“Doctors are and should be natural leaders, and part of the skill of being a leader is to work with other leaders in the intricate network of the National Health Service- Sir John Grugeon, hospital doctor, 5th July 1988.
Moving with the times
Cardiovascular disease risk prediction in the UK: which is the best risk prediction model?
Identifying those people at an increased risk of cardiovascular disease (CVD) who might benefit from a therapeutic intervention or lifestyle advice is an important challenge. We summarise here the performance of QRISK2 against the NICE version of the Framingham Risk Score.
Dabigatran in stroke prevention in atrial fibrillation
A practical guide for primary care. If we wanted to make things simple, all patients with atrial fibrillation (AF) would receive an oral anticoagulant to reduce their risk of stroke and other comorbidities. But historically this has been difficult because anticoagulants can cause bleeding. Decisions about oral anticoagulation in patients with AF are therefore complex, […]
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.
One in five strokes warn you they are coming: treat transient ischaemic attacks as emergencies
Transient ischaemic attack (TIA) is a powerful warning sign of an impending, and potentially disabling, stroke. It is important to understand differences between stroke and TIA, how the FAST test can help you recognise the signs, and the use of the ABCD2 score to assess the level of stroke risk. Treating TIAs as emergencies is critically important in preventing a full stroke so urgent referral to your local TIA service is best practice.
Eating well for your kidneys
Diet and lifestyle strategies are essential in the treatment and possibly in the prevention of chronic kidney disease (CKD). Dietary modification plays a fundamental role in helping to control increased levels of blood electrolytes and metabolic waste productsthat are often seen as renal function declines. Dietary and lifestyle modification may not directly influence disease progression in CKD, but several lifestyle factors have been highlighted as important due to the significant influence they exert over associated factors such as diabetes and hypertension, which are two of the leading causes of CKD, and obesity.
The big hitters for quitters
The impact of smoking on all aspects of health – physical, psychological and socioeconomic – is so serious that helping people to quit is a key priority for anyone working to improve health outcomes. In this article, we look at the best way to encourage smokers to quit, how to increase the quit rate in smokers who have decided that the time is right for them to stop, and review the latest information on pharmacological options for smoking cessation.
Back to Basics: Planning the seasonal flu vaccination campaign
Back to Basics: Secondary prevention for the four types of coronary artery disease
Preventing and treating bone disorders in chronic kidney disease
Chronic kidney disease mineral and bone disorders (CKD-MBD) is a slowly progressive complication of CKD occurring over many years. The kidneys are unable to maintain normal levels of calcium and phosphate and respond to the hormones needed to maintain healthy bones. CKD–MBD is a common problem in people with stage 3 CKD onwards and affects almost all patients receiving dialysis. This article explains why renal bone disease occurs, the problems it can cause for patients affected and provides practical tips on how to identify people at risk and management options.
American College of Cardiology Annual Scientific Sessions
Moving stroke prevention up the healthcare agenda
“There are lots of really powerful examples around o f things we can do to improve quality while improving productivity”
This statement from Sir David Nicholson, the NHS Chief Executive, appears on the NHS Evidence website, where the recognition and optimal treatment of atrial fibrillation (AF) is given as one of the top six Quality, Innovation, Productivity and Prevention (QIPP) examples from across the entire NHS.
