December 2013 Br J Cardiol 2013;20(suppl 3):S1–S19
Kornelia Kotseva, Mary Seed, David Wood
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
December 2013 Br J Cardiol 2013;20(suppl 3):S1–S19 doi:10.5837/bjc.2013.s03
David A Wood Full author details can be found here.
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
December 2013 Br J Cardiol 2013;20(suppl 3):S1–S19 doi:10.5837/bjc.2013.s06
Catriona Jennings, Alison Atrey, Jennifer Jones, Kornelia Kotseva, David A Wood, on behalf of the MyAction Central team
The programme is implemented according to national evidence-based guidelines and local policies. The programme integrates primary and secondary prevention in one programme and recruits all those who will benefit the most, i.e. patients with vascular disease, those at high risk of developing disease, and the close family members of the above, and takes into account the groups in which the prevalence of cardiovascular disease and risk factors is the highest. The programme is family centred and so recruits the spouse and/or others close to the patient in order to maximise the potential for adoption of positive healthy behaviours. Wherever possib
December 2013 Br J Cardiol 2013;20(suppl 3):S1–S19 doi:10.5837/bjc.2013.s07
Susan Connolly, Adrian Brown, Sarah-Jane Clements, Christine Yates, Kornelia Kotseva, on behalf of Westminster MyAction teams
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
December 2013 Br J Cardiol 2013;20(suppl 3):S1–S19 doi:10.5837/bjc.2013.s08
Irene Gibson, James Crowley, Jennifer Jones, Claire Kerins, Anne Marie Walsh, Caroline Costello, Jane Windle, Gerard Flaherty, on behalf of Croí MyAction team
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
February 2011 Br J Cardiol 2011;18:s13-s5
Julian Halcox - Professor of Cardiology and Consultant Cardiologist
To address the question of increasing engagement with CR programmes in target areas, in 2009, I chaired a Steering Committee convened by Abbott Healthcare Products Ltd. (formerly Solvay Healthcare) called ‘Setting the Standard for Cardiac Rehabilitation’ (START). The Steering Committee advised that the existing Cardiac Networks in each region would be the best forum for disseminating information about changes in CR funding and standards of care in this field. Abbott Healthcare Products Ltd. kindly agreed to organise a series of meetings in the UK, held during 2009 and early 2010, with the aim of raising awareness of the importance of CR a
February 2011 Br J Cardiol 2011;18:s13-s5
John Buckley
WHO definition The World Health Organization (WHO) defined CR in 1993 in a timeless way that is inclusive and sensitive to the psychosocial, biomedical, professional expertise and service delivery mode and location elements required of a contemporary CR service. “The sum of activities required to influence favourably the underlying cause of the disease so that (people) may by their own efforts preserve, or resume when lost, as normal a place in the community… …it must be integrated within secondary prevention services of which it forms one facet”.3 BACR definition This article reflects on how this definition dovetails with the BACR St
February 2011 Br J Cardiol 2011;18:s13-s5
Dr E Jane Flint
In fact, fewer than half of networks have ever benefited from Patient Choice Revascularisation Pathway monies, which were originally intended to support CR also.2 The START meeting in Birmingham in December 2009 was an opportunity to celebrate the innovative approach undertaken by the West Midlands’ Regional NSF Implementation Group for Cardiac Rehabilitation and Secondary Prevention, describing local CR pathway service standards against which West Midlands’ CR programmes could be audited to inform commissioning. The subsequent proportional allocation of ‘Patient Choice’ rehabilitation funding across Birmingham and the Black Country w
February 2011 Br J Cardiol 2011;18:s8-s10
Judith Edwards
The service at Charing Cross was used as the model for EUROACTION, a randomised, controlled trial of a preventive cardiology programme, conducted in eight European countries, including the UK. This nurse-led multidisciplinary programme significantly improved the management of lifestyle and medical risk factors for cardiovascular disease prevention in coronary patients and patients at high multifactorial risk for developing heart disease.1 The principles of the EUROACTION programme were used to found The MyAction community programme, commissioned in 2008 by NHS Westminster as a model for preventive cardiology care for its residents. The Imperi
February 2011 Br J Cardiol 2011;18:s11-s2
John Buckley
What is beneficial exercise? A prime question needs to be considered before furthering this discussion: what is meant by beneficial exercise? The benefits of exercise impact on all aspects of health – physiological, psychological and social. A study by Fox (1999) found that short bouts of any activity, even low-intensity activity that may not bring about a significant physiological risk factor change, if it is performed regularly, will provide psychological benefits to self-esteem and self-efficacy, and reductions in anxiety and depression.2 Angina patients engaging in regular walking on a similar premise to that expressed by Fox show signi
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