Tag Archives: cardiovascular risk

Introduction Throughout history, blood pressure has played an important role in medicine, especially in predicting and assessing risk. Despite its extensive use in clinical practice, blood pressure is still a developing field and a recent focus on blood pressure variability has prompted a contemporary review of this important topic. Blood pressure was first determined in 1733 by Stephen Hales, when he measured the blood pressure of a horse with a water manometer. Subsequently, the Russian surgeon, Nicolai Korotkoff, described the changing sounds heard by the stethoscope during cuff deflation, giving birth to the Korotkoff method, which is st

“The prescribed number of doses per day is inversely related to compliance.”4 Medicines usually work when they are taken, but definitely don’t when they are not! Box 1. Some reasons for non-adherence in patients I’m rattling like a pill-box with the number of tablets I can never remember the evening one I don’t want to take medications for the rest of my life I feel perfectly fine To be honest, I can’t afford them I want to try diet – they have a lot of side effects I lost the prescription I can’t remember why I stopped them What’s the point Adherence to medication has been widely identified as a risk factor in

Introduction Originally, icosapent ethyl (IPE) was developed as a treatment for hypertriglyceridaemia.2 However, in the Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial (REDUCE-IT),3 IPE significantly decreased the risk of ischaemic events (including cardiovascular [CV] death) by ~25% after a median follow-up of 4.9 years. The study included patients with fasting triglyceride (TG) levels of 1.7 to 5.6 mmol/L (150 to 499 mg/dL) and low-density lipoprotein cholesterol (LDL-C) levels of 1.1 to 2.6 mmol/L (41 to 100 mg/dL) who were on optimum statin treatment. Interestingly, this reduction in CV risk was independent of

Introduction It is time to adopt recent (and even some 20th century) evidence for obesity and weight management. Some aspects of current practice, both clinical and epidemiological, are still largely lodged in the mid-19th century. The body mass index (BMI) was first proposed in 1835 by Adolphe Quetelet, a Belgian mathematician, as a way to standardise body composition assessment for people of different heights. His work was published in the English language a few years later.1 At that time, few people, mostly affluent, had a BMI above 30 kg/m2, and far fewer had type 2 diabetes. The main public health concern was malnutrition, and BMI <18

Symptoms with which patients present vary widely, and include autonomic symptoms, such as sweating, shaking, palpitations, and hunger, or neuroglycopenic symptoms due to cerebral glucose deprivation, such as drowsiness, confusion, odd behaviour and speech disturbances. One of the most commonly used measures of the severity of hypoglycaemia, the Edinburgh Hypoglycaemia Scale, is shown in table 2. Sometimes, patients do not have the classical autonomic or neuroglycopenic symptoms related to hypoglycaemia. To a diabetologist, this hypoglycaemic unawareness is worrying. This is because, while the patient loses their warning symptoms, neurocogniti

Dr Gilbert Wagener (Transcrip Partners LLP) Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new target for the treatment of hyperlipidaemia. PCSK9 is apparently complimentary to 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibition with statins.6,7 Most advanced in the development path are two monoclonal antibodies (mAbs) against PCSK9, alirocumab (SAR236533) and evolocumab (AMG145), both subcutaneous injectable drugs administered at bi-weekly or four-weekly intervals. Both compounds demonstrated solid reductions in LDL-C, however, dose selection for both focused on the most effective dose and did not consider titration ac

Introduction Daily low-dose aspirin (75–100 mg per day) substantially reduces the risk of subsequent vascular events, such as myocardial infarction and ischaemic stroke.1 Evidence from primary prevention trials has indicated a reduction in the risk of a first vascular event,2 but the benefit–risk balance for this is open to debate.3 The prevalence of aspirin taking by patients at increased vascular risk and by the general population is unknown in the UK. The following reports a survey to determine the taking of regular aspirin within a representative community sample of adult individuals in the south Wales county of Caerphilly. Methods T

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NHA joins with BHS The Nurses Hypertension Association (NHA) has become part of the British Hypertension Society (BHS) after the BHS decided to invite nurses working in the field of hypertension and cardiovascular disease to be full members of the society. “This acknowledges the shift of care towards specialist nurses, particularly in primary care,” said Naomi Stetson, former head of the NHA. “In the current economic climate, it also made good business sense to have one united organisation.” All members of the NHA are now full BHS members and so the NHA has disbanded. “There is a strong Nurses Working Party within the society, which

The guidance states: “Although the committee did not change their conclusion that dronedarone is not as effective as other anti-arrhythmic drugs in preventing the recurrence of AF, it accepted evidence that the drug did not lead to an increase in the risk of mortality, unlike the anti-arrhythmics with which it was compared. The Appraisal Committee also noted comments from patients and clinical experts received during consultation on the previous draft that all current anti-arrhythmic drugs, but particularly amiodarone, had side effects which had a significant impact on quality of life with long term use. Overall, the Committee concluded tha