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Tag Archives: cardiovascular disease

Cardiovascular disease: the state of the nation, and the NHS Long Term Plan

September 2021 Br J Cardiol 2021;28(suppl 2):S3–S6 doi:10.5837/bjc.2021.s06

Cardiovascular disease: the state of the nation, and the NHS Long Term Plan

Shahed Ahmad, Xenophon Kassianides, Simon Thackray

Abstract

A silent pandemic Cardiovascular disease (CVD) is the primary cause of death worldwide, with an estimate of nearly 18 million lives lost each year, as figures from the World Health Organisation suggest.1,2 As life-expectancy and industrialisation have increased, a significant epidemiological transition has taken place, leading to a long-standing global pandemic in CVD.3 CVD is an umbrella term including disease states of both the heart and the vessels, and, therefore, has pathological implications and associations with most organs, including brain and kidney. It has a multi-faceted impact, not only in terms of mortality and morbidity but also

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Conversations on cholesterol: evaluating the role of LDL-cholesterol reduction in ASCVD

September 2021 Br J Cardiol 2021;28(suppl 2):S7–S12 doi:10.5837/bjc.2021.s07

Conversations on cholesterol: evaluating the role of LDL-cholesterol reduction in ASCVD

Chris J Packard

Abstract

Introduction Cardiovascular disease remains a major cause of morbidity and mortality in the UK even though mortality rates have declined significantly over the last 50 years.1 Improvements in the detection and treatment of people at elevated risk for atherosclerotic cardiovascular disease (ASCVD) have contributed to the decline, but findings from surveys of current practice indicate that much more could be done in both primary and secondary prevention settings to alleviate the disease burden.2 The following ‘conversations’ focus on recent developments in our understanding of the role of lipoproteins in ASCVD, and the potential of lipid-lo

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Inclisiran: testing a population health management methodology to implement a novel lipid treatment

September 2021 Br J Cardiol 2021;28(suppl 2):S19–S22 doi:10.5837/bjc.2021.s09

Inclisiran: testing a population health management methodology to implement a novel lipid treatment

Samantha Dixon, Linda Rootkin, Tracey Vell

Abstract

Introduction Cardiovascular disease (CVD) affects around seven million people in the UK. It is a significant cause of disability and is responsible for one in four premature deaths – accounting for the largest gap in health life-expectancy. It is also an area where there are significant health inequalities, with those in the most deprived 10% of the population almost twice as likely to die as a result of CVD, than those in the least deprived 10% of the population.1 Box 1. Five major practical changes to the NHS service model2 We will boost ‘out-of-hospital’ care, and finally dissolve the historic divide between primary and commu

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Adapting cardiovascular disease care to the ‘new norm’ of the COVID-19 era: same standard, different delivery

December 2020 Br J Cardiol 2020;27(suppl 2):S2–S16 doi:10.5837/bjc2020.s05

Adapting cardiovascular disease care to the ‘new norm’ of the COVID-19 era: same standard, different delivery

Martin R Cowie, Matthew Fay, Jo Jerrome, Abhishek Joshi, Jim Moore, Helen Williams

Abstract

Introduction to the steering committee From left to right: Professor Martin Cowie, Dr Matthew Fay, Ms Jo Jerrome,Dr Abhishek Joshi, Dr Jim Moore, Ms Helen Williams Conflicts of interest The steering committe received speaking and consultation fees from Bayer plc. MRC provides consultancy advice to Abbott, AstraZeneca, Bayer, Boston Scientific, Medtronic, Novartis, Roche Diagnostics and Servier. MF has received speaker honoraria, conference sponsorship, unrestricted educational grants, and/or attended meetings sponsored by AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Medtronic, Novartis, Pfizer, Roche, Sanofi-Aventis, and S

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May 2020 Br J Cardiol 2020;27:45–6 doi:10.5837/bjc.2020.010

Cardiac complications in end-stage renal disease: a shared care challenge

Xenophon Kassianides, Adil Hazara, Sunil Bhandari

Abstract

End-stage renal disease (ESRD) represents a state of dysregulation of many processes including inflammation, endothelial dysfunction, vascular calcification, bone mineral metabolism, oxidative stress, autonomic balance, uraemia, volume control, coagulation, insulin resistance, and haematopoiesis. The process of haemodialysis, the most common form of renal replacement therapy, causes myocardial stunning, leading to strain and potential damage,2 and can create a pro-arrhythmic environment.3 The early dialysis period is indeed high risk, with more cardiovascular events reported within the first five months of dialysis.4 It is, therefore, not an

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April 2020

COVID-19 and cardiovascular disease

BJC Staff

Abstract

Leading experts treating COVID-19 patients now provide advice on managing cardiovascular disease during the pandemic. New European Society of Cardiology (ESC) guidance provides healthcare professionals with the best available knowledge, based on practical experience, on how to diagnose and manage cardiovascular conditions in COVID-19 patients, treat the coronavirus infection, and organise and prioritise care. It will be updated as more evidence is gathered. The authors stress that document is not a guideline but rather a guidance document. The recommendations are the result of observations and personal experience from health care providers at

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March 2020 Br J Cardiol 2020;27:31–3 doi:10.5837/bjc.2020.007

Primary prevention aspirin among the elderly: challenges in translating trial evidence to the clinic

J William McEvoy, Michael Keane, Justin Ng

Abstract

Introduction The ASPirin in Reducing Events in the Elderly trial (ASPREE), published in 2018, was a landmark randomised-controlled trial (RCT) that contributed important knowledge about primary cardiovascular disease (CVD) prevention among healthy older adults.1 ASPREE found that daily low-dose aspirin (LDA) does not statistically prevent disability or CVD among adults aged over 70 years when compared with placebo, but does significantly increase risk of haemorrhage; findings that immediately influenced clinical practice guidelines.2 When used as a case study of large RCTs, ASPREE provides further, more existential, lessons for both researche

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November 2019 Br J Cardiol 2019;26:141–4 doi:10.5837/bjc.2019.041

Lipid testing and treatment after acute myocardial infarction: no flags for the flagship

Louise Aubiniere-Robb, Jonathan E Dickerson, Adrian J B Brady

Abstract

Introduction Cholesterol is a key risk factor for atheroma and coronary heart disease. The evidence-base for high-intensity lipid-lowering therapy in secondary prevention of cardiovascular disease is unequivocal.1-4 Despite the introduction of novel drugs, including ezetimibe5,6 and monoclonal antibodies,7 statins remain first-line therapy.8,9 Statins decrease hepatic cholesterol synthesis by competitively inhibiting 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase receptors, as they have an affinity up to 10,000 times greater than the natural substrate.10 Through reducing intra-cellular cholesterol concentration, statins up-regulate

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Insights in patients with atrial fibrillation and co-existing cardiovascular disease

July 2019 Br J Cardiol 2019;26(suppl 2):S4–S9 doi:10.5837/bjc.2019.s08

Insights in patients with atrial fibrillation and co-existing cardiovascular disease

Khalid Khan, Honey Thomas

Abstract

Introduction Atrial fibrillation (AF) is encountered with increasing frequency in clinical practice,1 and is associated strongly with adverse clinical outcomes, including stroke, cardiovascular events and death.2,3 Concomitant atherosclerotic disease may increase the risk of adverse outcomes in people with AF. For example, peripheral arterial disease was present in 11% of a large cohort of European patients with AF, and increased the risk of all-cause and cardiovascular death, compared with patients with AF but no peripheral arterial disease.4 In addition, AF is associated with adverse outcomes in a range of other subgroups of patients, inclu

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Manage frailty effectively or manage decline – your choice and responsibility!

January 2019 Br J Cardiol 2019;26(1) doi:10.5837/bjc.2019.001

Manage frailty effectively or manage decline – your choice and responsibility!

Srikanth Bellary, Alan J Sinclair

Abstract

Frailty is strongly associated with cardiovascular disease (CVD) and, while the precise pathophysiological mechanisms linking frailty and CVD remain to be elucidated, it is likely that this association is bi-directional.4,6,7 Loss of muscle mass and function (sarcopaenia), insulin resistance and chronic low-level inflammation observed in the frailty state can predispose to CVD. On the other hand, the presence of CVD can lead to reduced activity, muscle loss and exhaustion, thus, predisposing to frailty. Large cross-sectional and longitudinal studies have shown that those with CVD were up to two to three times more likely to be frail than tho

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