Over my lifetime, treatment for heart disease has improved beyond recognition. For the last six years, I have had the privilege of leading a programme that has accelerated that change, reducing waiting times, bringing in new treatments, training more specialists, and ensuring patients have more and better choices available. I am now working to repeat those strides forward for stroke, the brain's equivalent of heart attack. There are a similar number of strokes to heart attacks, but this equally devastating condition has been slower to catch the medical and public imagination in this country. With our ageing population, it represents a growing challenge for the future.
Primary healthcare professionals have been set a series of challenges and dilemmas for the management of lipids in the updated Joint British Societies' (JBS) guidelines for the prevention of cardiovascular disease (JBS2). In this article, we review the changes in emphasis of the new guidelines – teasing out how they can help to further reduce our patients' risk of cardiovascular disease with tougher cholesterol targets than ever before, together with practical advice on how to achieve these targets.
Cognitive behavioural therapy (CBT) is a combination of two types of therapy: cognitive (how we think about things) and behavioural (what we do). NICE guidelines recommend CBT as a frontline therapy for depression, obsessive compulsive disorder, post-traumatic stress disorder and anxiety. The National Institute of Mental Health suggests that a combination of CBT and medication may be the best treatment for many patients with panic disorder. As CBT is moving higher up the therapy agenda, this article takes you through what it is and what it involves in practice.