Most people with coronary heart disease (CHD) can be managed with lifestyle change and optimal medical therapy, but some patients need revascularisation procedures such as angioplasty with stenting (percutaneous coronary intervention [PCI]). These patients spend minimal time in hospital, and GPs have an increasingly important role in follow-up to minimise the risk of adverse events, promote lifestyle change and ensure continuing adherence to medication.
Patient perspectives on AF management: high satisfaction, but could do better
Patient satisfaction with treatment is a key component of the successful management of chronic conditions such as atrial fibrillation (AF). In the EUropean Patient Survey in Atrial Fibrillation (EUPS-AF) survey, UK patients reported the highest rates of satisfaction with their healthcare system and quality of care. However, only about half of UK patients reported receiving regular anticoagulation testing and about one third had never or rarely had a medication review. This survey provides important insights into the current provision of care that should be taken into account when designing and commissioning patient-centred AF services.
Let’s talk about sex to men with diabetes
Erectile dysfunction (ED) is three to four times more common in men with diabetes, and 20% have the condition at diagnosis. ED is a marker for heart disease, and men themselves value the opportunity to discuss their sexual problems with a health professional. The annual diabetes review offers the opportunity to identify and treat these men. Some practice nurses may find this task daunting, but treatment of ED can help to improve a man’s wellbeing and reduce his cardiovascular risk.
JBS3: A ‘heart age’ approach to cardiovascular risk
The long-awaited Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3) were issued at the end of March.
Catching the sun: The facts about vitamin D
The last decade has witnessed an explosion of interest in vitamin D. The vitamin has an established role in promoting bone health, but should we be routinely testing vitamin D levels in our patients? And what is the evidence that supplementation improves health beyond the skeleton?
Feeling good? Long-term conditions and psychological health
Compared with the rest of the population, people with long-term conditions—especially cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders—have two to three times the risk of experiencing a mental health problem. In this article we will consider how these issues affect long-term conditions, how we can assess their impact and how we can improve the psychological wellbeing of these patients.
The Eatwell Plate: Helping patients get the balance right
There are many fads about specific foods and their ‘super’ vitamins and minerals. Our choice of foods has also widened as supermarkets expand their ranges and previously specialist foods become mainstream. However, even though we can now buy tamarillos, Christmas-cake cheese or cranberry and pecan bread, the principle of proportion remains consistent. So the Eatwell Plate is very helpful in showing patients exactly what we mean when we advise them to follow a ‘healthy, balanced diet’.
Finding the right words to talk about weight
Excess body weight is associated with a higher risk of cardiovascular disease, type 2 diabetes, cancer and a range of other debilitating health conditions, and is the third leading cause of death in high-income countries like the UK. Since practice nurses may have long-term, regular contact with patients, they may be well placed to motivate and support individuals in losing weight. It can, however, be difficult for nurses to find the right words to discuss this very sensitive subject with patients.
NHS Health Check: A systematic approach to CVD prevention
The NHS Health Check offers 15 million people aged 40-74 years in England an assessment of cardiovascular risk, together with preventive interventions, once every five years. The programme has aroused some controversy, but there is an urgent need to take action now to reduce preventable, premature death and disability caused by vascular disease.
Using NOACs for stroke prevention in atrial fibrillation
Warfarin is highly effective in preventing strokes in people with atrial fibrillation (AF), but has its limitations. Only half of patients who could benefit actually receive warfarin, resulting in an estimated 7000 avoidable strokes each year.
Editorial
I was listening to the radio the other morning as the news was breaking that polyunsaturated fats seem to be no better for your heart than good old butter. My friend Mike Knapton from the British Heart Foundation was interviewed and in his radio clip he said: “Choose something for taste and texture!” Now I would bet my life savings, if I had any, that he was edited, and that he would have gone on to advise moderation in all things and that it is important to reduce the amount of fat in the diet.
The management of familial hypercholesterolaemia
Homozygous familial hypercholesterolaemia (FH) is a rare disorder with a very high risk of premature cardiac death that must be diagnosed and treated from childhood onwards, usually with lifelong lipoprotein apheresis. Heterozygous FH is much commoner, with a high risk of cardiovascular disease in adults that can be prevented by early diagnosis and statin therapy.
HEART UK – The Cholesterol Charity – has provided editorial support and review of this sponsored FH series.This article was made possible by an unrestricted educational grant by Sanofi, who had no control over content.
