Atrial fibrillation (AF) is one of those terms that we are hearing more and more in general practice. It is an important risk factor for stroke – particularly in older people – making it a good candidate for primary care teams to target in efforts to prevent cardiovascular disease.
Beta blockers
Beta blockers are well established drugs in the treatment of cardiovascular disease, after first being introduced 20 years ago. Today, they are used to treat patients with a range of cardiovascular conditions – hypertension, myocardial infarction, angina, heart failure and abnormal heart rhythms (arrhythmias). There is good evidence for beneficial effects with beta blockers and their use is recommended in many guidelines, including the recent British Hypertension Society guidelines. Prescribing of beta blockers in patients with heart disease is further encouraged as a ‘quality marker’ in the new GMS contract.
How to: create and maintain a Coronary Heart Disease
The aim of the National Primary Care Development Team (NPDT) is to develop healthcare professionals who have the knowledge and skills to apply quality improvement methods to local priorities. CHD is one such priority and has been within the focus of our work for almost four years. Working in partnership with other agencies who share our priorities is essential. Janet Potts, who leads on the work of the NPDT in West Yorkshire, joined forces with Adele Graham from the CHD Collaborative in West Yorkshire, to give the strongest possible support to local primary healthcare professionals. The CHD register ‘recipe’ was devised by this partnership.
Getting it right – how to measure BP in the surgery
It’s something that we do so often, but are we always doing it the best way? Check out how to measure blood pressure (BP) correctly, with latest advice from the National Institute for Clinical Excellence and the British Hypertension Society.
Bringing CHD management back to primary care
Managing heart failure effectively in the community Community-based nurses are at the forefront of vigorous efforts to improve the management of coronary heart disease. The Coronary Heart Disease Collaborative is spearheading 30 projects around the country to find practical ways forward. This issue reviews how Durham Dales PCT has brought the management of heart failure firmly back into primary care, with up-to-date registers of heart failure patients and regular clinics in the community.
Making sense of heart failure and its treatment
Heart failure is a high priority in primary care, with the National Service Framework for Coronary Heart Disease, the NICE Heart Failure Guidance, and the new General Medical Services contract quality indicators all setting clear standards for improving the management of patients with this increasingly common condition. This four-page pull-out supplement provides you with a need-to-know, need-to-keep guide.
Chest pain in Primary Care – would you and your team know what to do?
This article considers a possible scenario in primary care in which a patient presents with chest pain. Test yourself to see what you would do. Then check this against our recommendations, reflecting on your current procedures and policies within your practice.
Disease Focus on… Sleep Apnoea
Sleep apnoea is far more than just snoring associated with brief periods of suspended breathing while asleep. It is an important risk factor for cardiovascular disease and diabetes, so it is well worth asking patients whether they suffer breathing problems during the night and then following up those who do. More than one-third of people with sleep apnoea have hypertension, so measuring blood pressure is important in assessing risk factors and then establishing appropriate preventive treatment.
Information on withdrawal of four insulins by Lilly
Drug and Therapeutics Bulletin and Treatment Notes go online
Stress and heart disease: check out the link
New online service for RCN members – The Oxford Dictionary of Nursing and A-Z of Medicin
New British Hypertension Society guidelines tighten cardiovascular risk management
New British Hypertension Society (BHS) guidelines on hypertension focus on cardiovascular risk rather than risk of coronary heart disease, in order to improve the prevention of stroke as well as heart disease.
Protecting renal function in people with diabetes
Renal disease is common and is increasing in prevalence as the main risk factor for impaired kidney function – diabetes – affects more people. Approximately 30% of patients with type 2 diabetes develop some degree of nephropathy, with some ethnic groups at even higher risk. Diabetes is now the largest single cause of end-stage renal disease in the UK, accounting for 30–40% of all cases. The very early stages are asymptomatic and the disease process develops slowly over 15–20 years, so early screening and prevention strategies are paramount in reducing the burden of renal failure. Primary care nurses are well placed to play a pivotal role in this process.
Maintaining motivation: the long haul of weight loss
There is no doubt about it, achieving and maintaining weight loss long term is a great challenge. Primary care nurses have a significant role in motivating patients to adopt a healthy lifestyle and to persevere with weight management programmes. In the last issue of BJPCN we looked at how to raise the tricky subject of obesity with patients. This time, we continue the issue by exploring how practice nurses ensure a positive working relationship with their patients with weight problems and encourage them as they tackle the long-term issue of obesity.
