Volume 2, Number 2, April-May 2005

POPULAR
TOPICBACK TO BASICSAtrial fibrillation
Michael Schachter

POPULAR
TOPICDISEASE FOCUSIsolated systolic hypertension
Mike Kirby

Isolated systolic hypertension (ISH) – an increase in the higher of the two numbers when blood pressure (BP) is measured – is the commonest type of high BP in older people over the age of 60. The systolic pressure used to be dismissed as less important than the lower number – diastolic BP – but studies have shown that it is associated with increased risk of cardiovascular disease. ISH accounts for up to 75% of the overall incidence of uncontrolled hypertension in the elderly and appears to be more common in women than men.

POPULAR
TOPICEDITORIALOne year on: boldly going where no primary care nurse has gone before
Jan Procter-King

Welcome to the first year anniversary issue of the British Journal of Primary Care Nursing (BJPCN). It has been an eventful year for primary care nurses, with new challenges coming from all directions. In each issue of the journal we have tried to provide practical information and tools to help you find your way through the expanding universe of primary care in cardiovascular disease and diabetes – to boldly go where no primary care nurse has gone before!

FOOD FOR THOUGHTChewing the fat
Paul D McArdle

Some fat is essential for maintaining good health, in order to provide essential fatty acids and the fat-soluble vitamins A, D, E and K. Essential fatty acids can only be derived from foods because they cannot be synthesised by the body. However, the hard truth is that essential fatty acids represent only a very small amount of total energy needs and most people still consume too much fat. How much fat should we be eating? What is the difference between different types of fats and what advice should we be giving patients about fats to reduce their risk of cardiovascular disease?

EVIDENCE IN PRACTICEThere are just not enough hours in the day to read all the research journals, even if you wanted to. This section of the BJPCN – Evidence in practice – will keep you on top of relevant research without having to spend hours in the library.
Each journal review gives you a bite-sized summary of new research, pulling out key points for primary care and recommending the action that you might consider taking.

POPULAR
TOPICPOINTS MEAN PRIZESHow to score top marks for secondary prevention of coronary heart disease
Stewart Findlay

In this second article in our series on the Quality and Outcome Framework (QOF), we will discuss how to maximise points in the secondary prevention of coronary heart disease (CHD) and heart failure. This will include lipid management and smoking cessation.

HAVE YOU HEARD?NSF for Renal Services encourages prevention of kidney disease
Obesity increases diabetes risk by 80 times
Pioneering health promotion programme to target people at work
New report tracks smoking statistics
Health Foundation launches scheme to improve diabetes care
HumaJect S and HumaJect M3 changes

MONITORINGDiagnosing diabetes
Juliet Webb

The number of people with diabetes in the UK is almost 1.8 million and this is continuing to rise, according to recent figures. But only about half of these are currently diagnosed. It is obviously essential to ensure that these people are diagnosed as early as possible and then managed appropriately to ensure they receive the best possible care to minimise long-term complications. In this article, we review how to diagnose diabetes accurately, based on good practice recommended in standard two of the National Service Framework (NSF) for Diabetes. What should we be measuring in people who present with the classic symptoms and in those who do not to ensure an accurate diagnosis of diabetes?

PREVENTION IN PRACTICEHealthy eating for type 2 diabetes: let’s go shopping
Nicola McConnell

People with diabetes used to be advised to watch their carbohydrate – particularly sugar – intake. But dietary recommendations have developed over the past few years so that they are now similar to the healthy diet that we should all be eating. Are there any remaining differences in what we should be telling patients with diabetes about their diet? Fewer than you might think. In this article we take a ‘supermarket tour’ that explains what patients with diabetes should be putting in their trolleys and what they should be leaving on the shelves.

THERAPEUTICS REVIEWChanging practice in hypertension: ASCOT win for newer antihypertensives
Mike Mead

The British Hypertension Society Guidelines published last year were widely welcomed as a major step forward in the management of patients with high blood pressure. In common with all recent guidelines they were based on a review of all relevant evidence, mainly gained from clinical trials. However, medicine is never static and research is ongoing. A major study – ASCOT – has provided new information about the benefits of newer combinations of antihypertensives compared to older drugs. What did the study show and how should we act on the results to improve outcomes for our patients?