Tag Archives: cardiovascular disease

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

Introduction Since their discovery in the 1970s, statins are widely used in clinics for the treatment of atherosclerosis and other cardiovascular diseases (CVD). Statins attenuate the intracellular levels of cholesterol by inhibiting the rate-limiting enzyme 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase, either by competing with the normal substrate in the enzyme’s active site, or by altering the conformation of the enzyme by binding to its active site. Lipid-mediated effects Statins exert their lipid-mediated action by decreasing the production of cholesterol and low-density lipoproteins (LDL), by up-regulation of LDL-receptors and uptake

The heart is extensively described in multiple Qur’anic verses and prophetic traditions as both an organ of psyche, intelligence and emotion, as well as an important organ that can be harmed by several factors.2 The prophet Muhammad, Peace Be Upon Him (PBUH), stated: “Beware! There is a piece of flesh in the body if it remains healthy the whole body becomes healthy, and if it is diseased, the whole body becomes diseased. Beware, it is the heart”.3 This tradition holds true if taken either literally or spiritually. Fasting Ramadan and performing Hajj (Pilgrim) may pose problems to patients with cardiovascular disease, hence, it is import

Heart failure The recommendations on devices, drugs and diagnosis in heart failure were developed by the ESC in collaboration with a heart failure association of the ESC. There have been several major updates since the previous guidance published in 2008.  The new updates include: In devices, left ventricular assist devices (LVADs) have been hailed as a step change in the management of heart failure. LVADs are more reliable and lead to fewer complications than in 2008. Until now, LVADs have been used as a temporary measure in patients awaiting a heart transplant. Professor John McMurray (Glasgow, UK), chairperson of the ESC Clinical Practice

EVINCI study completed The prevalence of “significant” coronary artery disease in patients with chest pain symptoms is lower than expected in Europe, according to preliminary findings from the The EValuation of INtegrated Cardiac Imaging (EVINCI) study. Once the final analysis is completed, the EVINCI study is expected to demonstrate that performing adequate non-invasive imaging screening of patients with suspected coronary artery disease could safely avoid invasive procedures in 75 out of 100 patients.  The study will have sufficient power to answer the question of which is the most cost-effective non-invasive imaging strategy for the j

Background Observations on fish consumption in general Populations who consume large amounts of oily fish in their diet tend to have lower rates of coronary heart disease (CHD) and sudden cardiac death (SCD). Fish oils are rich in omega-3 polyunsaturated fatty acids (PUFAs), which have demonstrable cardioprotective properties. In line with these observations, extensive epidemiological data – including large meta-analyses – demonstrate clear associations between both increased fish consumption and increased omega-3 PUFA levels with a favourable cardiovascular prognosis.1-3 Most of the evidence for benefits has been observed in individuals

Iodine deficiency, thyroid stimulating hormone and cardiovascular disease Dear Sirs, The UK has been classified as iodine deficient.  This causes an increase in thyroid stimulating hormone (TSH), which also raises cholesterol.  Would it be wise to test for an iodine deficiency in patients with raised cholesterol? The American Association of Clinical Endocrinologists recommend an upper limit for TSH of 3.0 mIU/ml for the normal reference range.  I believe our UK endocrinologists are partly to blame for neglecting a suboptimal thyroid function which causes cardiovascular disease (CVD).  This theory can be related to countries like Japan tha

Introduction Type 2 diabetes mellitus is a major risk factor for developing both microvascular (retinopathy, nephropathy and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease and peripheral vascular disease).1 The link between maintaining good glycaemic control and prevention of these complications is well established.2-4 Guidelines recommend a target glycosylated haemoglobin (HbA1c) of 7% or less, but a large number of patients fail to meet this target and, as of yet, no ideal pharmacological blood glucose-lowering agent exists. Existing pharmacological therapies, which have been previously describ

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Requirements A range of providers, including GP practices and pharmacies, are carrying out NHS Health Checks. Whoever the provider, the NHS Health Check should be carried out in a setting or area that allows a private conversation to take place, face to face. The QRISK2 risk tool is the preferred tool for calculating the overall risk of developing CVD as it appears to take better account of ethnicity and deprivation. However, as the QRISK2 risk tool is currently not integrated into all GP practice clinical systems, the Framingham risk tool is also being used until such time as the QRISK2 is more widely available. All patients who undergo an