Tag Archives: hypertension

Introduction Essential or primary hypertension (HTN), defined as an office blood pressure (BP) ≥140/90 mmHg with no identifiable cause, is a well-documented risk factor for cardiovascular disease, and the most common cardiovascular condition to be seen in primary care.1 It also represents the strongest single modifiable risk factor with regards to future morbidity and mortality.2,3 As such, current guidelines advocate pharmacological treatment if lifestyle measures are insufficient. The National Institute for Health and Care Excellence (NICE) clinical guideline for the treatment of HTN recommends step 1 treatment with an angiotensin-convert

The initiative was launched in February 2015 and in a relatively short period of time, the project achieved success in all three areas with measurable improvement in outcomes, including a reduction in hospitalisations. Over 24 months, there have been around 21,000 clinical interventions, with the emphasis being on delivering change at scale, whilst being fastidious about minimising any extra workload on primary care. In this period, 13,000 patients either started statins or had their statins changed, more than 1,000 patients with atrial fibrillation were anticoagulated, and more than 5,200 hypertensive patients reached a blood pressure targe

Improvements in patient care mean hundreds more people are surviving heart failure, a new independent study has found. The latest report from the National Heart Failure Audit (April 2015– March 2016) (link below) has found that the mortality rate for people admitted to hospital with heart failure has dropped from 9.6% the previous year to 8.9%. The reduction in the mortality rate means that in the region of 500 lives have been saved in the past year compared to 2014–15. An assessment of patients admitted to hospital with heart failure at NHS Trusts also shows that more people are being provided with crucial medicines for heart disease as

Nanoparticles, inhaled from sources such as vehicle exhausts, have been shown to cross from the lungs into the blood stream. They can then accumulate in areas susceptible to heart problems, according to research part-funded by the British Heart Foundation.  Previous studies have identified a correlation but not a causal link between nanoparticles and strokes or cardiovascular disease. It is not currently possible to measure environmental nanoparticles in the blood. So, researchers from the University of Edinburgh, and the National Institute for Public Health and the Environment in the Netherlands, used a variety of specialist techniques to t

This publication in the British Journal of Cardiology is part of the need for coordinated publications to ensure that cardiologists are aware of the current consensus. The recommendations are limited to a specific scope – the period prior to planned surgery. Blood pressures that may cause an immediate risk to health are specified, rather than those that may cause risk over the long term. The best method of taking accurate blood pressure measurements is also examined. For the cardiologist who may be contacted to provide advice and management options for hospitalised patients with elevated blood pressure during the pre-operative period, this

Publisher: Oxford Cardiology Library, Oxford University Press, Oxford, 2015 ISBN: 9780198701972 Price: £19.99 I have always been fascinated by how primary care and secondary care look at hypertension in different lights. This pocket reference, written by cardiologists, demonstrates those differences and will mainly be of interest to their specialist colleagues. Examples of this are the inclusion of echocardiograms as basic investigations, whilst home blood pressure monitoring is never mentioned. Mostly written by Sunil Nadar, it is a collection of chapters that often repeat statements from previous chapters, particularly involving the epidem

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A 56-year-old woman attends for a well-woman blood pressure (BP) check. After three repeated measurements, a minute apart, her mean BP is 146/90 mmHg so the practice nurse decides to do an electrocardiogram (ECG), in accordance with the practice protocol. Figure 1 shows the ECG obtained. Figure 1. The electrocardiogram obtained during the well-woman check What is your impression? Does she need any further investigations? Discussion The main purpose of showing this ECG is to discuss the various voltage criteria for left ventricular hypertrophy (LVH). Interestingly, there is no one universally agreed criteria for diagnosis of LVH by ECG.  A fe