Cardiovascular disease

Editorial

Sometimes I shock myself with what I do not know. But one of the fantastic things about working as a practice nurse is that there are so many chances to find out something new. We can all learn things from simply talking to patients. When I was starting out, it bothered me (‘the professional’) when a patient knew more than I did. But the patients were so nice—I think they felt sorry for me— that I soon stopped feeling overwhelmed and became interested.

Editorial

Sometimes I feel like a nephron. These hard-working filters keep on working regardless of the pressure of blood flowing into the kidney. In just the same way, practice nurses must stay at the job no matter how many patients stream through the doors of the surgery. What is more, just as the kidney compensates when it loses nephrons, practice nurses take on more work to make sure that patients do not suffer when staffing levels fall.

The numbers expected to be treated (NETT): a way forward in CVD prescribing?

55 years; targeting those at high Framingham CVD risk; and tailoring dose according to risk stratification. By combining price and potency data with our CVD patient risks database, we modelled potential benefit (myocardial infarctions [MIs] prevented), cost and numbers expected to be treated for each strategy.

Genetic hyperlipidaemias: finding, diagnosing and managing them

Cardiovascular disease (CVD) risk assessment is a central part of the strategy for identification and treatment of high-risk cases, as was recognised in the National Institute for Health and Clinical Excellence (NICE) guidelines on lipid modification. A national strategy devised by the Department of Health for screening all individuals aged between 40 and 75 years exists in the UK though implementation and uptake have been variable. Unfortunately, in screening programmes the greatest uptake tends to be among the white population, wealthier people and women rather than among those groups in which CVD is over-represented: men, poor individuals and those from ethnic minorities. This has posed a great challenge to risk screening but non-traditional approaches including those in places of worship, pharmacies and communally-led initiatives seem to lead to greater success.

Editorial

It is commonly accepted that nurses are better than doctors at following guideline-based protocols. Protocols have a number of benefits. They provide us with a structured approach to the consultation and added confidence in clinical management. Following a protocol also means that patients are more likely to be offered evidenced-based therapies. But familiarity with practice protocols does have its drawbacks when they have to be revised when new guidelines are published.

The GRANITE project: evaluating a novel cardiovascular prevention model in Scotland

Targeted case-finding for cardiovascular disease (CVD) prevention may be preferable to universal screening. Quality Improvement Scotland (QIS) has recommended that identification of high-risk individuals is needed. In this study, probable CVD risk in patients within the 40-70 years age range who were not on the CHD, Diabetes and Stroke registers and who were not already receiving statins was analysed using a predictive software toolkit which utilised the ASSIGN risk calculator. This programme effectively identified a patient population with a probable high 10-year CVD risk requiring intervention for CVD prevention after clinical assessment.

Attitudes to taking medications for cardiovascular disease prevention

Cardiovascular disease prevention is one of the main challenges facing primary care today. In order to reduce the burden of disease, national guidelines recommend that asymptomatic patients who are at high risk of cardiovascular disease should be offered preventive medications. This article discusses cardiovascular disease risk assessment, communication of this risk to patients and attitudes of both general practitioners and patients to preventive medications.

Editorial

As practice nurses, our day at the surgery ends well when everything has gone smoothly and patients and colleagues have gone home happy. But we often feel the greatest sense of achievement when we have had to go beyond our usual routine to try a new approach to a problem, or do something that we never thought we could do.

Editorial

Spring has now well and truly sprung and the NHS is heading towards changes as the Health and Social Care Bill takes effect. But what won’t change is the need for primary care to do our very best to prevent, diagnose and treat cardiovascular disease and diabetes, as major causes of illness and premature death. At BJPCN we aim to equip you with the latest practical guidance and our conference in November will also help to keep you up to date, please come if you can.

Editorial

The start of a new year is always a good time to look forward to where we hope to go; but it is also to reflect on where we have come from. While the NHS has made massive improvements in the quality of life and outcomes of our patients. Our aspirations are even higher. Our objective over the coming year is to ensure that BJPCN gives you the information and inspiration to meet these challenges and to reach for even greater heights.

Editorial

It’s good to talk. Communicating effectively with our patients and their families is a key part of our jobs as primary care nurses and we have a major new communication job on our hands over the next few months. The new guideline from the National Institute for Health and Clinical Excellence makes ambulatory monitoring part of routine practice for diagnosing high blood pressure (BP), so we are going to need to explain to patients why we are sending them home with monitors rather than just taking BP readings in the practice.

Going back to basics in cardiovascular disease: Editorial

There are 28 cardiac and stroke networks in the country. They play an important part in implementation of national strategies, enabling high-quality services to be planned and delivered to patients within the framework of primary and community care.
One of the most useful contributions of the networks is provision of education and training for primary care staff. The “Back to Basics” material in this supplement forms the backbone of what is presented at study days. The articles cover some of the most common cardiovascular conditions that are seen in primary care, showing clearly what causes the symptoms, how best to assessand manage patients, and how the treatments actually work. They help healthcare workers both to understand these conditions and to explain them to patients, and therefore really improve patient care.

Featured articles

Join our community of Primary Care Professionals today

Educational Partners