Making Best Practice, Every Day Practice
In general, deaths from cardiovascular disease (CVD) are falling, except for the forgotten CVD, dementia. The rate of dementia is rising year on year and it is now one of the top 5 causes of death in the UK. Risk factors for dementia are similar to other CVDs and risk modification can reduce the risk of development of the condition.
The incidence and prevalence of cardiovascular diseases increase in older adults and are a common cause of morbidity and mortality. This article by Dr David Milne examines whether we can reduce cardiovascular risk in the elderly, and if so, should we try to do so?
The European Atherosclerosis Society has conducted a survey to assess the general public’s understanding of cholesterol. Professor Mike Kirby summarizes the survey findings and highlights the importance of a clear and constant focus on the JBS3 2014 consensus recommendations.
Two injectable antibody-based therapies inhibiting the activity of PCSK9 – alirocumab and evolucumab – have recently been licensed. This paper reviews the current status of lipid management, the actions of PCSK9, and the clinical trial results achieved with PCSK9 inhibitors in early studies.
Chronic Obstructive Pulmonary Disease (COPD) has a major impact on the health and quality of life of patients and there is often co-morbidity with cardiovascular disease. Well planned and structured training for the primary care team could have a major impact on outcomes.
Morbidity and mortality for women with COPD is increasing. This systematic review uncovers how women seem to experience COPD differently to men, and helps health care professionals to provide an individualised approach to caring for these patients.
The World Health Organization recognises that 80% of CHD could be prevented by positive lifestyle changes. Healthcare professionals should encourage and support patients to quit smoking, increase physical activity, and make positive dietary and lifestyle changes to help better manage their heart health.
Our study investigated the primary risk factors present in patients admitted for acute coronary syndromes. There were significant numbers of current smokers, and patients with hypertension, hyperlipidaemia and diabetes. Aggressive secondary prevention measures are recommended, and education on hospital discharge is essential.
Epidemiological and clinical research has determined that lipids contribute substantially to cardiovascular disease (CVD) and that modifying the lipid profile has a significant impact on coronary events. These findings are reflected in continuously updated CVD management guidelines, which focus on low-density lipoprotein cholesterol (LDL-C) as the primary therapeutic target. The guidelines have further defined LDL-C levels to which patients should be treated. An individual’s eligibility for treatment, and their LDL-C treatment goal and intensity of therapy is determined by their absolute CVD risk. Lipid abnormalities can be partly modified by lifestyle changes, which are integral to reducing risk for all patients. However, as lipid goals are progressively lowered, many patients will not be able to achieve them using lifestyle changes alone and these patients usually require treatment with lipid-modifying drugs. This article aims to provide practitioners with a concise guide to managing lipids with pharmacotherapy, based on recommendations from six of the most up-to-date clinical practice guidelines for prevention of cardiovascular disease.
Epidemiological research has clearly established that many risk factors contribute to cardiovascular disease(CVD). Some of them are modifiable, and treatment decisions are based on the level of risk determined by risk assessment. Positive lifestyle changes are crucial to the prevention and management of CVD, and can result in substantial risk reduction. These changes can include smoking cessation interventions, acardioprotective dietary pattern and increased physical activity. However, lifestyle changes are challenging forboth the healthcare professional and the patient, and behavioural counselling and regular follow-ups are often required to overcome barriers, encourage adherence and assist in the achievement of long-term lifestyle goals.This article aims to provide practitioners with a concise guide to the role and impact of lifestyle changesbased on recommendations from six of the most up-to-date clinical practice guidelines for prevention ofcardiovascular disease.
Cardiovascular disease continues to be the leading cause of premature morbidity and mortality in the UK.1 Primary prevention not only is cost-effective but is endorsed as a priority by healthcare systems in the UK, and indeed globally. We describe here a targeted prevention service, which showed that the modifiable risk factors of obesity and overweight, smoking and low levels of high-density lipoprotein cholesterol were highly prevalent in first-degree relatives of patients with premature coronary heart disease.
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