Volume 11, Number 2, Apr-May-Jun 2014

EDITORIALEditorial
Jan Procter-King

I was listening to the radio the other morning as the news was breaking that polyunsaturated fats seem to be no better for your heart than good old butter. My friend Mike Knapton from the British Heart Foundation was interviewed and in his radio clip he said: "Choose something for taste and texture!" Now I would bet my life savings, if I had any, that he was edited, and that he would have gone on to advise moderation in all things and that it is important to reduce the amount of fat in the diet.

POPULAR
TOPICEDITORIALNHS Health Check: A systematic approach to CVD prevention
Dr Matt Kearney, Jamie Waterall, Craig Lister

The NHS Health Check offers 15 million people aged 40-74 years in England an assessment of cardiovascular risk, together with preventive interventions, once every five years. The programme has aroused some controversy, but there is an urgent need to take action now to reduce preventable, premature death and disability caused by vascular disease.

BACK TO BASICSNHS Health Check Programme

POPULAR
TOPICCHANGING BEHAVIOURFinding the right words to talk about weight
Cindy M Gray

Excess body weight is associated with a higher risk of cardiovascular disease, type 2 diabetes, cancer and a range of other debilitating health conditions, and is the third leading cause of death in high-income countries like the UK. Since practice nurses may have long-term, regular contact with patients, they may be well placed to motivate and support individuals in losing weight. It can, however, be difficult for nurses to find the right words to discuss this very sensitive subject with patients.

DIABETES MANAGEMENTLet's talk about sex to men with diabetes
Professor Mike Kirby

Erectile dysfunction (ED) is three to four times more common in men with diabetes, and 20% have the condition at diagnosis. ED is a marker for heart disease, and men themselves value the opportunity to discuss their sexual problems with a health professional. The annual diabetes review offers the opportunity to identify and treat these men. Some practice nurses may find this task daunting, but treatment of ED can help to improve a man's wellbeing and reduce his cardiovascular risk.

POPULAR
TOPICFOOD FOR THOUGHTThe Eatwell Plate: Helping patients get the balance right
Jan Procter-King

There are many fads about specific foods and their ‘super’ vitamins and minerals. Our choice of foods has also widened as supermarkets expand their ranges and previously specialist foods become mainstream. However, even though we can now buy tamarillos, Christmas-cake cheese or cranberry and pecan bread, the principle of proportion remains consistent. So the Eatwell Plate is very helpful in showing patients exactly what we mean when we advise them to follow a ‘healthy, balanced diet’.

POPULAR
TOPICPRACTICE TOOLSFeeling good? Long-term conditions and psychological health
Beverley Bostock-Cox

Compared with the rest of the population, people with long-term conditions—especially cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders—have two to three times the risk of experiencing a mental health problem. In this article we will consider how these issues affect long-term conditions, how we can assess their impact and how we can improve the psychological wellbeing of these patients.

PREVENTION IN PRACTICEJBS3: A 'heart age' approach to cardiovascular risk
Professor Mike Kirby

The long-awaited Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3) were issued at the end of March. This launch came nine years after publication of JBS2, which caused much debate about recommended lipid targets of 4.00 mmol/l and 2.00 mmol/l that were subsequently endorsed by NICE. So what are the most important new recommendations from JBS3, and what will they mean for our patients and our clinical practice?

POPULAR
TOPICTHERAPEUTICS REVIEWUsing NOACs for stroke prevention in atrial fibrillation
Dr Clare Hawley

Warfarin is highly effective in preventing strokes in people with atrial fibrillation (AF), but has its limitations. Only half of patients who could benefit actually receive warfarin, resulting in an estimated 7000 avoidable strokes each year. There are now three NICE-approved novel oral anticoagulant drugs (NOACs) licensed for stroke prevention in non-valvular AF. NOACs are easy to use and can provide a safe and effective alternative to warfarin in selected patients who can adhere to the treatment regimen.

PATIENT ADVICECatching the sun: The facts about vitamin D
Dr Andrew Blann

The last decade has witnessed an explosion of interest in vitamin D. The vitamin has an established role in promoting bone health, but should we be routinely testing vitamin D levels in our patients? And what is the evidence that supplementation improves health beyond the skeleton?

EVIDENCE IN PRACTICEEvidence in practice
Sue Lyon

Providing need-to-know information and recommended actions resulting from new clinical research

HAVE YOU HEARD?Have you heard?
Sue Lyon