Lesson 1Adapting communication and plans for low-literacy, low-income patients: teach-back, pictorial aids, low-cost medication choicesThis part describes how to change advice and plans for low-reading, low-money patients in Gambia, using teach-back, picture tools, easy regimens, cheap drugs, and culture-fit talking.
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 part covers when to use statins by risk levels, strength choice, LDL-C goals, starting and follow-up labs, handling side effects, and ways to boost sticking to treatment in high-risk Gambian patients.
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 part looks at lifestyle ways to prevent heart issues in Gambia, stressing DASH and Mediterranean eating, salt and portion goals, label reading, and cheap changes for local food ways.
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 part explains how to give safe, good physical activity plans in Gambia, including heart and strength training, step goals, and easy home routines for low-resource patients with different fitness and illnesses.
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 part reviews sugar control for cutting heart risk in Gambia, focusing on when to start metformin, personal A1c goals, picking drugs with heart benefits, and linking with lifestyle and BP control.
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 part clears up when to use aspirin and other blood thinners for first-time vs after-event prevention in Gambia, including doses, length, bleeding checks, no-go cases, and linking with other blood thinners.
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 part deals with alcohol, sleep, and stress as heart risk changers in Gambia, outlining quick check tools, advice ways, simple change strategies, and links to local or online help.
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 part reviews planned tobacco quit care in Gambia, covering quick advice steps, drug choice and doses, advice flows, relapse stop, and changes for low-reading or low-resource heart patients.
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 part focuses on full after-heart attack or stroke prevention in Gambia, including blood thinner length, strong statins, BP and sugar goals, heart rehab links, and long-stick strategies.
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 part details drug prevention of high BP in Gambia, including when to start meds, first drugs, mix strategies, step-up plans, side effect watches, and changes for low-resource areas.
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
