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.
The long-awaited Joint British Societies' consensus recommendations for the prevention of cardiovascular disease (JBS3) were issued at the end of March.
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.
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.
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.
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'.
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.
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?