It is unsurprising that statins have become the most commonly prescribed drugs in many parts of the world, given the extraordinarily large and complete evidence base that supports their use. Their role in reducing cardiovascular (CV) events in both primary and secondary prevention is clear and predictable, with recent data extending their utility across most […]
Type 2 diabetes patient without CVD, not achieving lipid targets
Previous coronary artery bypass graft (CABG) surgery
How well are we doing in lipid management?
Ensuring that patients are prescribed statin therapy tailored to individual risk
Solving your cholesterol conundrums: Case studies in lipid management for primary care today
The benefits of lowering low-density lipoprotein (LDL) cholesterol with statin therapy for cardiovascular disease (CVD) prevention are well established. Recent guidelines from the National Institute for Health and Clinical Excellence (NICE) have emphasised the importance of achieving lower lipid levels, by adopting targets of 4 mmol/L for total cholesterol and 2 mmol/L for LDL cholesterol […]
Postprandial hyperglycaemia: red herring or red flag?
Several studies have suggested that postprandial rather than fasting hyperglycaemia may be a major determinant of cardiovascular risk. This article reviews the importance of postprandial hyperglycaemia and explores the benefits and risks of managing postprandial hyperglycaemia aggressively in order to prevent diabetes-related complications.
An innovative strategy for improving the management of chronic heart failure
Mandy Davies, Christine Thomson and their practice team from Elgin provide a ‘how to’ guide on setting up an innovative strategy for managing chronic heart failure, based on their programme that recently won an Innovation in Primary Care Award.
DEBATE – The argument against an HbA1c target of 6.5%
The argument against an HbA1c target of 6.5%Richard Lehman
The argument against an HbA1c target of 6.5%: Aiming for too low an HbA1c will achieve no additional benefit and may do patients harm.
DEBATE – How low is too low: should we be aiming for an HbA1c target of 6.5%?
How low is too low: should we be aiming for an HbA1c target of 6.5%? Brian Karet
The argument for: Studies consistently show the benefits of aggressive glucose lowering. What is the evidence supporting this approach?
What is the clinical trial evidence for the benefits of long-term statin therapy?
What is the clinical trial evidence for the benefits of long-term statin therapy?Alan Begg
Structured monitoring of patients with long-term conditions has become a major component of scheduled care and a GP’s workload. The length of time a patient should remain on a certain medication to prevent a further cardiovascular event is often controversial, and phrasing recommendations to reflect the often absent evidence base is a problem for guideline writers. Recommendations on length of treatment are often informed by the results of randomised trials carried out for a limited period of time rather than reflecting long-term use in a defined patient cohort. This review reflects on the clinical trial evidence for long-term statin treatment in both primary and secondary prevention.
Look before you leap: do patient care plans improve the secondary prevention of heart disease in general practice?
Look before you leap: do patient care plans improve the secondary prevention of heart disease in general practice?Mark Davis
Mark Davis reviews a recent primary care study assessing the impact that tailored care and care plans can have on the secondary prevention of heart disease. Murphy AW, Cupples ME, Smith SM et al. Effect of tailored practice and patient care plans on secondary prevention of heart disease in general practice. BMJ 2009; 339: B4220.
