The prison population in the UK tends to have several risk factors for the development of chronic liver disease. Prison provides a stable environment, which often enables thorough health assessment, monitoring and stabilisation of substance misuse, management of chronic disease and mental health issues, and treatment for viral hepatitis to be performed.
Liver health in prisoners: an opportunity for care
Identifying people with or at risk of type 2 diabetes
In this paper, we summarise previously reported findings from the MY-WAIST study, which aimed to evaluate a primary care strategy for identifying people with undiagnosed type 2 diabetes or at increased risk of developing this condition. Recruitment was unexpectedly low, but the qualitative data collected, including interviews with healthcare providers, helped to highlight some of the reasons for poor uptake of the appointments offered. Perceived barriers to recruitment included heavy workloads and competing demands in primary care. Lower uptake in people from harder-to-reach groups was identified in our quantitative findings and was also suggested by healthcare providers’ perceptions about the characteristics of patients who attended.
The ESH/ESC guidelines for the management of arterial hypertension
There still remains a significant gap between the goal of optimal treatment of hypertension and ‘real life’ practice. As a consequence, hypertension remains a leading cause of cardiovascular related morbidity and mortality. There is a continuing need to improve both the detection and management of hypertension, with a view to improving the efficacy of treatment including lifestyle interventions and outcomes. In order to address these issues. The European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) have recently published guidance on the management of arterial hypertension.
Chronic kidney disease, cardiovascular risk and primary care
This article describes the interrelationship between chronic kidney disease (CKD) and cardiovascular disease and defines the basis for the various interventions which have been recommended in national guidelines. It also provides a critique of currently available guidelines and suggests where changes may be desirable in future.
The importance of early diagnosis: how to identify patients with FH for diagnosis and referral
Familial hypercholesterolaemia (FH) is under-diagnosed and under-treated, despite clear evidence-based guidelines for identification and management, and the availability of low-cost, generic, high-intensity statin treatment. Genetic cascade testing is the key to early diagnosis, which can help ensure that this treatment is no longer ‘too little, too late’.
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.
It’s not just a high cholesterol level, it can be an indicator of genetic disorder
7.5 mmol/L) should prompt clinicians to think of familial hypercholesterolaemia. A family history of premature heart disease should further raise suspicion. This dominantly inherited genetic abnormality deserves as much attention as the oncogenes such as BRAC 1 and 2. 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.
Regional variation in treatment: the London effect
This study shows that people living in London have better treatment rates with lipid lowering drugs than the general population. This observation may be explained in part by the fact that London is a highly mobile population, so new patient checks are more common.
Delivering CVD care: GPs under pressure and disempowered – a qualitative study
GPs, practice nurses and other primary healthcare professionals are now at the frontline of managing cardiovascular disease (CVD) and delivering preventive care. The aim of this study was to explore clinicians’ experiences and their views on the factors that influence their ability to fulfilthis demanding role. GPs and other primary healthcare professionals expressed similar views. In particular, they reported a sense of pressure and disempowerment, and voiced concerns about the ability of general practice to take on its greater role in reducing the burden of CVD.
Coherent management of diabetes, weight & cardiometabolic risk
Successful management of individuals with diabetes, or any other single component of the metabolic syndrome, requires treatment of all the related physiological systems as a whole. This treatment must be underpinned by the management of obesity, and drugs should be preferred that address the entire portfolio of the metabolic syndrome.
Statins, side-effects and missed opportunities
“I like to think of medicine in our day as an ever-broadening and deepening river, fed by the limpid streams of pure science-
Christian A. Herter (1865-1910), US neurologist, New York.
Hypertension: an evidence update
Since the publication of the National Institute for Health and Clinical Excellence (NICE) clinical guidance (CG 127) on the management of hypertension in adults two years ago, new evidence has been published which is relevant to – and potentially has an impact on – the guideline recommendations. This evidence is presented and reviewed in the following article.
