Volume 2, Number 3, June-July 2005

POPULAR
TOPICBACK TO BASICSCalculating cardiovascular risk score

DIABETES MANAGEMENTMeasuring waist circumference will help target diabetes prevention
Susan Mayor

Primary care nurses can target efforts to prevent type 2 diabetes by measuring patients’ waist circumference, according to a new definition of metabolic syndrome announced recently by the International Diabetes Federation. The definition focuses on excess abdominal fat – which results in people being ‘apple’ shaped – as a key contributor to the development of the dangerous mix of impaired glucose control, hypertension and hyperlipidaemia that sets people on the road to type 2 diabetes. Just looking at people’s body shape as they come into the surgery, measuring their waist size and taking steps to reduce it where indicated, can help in the ongoing fight against the disease.

POPULAR
TOPICDISEASE FOCUSUnstable angina
Mike Kirby

Unstable angina describes a syndrome that is intermediate between stable angina and myocardial infarction: an accelerating or ‘crescendo’ pattern of chest pain that lasts longer than stable angina, occurs with less exertion or at rest, or is less responsive to medication. Unstable angina – like myocardial infarction – is an acute coronary syndrome (ACS), in contrast to stable angina, which is a chronic condition. It affects approximately six out of every 10,000 people. In this article, we review what causes unstable angina and how it should be diagnosed and treated.

EDITORIALEditorial
Jan Procter-King

Welcome to this issue of BJPCN. The sun is starting to make the odd appearance between the clouds. Are you starting to get that holiday feeling?

EVIDENCE IN PRACTICEEvidence in Practice

There 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-size summary of new research, pulling out key points for primary care and recommending the action that you might consider taking.

POPULAR
TOPICPOINTS MEAN PRIZESHypertension: the big one for QOF points
Stewart Findlay

In the third article in our series on the Quality and Outcomes Framework (QOF) we are reviewing how to score top marks for hypertension. This is probably the most difficult condition to treat to target but with careful attention to regular monitoring of patients with high blood pressure, treatment based on latest guidelines and careful recording of the outcomes of patient consultations, all practices should be able to gain points in this area.

HAVE YOU HEARD?Have you heard?

Action Pack to help meet hypertension targets
Novo Nordisk to withdraw Actrapid
LifeScan meters alert
Obesity in children in England continues to rise
Planning ahead for ‘Know your numbers’ week in September
Who’s who in health? Government and parliamentary health ministers

POPULAR
TOPICMONITORING24-hour ambulatory blood pressure monitoring
Joanne Wilkins

Ambulatory blood pressure monitoring (ABPM) is used widely in secondary care hypertension clinics, so what about its use in the primary care setting, where the majority of hypertension clinics take place? What are the potential benefits of ambulatory monitoring? Which patients should ABPM be used for? In this article we review the nuts and bolts of ABPM – when to use it, how to perform the test to obtain an accurate assessment of 24-hour BP and how to apply the results in clinical practice.

PREVENTION IN PRACTICEHappy holidays for people with heart disease or diabetes
Sandra Waddingham

Patients with chronic conditions such as heart disease or diabetes need to plan carefully before travelling long distances and taking holidays. Lifestyle changes can have an important impact on disease control, but a bit of thought and preparation beforehand should ensure that your patients’ holidays are both happy and healthy.