens, affordable medication options, and culturally appropriate communication techniques.
Assessing literacy and financial barriersUsing teach-back to confirm understandingPictorial and color-coded medication aidsChoosing effective low-cost drug optionsSimplifying dosing schedules and refillsCulturally sensitive communication skillsLesson 2Statin therapy and lipid targets: risk-stratified thresholds for starting statins and monitoringThis section covers statin indications using risk-based thresholds, intensity choices, LDL-C targets, baseline and follow-up labs, handling statin side effects, and ways to boost adherence in high-risk cardiovascular patients in Ghana.
Estimating ASCVD risk in primary preventionThresholds to start moderate vs high-intensity statinsLDL-C targets for primary and secondary preventionBaseline labs and follow-up lipid monitoringManaging statin intolerance and myalgiasImproving adherence and shared decisionsLesson 3Lifestyle interventions: evidence-based dietary patterns (DASH, Mediterranean), portion and sodium targets, practical low-cost adaptationsThis section examines lifestyle interventions for cardiovascular prevention, emphasising DASH and Mediterranean diets, sodium and portion targets, label reading, and affordable adaptations fitting diverse Ghanaian cultural food habits.
Core principles of DASH and Mediterranean dietsSetting sodium and portion size targetsLow-cost substitutions for staple foodsCounseling on cooking methods and oilsReading food labels and hidden sodiumAdapting plans to cultural food patternsLesson 4Physical activity prescriptions: intensity, duration, step-counts, home-based exercises for low-resource patientsThis section explains prescribing safe, effective physical activity, including aerobic and resistance training, step-count goals, and simple home routines tailored to low-resource patients with varying fitness and health issues in Ghana.
Assessing baseline activity and functional capacityPrescribing aerobic intensity using METs and RPESetting weekly duration and frequency targetsStep-count goals and use of simple trackersDesigning home-based programs for low resourcesSafety screening and red-flag symptomsLesson 5Glycemic management for cardiovascular prevention: thresholds for metformin and glycemic targets relevant to CVD riskThis section reviews glycemic management for reducing cardiovascular risk, focusing on metformin thresholds, personalised A1c targets, agents with proven CVD benefits, and linking with lifestyle and blood pressure control in local settings.
Screening for diabetes and prediabetesWhen to start metformin for CVD preventionIndividualizing A1c targets by comorbidityAgents with proven cardiovascular benefitAvoiding hypoglycemia in high-risk patientsIntegrating glucose, BP, and lipid controlLesson 6Use of aspirin and antiplatelet therapy: primary vs secondary prevention guidance and contraindicationsThis section clarifies when to use aspirin and other antiplatelets for primary versus secondary prevention, including dosing, duration, bleeding risk checks, contraindications, and coordination with other blood thinners in Ghanaian care.
Evidence for aspirin in primary preventionSecondary prevention indications after MI or strokeDual antiplatelet therapy indications and durationAssessing bleeding risk and contraindicationsManaging therapy with anticoagulant overlapPatient counseling on adherence and safetyLesson 7Alcohol, sleep, and stress management: brief interventions and local resourcesThis section addresses alcohol use, sleep quality, and stress as cardiovascular risk factors, outlining brief screening tools, counselling methods, practical change strategies, and links to local or digital support in Ghana.
Screening for unhealthy alcohol useBrief alcohol interventions and limitsAssessing sleep duration and sleep disordersSleep hygiene strategies for CVD patientsStress assessment and basic coping skillsLinking patients to local and online resourcesLesson 8Tobacco cessation strategies: brief advice, pharmacotherapy indications (NRT, bupropion, varenicline), counseling workflowsThis section reviews structured tobacco cessation care, covering brief advice models, pharmacotherapy choices and dosing, counselling workflows, relapse prevention, and adaptations for low-literacy or low-resource patients in Ghana.
Ask–Advise–Assist brief intervention stepsIndications and dosing for NRT productsUsing bupropion and varenicline safelyBehavioral counseling and quit planningManaging withdrawal and relapse preventionAdapting support for low-resource patientsLesson 9Secondary prevention after MI/stroke: dual antiplatelet duration, high-intensity statin, BP and glycemic targets, cardiac rehab referralThis section focuses on full secondary prevention after MI or stroke, including dual antiplatelet duration, high-intensity statins, blood pressure and glycemic targets, cardiac rehab referrals, and long-term adherence plans in Ghana.
Core medication bundle after MI or strokeDual antiplatelet therapy duration choicesHigh-intensity statin use and LDL-C goalsBlood pressure and glycemic targets post-eventCardiac rehab referral and program elementsCoordinating follow-up and adherence supportLesson 10Pharmacologic prevention: antihypertensive initiation and titration protocols, first-line drug classes and combinationsThis section details drug prevention of hypertension, including when to start medication, first-line drug classes, combination strategies, titration protocols, side effect monitoring, and adapting for low-resource Ghanaian settings.
Confirming diagnosis and baseline BP profileThresholds to start antihypertensive therapyChoosing first-line drug classes and dosesStepwise titration and combination therapyMonitoring labs and adverse effectsSimplifying regimens for low-cost access
