This website is intended for UK healthcare professionals only Log in | Register

Latest articles

June 2018 Br J Cardiol 2018;25:73–6 doi: 10.5837/bjc.2018.016

Prescribing glucose-lowering drugs for patients with cardiac disease

Miles Fisher, Emma Johns, Gerry McKay

Abstract

The past decade has seen the emergence of several new classes of drugs for the treatment of type 2 diabetes mellitus (T2DM). Despite the increasing use of these agents, metformin and sulfonylureas remain the most commonly prescribed glucose-lowering drugs in people with T2DM. This reflects the National Institute for Health and Care Excellence (NICE) guideline from 2015 and the Scottish Intercollegiate Guidelines Network (SIGN) guideline from 2010, which recommended metformin as first-line treatment and sulfonylureas as the ‘usual’ second-line treatment for patients with T2DM. SIGN has recently provided an updated guideline on the pharmacological management of glycaemic control in people with T2DM. For the first time in UK guidelines, this recommends that in individuals with diabetes and cardiovascular disease, sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists with proven cardiovascular benefit (currently empagliflozin, canagliflozin and liraglutide) should be considered. It is anticipated that implementation of these new guidelines will lead to increased prescribing of these drugs in people with diabetes and cardiac disease, with reductions in prescribing of dipeptidyl peptidase-4 (DPP-4) inhibitors and other drugs in the GLP-1 receptor agonist class, where cardiovascular benefits have not been clearly demonstrated.

| Full text

June 2018 Br J Cardiol 2018;25:77–80 doi: 10.5837/bjc.2018.017

‘Normal’ blood pressure: too good to be true? Case series on postural syncope and the ‘white-coat’ effect

Haqeel A Jamil, Noman Ali, Mohammad Waleed, Yvonne Blackburn, Caroline Moyles, Christopher Morley

Abstract

Ambulatory blood pressure monitoring (ABPM) can confirm diagnosis in essential hypertension (HTN) and mitigate the ‘white-coat’ effect, preventing erroneous antihypertensive therapy. We aimed to collect a case series of over-treated hypertension in the context of ‘white-coat’ effect, resulting in pre-syncopal or syncopal episodes. We collected data retrospectively from patients presenting to syncope clinic between January 2016 and March 2017. ABPM was used at baseline and repeated at three months, following withdrawal of one or more antihypertensive agents.

There were 39 patients with orthostatic symptoms of syncope/pre-syncope, previous HTN diagnosis and ‘white-coat’ effect included. Reducing antihypertensive therapy increased daytime ABPM (baseline vs. three months: systolic 119 ± 11 vs. 128 ± 8 mmHg, p<0.05; diastolic 70 ± 9 vs. 76 ± 9 mmHg, p<0.05) and resolved symptoms.

In conclusion, some patients exhibit pre-syncope or syncope due to over/erroneous HTN treatment resulting in orthostatic hypotension. Our findings suggest that reducing antihypertensive medications may resolve symptoms, without rendering them hypertensive.

| Full text

May 2018 Br J Cardiol 2018;25:63–8 doi: 10.5837/bjc.2018.014 Online First

3D echocardiography: benefits and steps to wider implementation

Kevin Cheng, Mark J Monaghan, Antoinette Kenny, Bushra Rana, Rick Steeds, Claire Mackay, DeWet van der Westhuizen

Abstract
Advancements in computer and transducer technologies over the past two decades have allowed the development of three-dimensional (3D) echocardiography (3DE), which offers significant additional clinical information to traditional two-dimensional (2D) echocardiography (2DE). However, the majority of departmental studies today remain 2D, and adoption of 3DE as a complementary tool into mainstream clinical practice has not been without its difficulties. Although cardiologists have a range of alternative imaging modalities at their disposal to investigate cardiovascular structure and function, given the pace of technological innovation and improvements in data analysis, the field of 3DE is one of great expectation and is likely to be of increasing clinical importance. In this review, we discuss the role of 3DE, its advantages and limitations, and how novel technology will help workflow and expand its routine use.
| Full text

April 2018 Br J Cardiol 2018;25:48–9 doi: 10.5837/bjc.2018.009 Online First

Implications of Brexit for medical research

Chloe Watson

Abstract
On 23 June 2016, the UK public took to the polls and voted to leave the European Union (EU). Since that vote, everyone – from the farming community to the financial sector – has been trying to digest the result and understand what it might mean for them. The science community has been no exception, and with good reason. Scientific research is widely acknowledged as an international endeavour and, until now, EU membership has played a role in this. Science is also a real UK strength – UK institutions, when compared internationally, are ranked second in the world for the quality of their research,1 and the UK has one of the largest drug development pipelines globally – making it all the more important that we secure a positive future for UK science post-Brexit.
| Full text

April 2018 Br J Cardiol 2018;25:50 doi: 10.5837/bjc.2018.010 Online First

Celebrating 25 years of the Scottish Cardiac Society

Hany Eteiba

Abstract
In September last year, the Scottish Cardiac Society (SCS) celebrated its 25th anniversary with a two-day symposium held in Crieff – the same venue where the inaugural meeting took place in 1992.
| Full text
READ MORE

Latest news

NEWS

General news

June 5, 2018

IN BRIEF

In brief

June 5, 2018

IN BRIEF

In brief

March 6, 2018

MEETING REPORT Online First

News from the British Society for Heart Failure 2017

January 23, 2018

READ MORE
Close

You are not logged in

You need to be a member to print this page.
Find out more about our membership benefits

Register Now Already a member? Login now
Close

You are not logged in

You need to be a member to download PDF's.
Find out more about our membership benefits

Register Now Already a member? Login now

UPDATE YOUR PREFERENCES

Welcome to the website of the British Journal of Cardiology.

Due to the new European Union General Data Protection Regulations in effect from May 2018, we have updated our privacy policy and terms and conditions.
Please take a moment to read these updated notices and change your account preferences to confirm you are happy with them.