Tag Archives: atherosclerosis

Introduction Atherosclerosis is a systemic disease of the large- and medium-sized muscular arteries, which is characterised by endothelial dysfunction, vascular inflammation, and the build up of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall. This build up results in plaque formation, vascular remodelling, acute and chronic luminal obstruction, abnormalities of blood flow and diminished oxygen supply to target organs.1 Plaque rupture and thrombosis result in the acute clinical complications of atherosclerosis. The process of atherosclerosis begins early in life and progresses over many decades. Rupture

Promoting cardiovascular health is central to the national strategy to reduce premature mortality in our population. In this supplement, we offer a new approach to cardiovascular disease (CVD) prevention through the MyAction preventive cardiology programme, developed by Imperial College London. This nurse-led, multi-disciplinary, family-centred service embraces all patients with atherosclerotic disease – coronary heart disease, stroke and peripheral arterial disease – together with those identified through Health Checks to be at high risk of developing CVD in one community-based programme. In this supplement, we describe the studies that

Introduction Cardiovascular diseases (CVDs) are a single family of diseases with common antecedents requiring a holistic approach to prevention. This is the central theme of the new cardiovascular outcomes strategy for NHS England.1 Atherosclerosis is ubiquitous in the population, manifesting itself in different ways – acute coronary syndromes, transient cerebral ischaemia or claudication – but linked by a common pathology and underlying causes in terms of lifestyle and related risk factors. Many with one expression of this disease commonly suffer from another, and yet each is managed in silos of care through cardiology, stroke and vascul

The main objective of cardiovascular prevention and rehabilitation in clinical practice is to reduce the risk of future vascular events, to improve quality of life and increase life expectancy. Cardiac rehabilitation (CR) is recommended by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR).1 This second edition of the Standards and Core Components (SCC) for Cardiovascular Disease Prevention and Rehabilitation from the BACPR, define CR through seven standards and seven core components for assuring a quality service of care using a multi-disciplinary biological and psychosocial approach.2 However, the implementatio

Background Statins are first choice for treatment of dyslipidaemia in both secondary and primary cardiovascular disease prevention. For every 1.0 mmol/L reduction in low-density lipoprotein cholesterol (LDL‑C), the risk of coronary heart disease (CHD) mortality decreases by 19% and overall mortality decreases by 12%.1 Despite statin treatment, a substantial number of cardiovascular events still occur, and one reason may be persistent lipid abnormalities including total cholesterol and LDL-C not at target, or low levels of high-density lipoprotein cholesterol (HDL-C) or elevated triglycerides. Results from the DYSlipidaemia International Stu

MyAction Westminster: background In response to the Department of Health (DoH) policy document Putting Prevention First,1 NHS Westminster launched its Health Checks programme in primary care in 2009. The MyAction Westminster programme was concomitantly commissioned by NHS Westminster so that those individuals identified to be at high cardiovascular disease (CVD) risk through the Health Checks could access, with their families, an effective vascular prevention programme that would help them achieve measurably healthier lives. Imperial College Healthcare NHS Trust were successful in becoming the providers of the programme with an annual budget

Background Cardiovascular disease (CVD) is the single most common cause of death in Ireland, with diseases of the circulatory system accounting for 33.5% of deaths.1 While there has been a significant decline in death rates over the last 30 years, CVD mortality rates in Ireland remain high in comparison with European averages.2 There is compelling evidence that managing risk factors through lifestyle intervention and cardioprotective drug management can reduce cardiovascular morbidity and mortality by up to 90%.3 In Ireland, high-risk approaches to prevention have traditionally targeted those with established heart disease, yet there are many

Introduction Statins have proved beyond doubt the relevance of reducing low-density lipoprotein (LDL) in atherogenic cardiovascular disease (CVD), with the risk of a new CVD event reducing by one-fifth for each 1 mmol/L decrease in LDL-cholesterol (LDL-C) achieved.1 A typical patient experiencing an acute coronary event in the UK will do so with LDL-C of 3.8 mmol/L.2 Thus, introducing a statin to achieve a target of just under 2 mmol/L will decrease the risk of a future event by no more than 40%. Unlike more uncommon patients with much higher LDL-C levels, such as those with heterozygous familial hypercholesterolaemia,3 the pre-treatment LDL-

This supplement is a report from the inaugural meeting of the Cardiometabolic Forum, jointly organised by the British Journal of Cardiology and HEART UK – The Cholesterol Charity. The meeting was held at the Royal Pharmaceutical Society, London, on 24th November 2011. Meeting chairs were Dr Dermot Neely (Royal Victoria Infirmary, Newcastle upon Tyne) for HEART UK, and Dr Henry Purcell (Royal Brompton Hospital, London, and Editor) for BJC. We hope this supplement will provide readers with an independent overview on recent developments in our knowledge of cholesterol metabolism and its implications for clinical practice. Speakers Dermot Neely

Worldwide, cardiovascular disease remains the leading cause of death and a major cause of disability affecting quality of life.1 Elevated cholesterol is one of the key risk factors accounting for a substantial proportion of this disease burden. In developed countries, at least one-third of all cardiovascular disease is attributable to five risk factors: smoking, excessive alcohol intake, elevated blood pressure, elevated cholesterol and obesity.2 In particular, elevated cholesterol accounted for 56% of all cases of coronary heart disease (CHD) and 18% of cases of ischaemic stroke (2002 data).2   Improved management of risk factors and