The online home for the primary care professionals managing patients with cardiovascular disease, diabetes and related diseases.

Saturday, 28 November 2015
Electronic cigarettes, e-cigs, vaporisers and the various other names given to these new devices have become a phenomenon. Their popularity over the past few years has grown significantly, with an expansion of highstreet e-cigarette shops, marketing via the internet and social media, as well as traditional approaches using print advertisement and mass media campaigns. Despite their increasing usage largely by smokers and ex-smokers, e-cigarettes have divided opinion as to whether they can offer real benefits or they are potentially damaging to public health. While a recent Public Health England review concluded that e-cigarettes could be prescribed to help smokers to quit, the Welsh government plans to restrict their use in the same way as for conventional cigarettes. This paper will present some of the main issues that surround e-cigarettes and highlight the potential consequences good and bad that this new technology may bring.
Category: Editorial
Topics covered:
Saturday, 28 November 2015
This article provides an overview of gout, including its optimal treatment, links with cardiovascular disease and the value of European and UK guidelines.
Category: Editorial
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Wednesday, 25 November 2015
Therapeutic interventions in atrial fibrillation primarily aim at reducing symptoms and improving or maintaining patients’ health-related quality of life (HRQoL). As most studies in this area have focused on randomised trial populations with highly symptomatic patients, this large observational study aims to assess HRQoL in a typical UK general practice setting.
Category: Editorial
Tuesday, 10 November 2015
Percutaneous coronary intervention (PCI) has no benefit over optimising medical therapy (OMT) in the management of patients with chronic stable angina. Guidelines recommend an initial OMT approach; however, the use of medicines remains suboptimal. The aim of this study was to test whether a primary care clinical pharmacist service could enhance the management of patients with chronic stable angina.
Category: Editorial
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Friday, 30 October 2015
Heart failure (HF) is an important cause of morbidity, mortality and misery for patients. However, there are many ways to improve and extend the lives of people with HF, if clinicians are familiar with and apply the numerous traditional, less mainstream and more innovative evidence-based treatment options. This article reviews current best practice in the management of chronic HF and of acute decompensated HF, and considers recent insights, controversies and innovations in this important, fast moving field.
Category: Editorial
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Friday, 30 October 2015
The outlook is bleak for patients with untreated or suboptimally treated heart failure (HF). Conversely, optimising management (HF) improves patient survival and reduces hospital admissions. However, standards of care continue to vary, and many HF patients are still not receiving recommended therapy with disease-modifying drugs or specialist input to their care. Outcomes will only improve for all our HF patients if evidence-based clinical guidelines are implemented throughout the NHS.
Category: Editorial
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Thursday, 10 September 2015
The updated guideline on lipid modification from the National Institute for Health and Care Excellence (NICE), which was published in summer 2014, has continued to cause a great deal of controversy, both among health professionals and the general public. Now that the dust has settled just a little, it is time to review the messages of this guideline in detail rather than relying on the headlines.
Category: Editorial
Thursday, 30 July 2015
Alcohol has been identified as one of Public Health England's seven key priorities. After smoking and obesity, it is the biggest lifestyle risk factor for morbidity and mortality in the UK, accounting for 10% of disease and death. An estimated 9 million adults drink alcohol at levels detrimental to their health, with an estimated 1.6 million portraying signs of alcohol dependence. There is a misconception that drinking alcohol will only have a negative impact on health in those who binge drink or regularly get drunk. However, alcohol harms not only the individual drinker but also society as a whole, costing £21 billion a year, including annual direct costs to the NHS of £3.5 billion.
Category: Editorial
Thursday, 30 July 2015
Despite advances in management, heart failure (HF) remains a deadly clinical syndrome, with a five-year survival of 58% compared with 93% in the matched general UK population. In this comprehensive supplement, my colleagues provide excellent reviews of all aspects of chronic and acute HF, from epidemiology, through diagnosis, lifestyle interventions, pharmacological and device therapies to implementation of current guidelines. Rather than regurgitating the content of their articles, I would like to pick out some areas worthy of thought and discussion. I will discuss challenges to clinicians in the diagnosis and management of HF, diagnostic use of natriuretic peptides (NPs), newer medical therapies and their future use, device therapies, and implementation of the evidence base into clinical practice.
Category: Editorial
Topics covered:
Thursday, 30 July 2015
Heart failure (HF) was singled out as an emerging epidemic in 1997. Since then, rates have continued to rise and it remains a major public health problem with a prevalence ofmore than 23 million worldwide. HF is associated with significant morbidity, mortality and healthcare costs, particularly in the over-65s. Changes in the case mix mean morepatients are presenting with preserved ejection fraction, for which management is aimed to stop progression, relieve symptoms, eliminate exacerbations and reduce the mortality. Despite reductions in HF-related mortality, hospitalisations remain frequent and readmissions continue to rise. It is these admissions to hospital that put a financialstrain on the local health economy, and cause stress and anxiety for the patient and supporting family.
Category: Editorial
Topics covered:

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