Risk factors

E-cigarettes: key issues and potential impact on public health

Electronic cigarettes, e-cigs, vaporisers and the various other names given to these new devices have become a phenomenon. Their popularity over the past few years has grown significantly, with an expansion of highstreet e-cigarette shops, marketing via the internet and social media, as well as traditional approaches using print advertisement and mass media campaigns. Despite their increasing usage largely by smokers and ex-smokers, e-cigarettes have divided opinion as to whether they can offer real benefits or they are potentially damaging to public health. While a recent Public Health England review concluded that e-cigarettes could be prescribed to help smokers to quit, the Welsh government plans to restrict their use in the same way as for conventional cigarettes. This paper will present some of the main issues that surround e-cigarettes and highlight the potential consequences good and bad that this new technology may bring.

JBS3: A ‘heart age’ approach to cardiovascular risk

The long-awaited Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3) were issued at the end of March.

Back to Basics: CHA2DS2-VASc – Assessing stroke risk in atrial fibrillation

Danger: clots kill! Controlling risk factors for thrombosis

Clots are life-saving in the right place at the right time, when they can stop us bleeding to death. But a clot in the wrong place can spell disaster, leading to heart attack, stroke, deep vein thrombosis or pulmonary embolism. This article explains why life-threatening clots can develop so quickly, what can be done to prevent them, and how each type of clot is treated.

In the balance: Testosterone deficiency and cardiovascular health

Male hypogonadism—also known as testosterone deficiency syndrome—occurs when the testes no longer produce enough testosterone. Testosterone deficiency may be an important factor in increasing a man’s cardiovascular risk. However, the symptoms are often overlooked in older men, both by primary healthcare professionals and by patients themselves.

Explaining the concept of absolute cardiovascular risk to patients

Putting Prevention First – the national strategy for assessing cardiovascular risk in everyone between the ages of 40 and 74 years – is here to stay, regardless of any changes in the NHS. This strategy is based on assessing a patient’s individual risk of cardiovascular disease and, where this risk is significant, offering them measures to reduce this risk. In this article, we look at how to achieve a key step in this process: explaining the complex concept of absolute cardiovascular risk to patients so they understand what’s at stake when deciding whether or not to take their statin or antihypertensive.

Back to Basics: Assessing risk of stroke in atrial fibrillation

Proteinuria: should it replace cholesterol as a marker for people at high risk of CVD?

We have all seen paintings of early physicians looking at flasks of urine to give an indication of a person’s health. And most of us can remember days of rows of urine pots lined up to test for new patients in primary care and in hospital outpatient clinics. We may assume that those days have gone in the era of blood testing and CT scans. So why are we suggesting that urine testing has a central role in finding patients with previously undiagnosed cardiovascular disease?

Back to Basics: Using ABCD2 score to assess stroke risk in TIA

Transient ischaemic attack: act fast to reduce the risk of stroke

The White Paper, Saving lives: our healthier nation (1999), set out a target to reduce the death rate from coronary heart disease and related illnesses such as stroke by 40% in the under-75s by 2010; recent trends indicate that this target will be met. Although the past forty years have seen a significant reduction in age-standardised stroke mortality rates, stroke still accounts for around 53,000 deaths each year in the UK, with more than 9,500 of these occurring in the under-75s. This article reviews how we might reduce the huge burden of stroke by improving the management of transient ischaemic attack (TIA).

Feeling the pinch: the impact of weight loss surgery on cardiovascular risk

Weight loss (bariatric) surgery is becoming increasingly common as the obesity epidemic continues to flourish, and recent NICE guidelines have supported this approach. In this article, we review the procedures used in bariatric surgery, the impact on patients’ cardiovascular risk and type 2 diabetes, what the guidelines recommend and the long-term care of patients who have undergone this type of surgery.

Proteinuria: replacing cholesterol as a key risk factor for revealing patients with CVD?

We have all seen paintings of early physicians looking at flasks of urine to give an indication of a person’s health. And most of us can remember days of rows of urine pots lined up to test for new patients in primary care and in hospital outpatient clinics. We may assume that those days have gone in the era of blood testing and CT scans. So why do we have a cluster of urine pots on the cover of this issue of BJPCN and why are we suggesting that urine testing has a central role in finding patients with previously undiagnosed cardiovascular disease?

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