Stroke is devastating – for the person affected, their family and the NHS. Figures in the recent NICE guideline on stroke show that around 110,000 people have a first or recurrent stroke each year in England, and a further 20,000 have a transient ischaemic attack (TIA).
Editorial
The government’s new public health strategy, Healthy Lives, Healthy People, aims to transform public health and – perhaps for the first time – to create a ‘wellness’ service to meet today’s health challenges. We may have our reservations about the NHS reforms, but improving public health is something we can all sign up to. So this issue of BJPCN focuses on one of today’s key public health challenges – obesity.
The ultimate cholesterol-lowering plan – part 2
Part 1 explained how powerful a diet can be in lowering low density lipoprotein-cholesterol (LDL-C) and reducing cardiovascular risk published in BJPCN 2011;8:36-8. Part 2 will focus on the practical step-by-step approach of the Ultimate Cholesterol-Lowering Plan (UCLP) by introducing an alternative consultation technique and detailing the core food elements of the UCLP.1-7 The UCLP includes a number of key strategies each scientifically proven to provide a dose-response effect to cholesterol reduction or cardiovascular risk.
Maintaining tight glucose control during Ramadan
What are the practicalities of supporting people with diabetes who fast during Ramadan? Practice nurses can make a real difference by educating patients before Ramadan starts and advising them on what they need to consider before starting their fast. Patients need to be involved in the whole process so that they are well aware of the importance of managing their diabetes to ensure good control of their glucose levels throughout Ramadan. We review how to assess patients before Ramadan, what adjustments to make to medication and how to follow up.
Very low energy diets: the key facts
In recent years it seems as if there has been an increase in the popularity of very low energy diets (VLEDs) and new programmes are readily available to our patients on the high street. This article explains the background and theory behind VLEDs so that you can better inform and support your patients if they are considering one of these diets.
How to advise patients on fortifying their diet
Adequate nutrition is an important part of keeping healthy. Some patients – particularly the elderly – may find it difficult to consume an adequate diet to provide all the components to maintain good health. In this case, fortifying the diet may be helpful. Our keep and copy guide over the page provides practical tips for you to photocopy and give to patients and their carers on how to fortify their diet without using oral nutritional supplements.
Whole grain breakfasts for trimmer waists
Central obesity remains a big issue in the UK. The accumulation of adipose tissue in the abdominal region is a particular risk factor for chronic disease and mortality.1 In 2008, 39% of adults in England had a waist circumference indicative of central obesity (above 88 cm for women and 102 cm for men).2,3 Two proven effective dietary strategies for reducing waist circumference are the inclusion of whole grain foods in the diet and the avoidance of meal skipping.4 Advice to start the day with whole grain breakfast cereal and/or whole grain bread combines these two strategies in one simple and feasible practical message.
Back to Basics: Recognising the four types of coronary artery disease
Hearts and hormones: what’s the impact of hormonal contraception and HRT on cardiovascular risk?
The impact of female hormones on cardiovascular risk is a hot issue. Many nurses working in the NHS, including in general practice, are aged 50 or older. This means that there is a strong possibility that some of us may be experiencing menopausal symptoms, along with our patients. In this article, we look at the use of hormonal therapies at the time of the menopause, with particular reference to cardiovascular risk. We will also touch on the use of oral contraception and associated cardiovascular factors.
Helping patients with swallowing problems after a stroke
Swallowing really is a life or death matter. Nearly half of people who have had a stroke will initially experience difficulty swallowing. This is called dysphagia. In this article, we look at the anatomy and physiology of swallowing, what can go wrong in people who have had a stroke, and what can help. Explanations are given clearly, using simple language that you can use with patients and their family members.
Proteinuria: replacing cholesterol as a key risk factor for revealing patients with CVD?
We have all seen paintings of early physicians looking at flasks of urine to give an indication of a person’s health. And most of us can remember days of rows of urine pots lined up to test for new patients in primary care and in hospital outpatient clinics. We may assume that those days have gone in the era of blood testing and CT scans. So why do we have a cluster of urine pots on the cover of this issue of BJPCN and why are we suggesting that urine testing has a central role in finding patients with previously undiagnosed cardiovascular disease?
Editorial
Are you sitting comfortably? Then I’ll begin. Once upon a time… Telling stories is something that many of us do with our children. But what about with our patients, and what about encouraging patients to tell their stories? In this issue of BJPCN, we share some exciting new research showing that patients with high blood pressure can learn from each others’ stories. And we help you to fill in the gaps so you’ve got a clear story to tell during routine consultations with patients with cardiovascular disease and diabetes.
