Varenicline (Champix) is the newest, prescription-only oral drug we have to treat patients with today’s most important preventable health risk – smoking. With the 1st July deadline for no smoking in public places, there is more reason than ever for people to quit. NICE has recommended use of varenicline by the NHS in recent draft guidance, alongside counselling and support. In this article, we review how the drug fits into our strategies for helping our patients to stop smoking.
The Role Of Varenicline In Smoking Cessation
Body Mass Index (BMI) Or Waist-Hip Ratio?
The association between body mass index (BMI) and mortality from both cardiovascular disease (CVD) and coronary heart disease (CHD) is well accepted. Individuals with high BMIs are also at increased risk of developing other conditions such as sleep apnoea, osteoarthritis, female infertility, varicose veins, gastro-oesophageal reflux and stress incontinence. BMI has been the gold standard for predicting health by measuring body weight in relation to height. However, although BMI may be helpful in estimating overall obesity, it is becoming increasingly apparent that waist-hip ratio, which estimates central obesity, is a more accurate predictor of the risk of health problems generally and CVD in particular.
Back To Basics: Making sense of healthy and unhealthy fats
Peripheral Arterial Disease: The Forgotten Aspect Of CVD
Peripheral arterial disease (PAD) is emerging as being particularly important in terms of cardiovascular risk but its importance as a clear marker for serious underlying vascular disease goes largely unrecognised, with PAD being the only cardiovascular disease not included in the Quality and Outcomes Framework. PAD is often detected late, because patients tend to think that pain in their legs is simply a part of ageing. In this article, we discuss how to recognise and treat people with, or at risk of, PAD using both pharmacological and non-pharmacological interventions. We will also consider when referral to secondary care is appropriate.
Apocalypse Now: Can We Prevent The Next Generation Dying Before Their Parents?
Death rates from coronary heart disease (CHD) have halved in most industrialised countries since the 1970s and those in the UK by 44% over the last decade in people under 65. But death rates from cardiovascular disease have been falling more slowly in the UK compared to other countries, particularly in the younger age group. CHD deaths fell by 49% in men aged 55-64 but only by 30% in younger men aged 35-44 between 1994 and 2004 in the UK. In women, there was only a 20% drop in the 35-44 age group compared to a 56% fall in deaths in the older age bracket. Why are younger people doing so badly and what does this mean for their future?
Practice-Based Commissioning: Collaboration or Competition?
Practice-based commissioning – in which practices and other primary care professionals commission services for their patients – is the latest strategy designed to improve the fit between patients’ needs and service provision. In this article, we take a detailed look at why practice-based commissioning has been introduced, what it will mean in practice and how it will work with other purchasing strategies currently operating.
Editorial
“A little knowledge that acts is worth infinitely more than much knowledge that is idle,” to quote the Lebanese poet, Kahlil Gibran. Well, that’s what the British Journal of Primary Care Nursing (BJPCN) is all about – putting knowledge into action. And it sums up what primary care nurses do too. We are not people who sit about debating what to do, we get on and do it.
You and your treatment: starting on your statin
Inhaled insulin: a breath of fresh air in diabetes
Back to Basics: How drugs work in heart failure
Mending hearts and brains: the clinical case for change
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.
