What are the health benefits of walking,and how much should we walk and how often? In this article,we review the evidence on the impact of walking on health, the latest recommendations on walking,how to overcome barriers to walking,how to motivate our patients to start walking and how to keep it going.
Editorial
The menopause has moved on from simply being a source of euphemisms for hot flushes as ‘power surges’ or ‘tropical moments’ to being recognised as an important stage in a woman’s life. It also has particular significance in CVD risk, which we address head-on in this issue of BJPCN.
Starting on a statin for primary prevention
Tredaptive: a new option in lipid management
Blood cholesterol levels play an important role in the development of atherosclerosis and cardiovascular disease (CVD), and the incidence of CVD is closely related to the concentration of the specific lipoproteins in the blood. In this article, we review the role of different lipoproteins and the mechanism of action and potential role of a new agent for lipid modification – Tredaptive.
How to prevent and manage lipohypertrophy at injection sites
Lipohypertrophy is surprisingly common in people using insulin to control their diabetes. As more and more people with diabetes are managed in primary care, practice nurses take on a greater role in the management and education of these patients. This article considers what lipohypertrophy is, how it can be prevented and how it should be managed once it has been identified.
Diagnosing hypertension: getting the numbers right
Hypertension is a silent, malevolent factor in both cardiovascular and renal disease. Raised blood pressure (BP) rarely causes any symptoms – in fact the presenting symptom of hypertension is too often the heart attack or stroke that is the end result. Diagnosis of prolonged abnormal blood pressure is therefore key in the prevention of a range of long-term conditions. In this article, we will examine the importance of measuring blood pressure correctly before making the diagnosis of hypertension. We will also look at the different levels of blood pressure that constitute a diagnosis of hypertension according to the variety of guidelines that exist.
Back to Basics: Detecting and managing chronic kidney disease
Dietary fibre – more than just roughage
Dietary fibre is a frequently neglected nutrient, with eight out of ten UK adults eating less than is needed for good health. Most people think of fibre simply as roughage or bran and know that it helps with constipation and bowel disorders, but fibre is far more than this, with a wide range of health benefits. Evidence indicates that eating a fibre-rich diet will not only improve digestive health, but also aid weight loss, help to reduce cholesterol levels, and reduce the risk of certain cancers (including bowel and breast cancer) and type 2 diabetes. It will also boost intake of vitamins, minerals and antioxidants. This review explores the major role of fibre in health and wellbeing and gives practical tips for dietary advice.
Transient ischaemic attack: the ‘funny do’ that is no joke
How do you recognise a transient ischaemic attack (TIA) and how does this differ from a full stroke? In this article, we explore the ABCD2 score, which can be used to identify high- and low-risk TIAs, and the best course of action if a TIA is suspected. A TIA is very often the herald of a more serious and permanent stroke, underlining why it should be acted on as a matter of urgency, and there is an update on the current guidance from NICE and the Royal College of Physicians.
Looking through the window of cardiovascular opportunity at the menopause
Most women think they are at greatest risk of dying from cancer, especially breast cancer, but in fact, women are nine times more likely to die from cardiovascular disease (CVD) than from breast cancer. The menopause has particular significance in CVD risk. In this article we look at what happens to cardiovascular risk at the menopause and opportunities for CVD prevention.
Why do People with Diabetes Fall Off the Rails?
Why is it that some patients with diabetes are able to stick to the ‘straight and narrow’ while others fall off the rails? I decided to look at my client group to see if I could pick up on any particular issues that made people either forget that they have diabetes, or struggle to continue to control their blood glucose levels as they had previously been doing. This article reviews what I found and offers some suggestions on how to help patients get back in control.
Putting the NICE Guideline on Type 2 Diabetes into Practice
At last, the updated NICE (National Institute for Health and Clinical Excellence) guideline for the management of type 2 diabetes has been published. It includes an update on the management of blood glucose, blood pressure, lipids, renal function and retinopathy, but the key priorities for implementation are based on taking a patient-centred approach to care. In this article, we will focus on the important areas of patient education, dietary assessment, setting targets for HbA1c, self-monitoring and starting insulin therapy.
