CARDIO HORIZON SCANNING FEB 2011

Articles include the following
Cardiovascular Horizon Scanning Volume 3 Issue 2
Multiple risk factor interventions for primary prevention of coronary heart disease
Exercise on prescription: changes in physical activity and health-related quality of life
Efficacy of quantified home-based exercise and supervised exercise
Improving cardiovascular health at population level
NHS failing to screen for deadly heart condition
Considerable uncertainty remains in the evidence for primary prevention of cardiovascular disease
Parental history and myocardial infarction
The association of breast arterial calcification and coronary heart disease
Conventional versus automated measurement of blood pressure in primary care
Early life socioeconomic adversity is associated in adult life with chronic inflammation, carotid artherosclerosis, poorer lung function and decreased cognitive performance: a cross-sectional, population-based study
Further dissemination

Cardiovascular Horizon Scanning Volume 3 Issue 2
Posted: 14 Feb 2011 07:50 AM PST
Filed under: Cardiovascular diseases, Volume 3 Issue 2

Multiple risk factor interventions for primary prevention of coronary heart disease
Posted: 11 Feb 2011 09:37 AM PST
Source: Cochrane Database of Systematic Reviews 2011, issue 1
Follow this link for fulltext
Date of publication: January 2011
Publication type: Systematic review
In a nutshell: The evidence from this Cochrane systematic review suggests that multiple risk factor interventions using counselling and educational methods to change behaviour do not reduce coronary heart disease (CHD) mortality and morbidity. However, they may be effective in reducing mortality in high-risk hypertensive and diabetic populations. It concludes that health promotion interventions have limited use in general populations.
Length of publication: 175 pages
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Cardiovascular diseases, Volume 3 Issue 2 Tagged: behaviour change, CHD, health promotion, risk factors

Exercise on prescription: changes in physical activity and health-related quality of life
Posted: 11 Feb 2011 07:06 AM PST
Source: European Journal of Public Health, 2011, 21 (1), p. 56-62
Follow this link for fulltext
Date of publication: January 2011
Publication type: Research
In a nutshell: This study analysed changes in physical activity among participants of five Exercise on Prescription (EoP) programmes in Denmark. EoP helped to contribute to improved levels of physical activity and health-related quality of life.
Length of publication: 7 pages
Some important notes: You will need an NHS Athens username and password to access this article. Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Cardiovascular diseases, Physical activity, Volume 3 Issue 2 Tagged: behaviour change, Exercise, lifestyle

Efficacy of quantified home-based exercise and supervised exercise
Posted: 10 Feb 2011 09:49 AM PST
Source: Circulation, 2011, 123 (5) p. 491-498
Follow this link for fulltext
Date of publication: February 2011
Publication type: Research
In a nutshell: This clinical trial compared home-based and supervised exercise programmes among peripheral artery disease patients. The results of the study found that a home-based exercise programme had high adherence and was effective in improving claudication measures and increasing daily ambulatory activity.
Length of publication: 8 pages
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.
Acknowledgement: American Heart AssociationFiled under: Cardiovascular diseases, Volume 3 Issue 2 Tagged: claudication, peripheral artery disease, Physical activity

Improving cardiovascular health at population level
Posted: 10 Feb 2011 09:25 AM PST
Source: BMJ 2011; 342:d442 (Online First)
Follow this link for fulltext
Date of publication: February 2011
Publication type: Research
In a nutshell: The Cardiovascular Health Awareness Program (CHAP) was implemented as an intervention to reduce morbidity from cardiovascular disease among older adults in 39 communities in Canada. This collaborative, community-based health promotion and prevention programme was found to reduce cardiovascular morbidity at a population level.
Length of publication: 8 pages
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Canada, Cardiovascular diseases, Prevention, Volume 3 Issue 2 Tagged: community-based programmes, education, health promotion, Risk assessment

NHS failing to screen for deadly heart condition
Posted: 10 Feb 2011 09:16 AM PST
Source: National Institute for Health and Clinical Excellence
Follow this link for fulltext
Date of publication: January 2011
Publication type: Press release
In a nutshell: 100.000 people are at risk of developing familial hypercholesterolaemia (FH) as trusts fail to act on NICE guidelines which call for early diagnosis. A UK-wide audit found that very few families were systematically genetically screened for the inherited condition.
Length of publication: 1 webpage
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Cardiovascular diseases, Diagnosis, Volume 3 Issue 2 Tagged: familial hypercholesterolaemia, family history, genetics, screening

Considerable uncertainty remains in the evidence for primary prevention of cardiovascular disease
Posted: 10 Feb 2011 07:30 AM PST
Source: The Cochrane Library
Follow this link for fulltext
Date of publication: 14 January 2011
Publication type: Editorial
In a nutshell: This editorial is written by Carl Heneghan, Director of the Centre for Evidence Based Medicine, and Clinical Reader in the Department of Primary Health Care, University of Oxford. It is based on the evidence from two new Cochrane reviews of preventive strategies: multiple risk factor interventions for primary prevention of CHD, and statins for the primary prevention of CVD.
Length of publication: 1 web page
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Cardiovascular diseases, Prevention, Volume 3 Issue 2 Tagged: evidence, preventative services, Prevention

Parental history and myocardial infarction
Posted: 10 Feb 2011 06:18 AM PST
Source: Reuters 27.1.11
Follow this link for fulltext
Date of publication: 27 January 2011
Publication type: News item
In a nutshell: Reports on the findings of the INTERHEART study, published recently in the Journal of the American College of Cardiology. 12 000 participants from 52 countries were studied, and across all nationalities, the risk of heart disease was almost doubled in those with a family history of heart attack.
Length of publication: 1 web page
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.
Acknowledgement: Journal of the American College of Cardiology (JACC), 2011, 57, pp 619-627Filed under: Cardiovascular diseases, Volume 3 Issue 2 Tagged: family history, risk factors

The association of breast arterial calcification and coronary heart disease
Posted: 10 Feb 2011 04:01 AM PST
Source: Obstetrics and Gynecology, 2011, 117 (2 part 1) p. 233-241
Follow this link for fulltext
Date of publication: February 2011
Publication type: Research
In a nutshell: The objective of this study was to determine whether mammography could be an early prediction tool for the development of coronary heart disease (CHD). The study found that the presence of breast arterial calcifications on mammograms indicated a significantly increased risk of developing CHD or a stroke, and could therefore be used as a marker.
Length of publication: 9 pages
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Cardiovascular diseases, Prevention, Volume 3 Issue 2 Tagged: CHD, mammography, risk markers, risk prediction tools

Conventional versus automated measurement of blood pressure in primary care
Posted: 10 Feb 2011 03:23 AM PST
Source: BMJ 2011;342:d286 (Online First)
Follow this link for fulltext
Date of publication: 7th February 2011
Publication type: Research
In a nutshell: The objective of this randomised controlled trial was to compare the quality and accuracy of manual office blood pressure and automated office blood pressure. Primary care practices in five Canadian cities were randomly allocated to the use of either manual or automated office blood pressure.
Length of publication: 9 pages
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Canada, Cardiovascular diseases, Prevention, Volume 3 Issue 2 Tagged: BP monitoring

Early life socioeconomic adversity is associated in adult life with chronic inflammation, carotid artherosclerosis, poorer lung function and decreased cognitive performance: a cross-sectional, population-based study
Posted: 09 Feb 2011 07:14 AM PST
Source: BMC Public Health, 2011, 11:42
Follow this link for fulltext
Date of publication: 17 January 2011
Publication type: Journal article
In a nutshell: The Scottish Psychosocial and Biological Determinants of Ill-health (pSoBid) Study was conducted to examine links between early life adversity, intermediary phenotypes and markers of ill-health in adulthood, including artherosclerosis.
Length of publication: 16 pages
Some important notes: Please contact your local NHS library if you cannot access the full text. Follow this link to find your local NHS library.Filed under: Cardiovascular diseases, Volume 3 Issue 2 Tagged: health inequalities, risk factors

Further dissemination
Posted: 08 Feb 2011 05:44 AM PST
If you think someone would benefit from receiving this posting, please e-mail them the link to this blog and suggest that they sign up to the e-mail newsletter to stay up to date with new content.Filed under: Cardiovascular diseases, Volume 3 Issue 2

CARDIO HORIZON SCANNING

CARDIOVASCULAR HORIZON SCANNING Volume 2 Issue 11

• WoW (Walk once a Week)
  Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness
  The polypill in the prevention of cardiovascular diseases
  National exercise proven to be cost effective in Wales
  Association of features of primary health care with coronary heart disease mortality
  Trends in coronary heart disease mortality in England by socio-economic circumstances, 1982 – 2006
  Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care
  Further dissemination

CARDIOVASCULAR HORIZON SCANNING Volume 2 Issue 11
Posted: 14 Dec 2010 06:31 AM PST
Filed under: Cardiovascular diseases, Volume 2 Issue 11

WoW (Walk once a Week)
Posted: 09 Dec 2010 08:56 AM PST
Source: Walk to School
Follow this link for fulltext
Date of publication: 2010
Publication type: Website
In a nutshell: WoW stands for Walk Once a Week and is a year-round walking promotion scheme. The DH-funded regional scheme is delivered by Living Streets in partnership with school travel advisers and participating schools. It encourages parents and pupils to walk to school at least once a week throughout the school year. Children record how they travel to school and if they walk at least four times a month, they receive collectable badges. Seven local authorities in the northwest joined the scheme in September 2010.
Length of publication: 1 webpage
Some important notes: Please contact Basildon Healthcare library if you cannot access the full text.
Acknowledgement: Living Streets
Filed under: Cardiovascular diseases, Physical activity, Prevention, Volume 2 Issue 11
Tagged: children, exercise, obesity

Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness
Posted: 09 Dec 2010 04:19 AM PST
Source: Lancet, 2010, 376 (9754) p. 1775-1784
Follow this link for the fulltext [requires registration]
Date of publication: November 2010
Publication type: Report
In a nutshell: This report assesses public health strategies designed to tackle behavioural risk factors for chronic diseases in low-income and middle-income countries. England was included for comparative purposes. Cost-effective interventions such as health information and communication strategies, fiscal and regulatory measures are discussed.
Length of publication: 8 pages
Some important notes: Please contact Basildon Healthcare library if you cannot access the full text.
Filed under: Cardiovascular diseases, Physical activity, Prevention, secondary prevention, Volume 2 Issue 11
Tagged: Exercise, health promotion, nutrition, population-based policies

The polypill in the prevention of cardiovascular diseases
Posted: 09 Dec 2010 03:41 AM PST
Source: Circulation, 2010, 122 (20) p. 2078-2088
Follow this link for the abstract
Date of publication: November 2010
Publication type: Report
In a nutshell: This report looks at the case for the polypill as primary prevention, either for individuals at high-risk or to lower risk factor levels in entire populations. It also maintains that the polypill may lead to more widespread and cost-effective secondary prevention, but states that it should be considered as part of a comprehensive global strategy to prevent cardiovascular disease.
Length of publication: 11 pages
Some important notes: You will need an NHS Athens username and password to access this article. Please contact Basildon Healthcare library if you cannot access the full text.
Filed under: Cardiovascular diseases, prescribing, Prevention, secondary prevention, Volume 2 Issue 11
Tagged: pharmacological therapies, population-based policies

National exercise proven to be cost effective in Wales
Posted: 08 Dec 2010 07:25 AM PST
Source: Chartered Society of Physiotherapy
Follow this link for fulltext
Date of publication: 16 November 2010
Publication type: News item
In a nutshell: The Welsh National Exercise Referral Scheme (NERS) was introduced in 2007, replacing local schemes. Research and evaluation by Cardiff and Bangor universities shows it to be cost-effective in helping people reduce the risk of chronic diseases such as CVD.
Length of publication: 1 web page
Some important notes: Please contact Basildon Healthcare library if you cannot access the full text.
Filed under: Cardiovascular diseases, Physical activity, Prevention, secondary prevention, Volume 2 Issue 11
Tagged: cost-effectiveness, Exercise, preventative services, rehabilitation

Association of features of primary health care with coronary heart disease mortality
Posted: 08 Dec 2010 06:30 AM PST
Source: JAMA, 10 November 2010, vol 304 no 18, pp 2028 – 2034
Follow this link for fulltext
Date of publication: November 2010
Publication type: Journal article
In a nutshell: This report aims to explain the reasons for the variations in mortality rates from CVD between different primary care trust populations in England.
Length of publication: 7 pages
Some important notes: You will need an NHS Athens username and password to access this article. Please contact your Basildon Healthcare library if you cannot access the full text.
Filed under: Cardiovascular diseases, Volume 2 Issue 11
Tagged: health inequalities, mortality rates

Trends in coronary heart disease mortality in England by socio-economic circumstances, 1982 – 2006
Posted: 07 Dec 2010 05:20 AM PST
Source: Journal of Epidemiology and Community Health, September 2010, vol 64 suppl 1, p A2
Follow this link for fulltext
Date of publication: September 2010
Publication type: Abstract
In a nutshell: This analysis shows decreasing mortality rates across England over this timespan, but with persistent large and increasing inequalities in those rates, patterned by social group.
Length of publication: 1 page
Some important notes: You will need an NHS Athens username and password to access this article. Please contact Basildon Healthcare library if you cannot access the full text.
Filed under: Cardiovascular diseases, Volume 2 Issue 11
Tagged: health inequalities, mortality rates

Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care
Posted: 07 Dec 2010 05:19 AM PST
Source: Archives of Internal Medicine, 13 September 2010, vol 170 no 16, pp 1470-1479
Follow this link for fulltext
Date of publication: September 2010
Publication type: Journal article
In a nutshell: This Swedish study of 151 patients over 3 years, demonstrated clear and cost-effective impact of group-based lifestyle interventions on quality of life (QOL) in patients at moderate to high risk of CVD. The researchers performed health economic evaluation, cost-utility analysis and cost-effectiveness using the net monetary benefit method.
Length of publication: 10 pages
Some important notes: You will need an NHS Athens username and password to access this article. Please contact Basildon Healthcare library if you cannot access the full text.
Filed under: Cardiovascular diseases, Prevention, secondary prevention, Volume 2 Issue 11
Tagged: cost-effectiveness, diet, Exercise, lifestyle advice, preventative services, Prevention, quality of life

Further dissemination
Posted: 07 Dec 2010 05:14 AM PST
Filed under: Cardiovascular diseases, Volume 2 Issue 11

PUBLIC HEALTH NEWS ON CARDIOVASCULAR DISEASE

Cardiovascular disease

Impact of smokeless tobacco products on cardiovascular disease: Implications for policy, prevention and treatment.
Circulation

Meta-analysis of the effect of comprehensive smoke-free legislation on acute coronary events. Heart and Education

Will cardiovascular disease prevention widen health inequalities?
PLoS Medicine

CARDIOVASCULAR DISEASE in CHILDREN

Cardiovascular Diseases:
Physical activity, obesity and cardiometabolic risk factors in 9- to 10-year-old UK children of white European, south Asian and black African-Caribbean origin: the child heart and health study in England (CHASE)
Objective physical activity measurements are used in this study to quantify associations of obesity and cardiometabolic risk with levels of physical activity in south Asian, black African-Caribbean and white European children.

SNIPPETS FROM JOURNAL WATCH

NEJM 15 July 2010 Vol 363
245 If anything can cause a company's profits to BLOOM, it's a new obesity drug. The BLOOM (Behavioural Modification and Lorcaserin for Overweight and Obesity Management) trial was funded by Arena Pharmaceuticals, who will be hoping for vast returns on the latest drug to target the serotonin receptor. Those with supernaturally good memories and profound knowledge of clinical pharmacology (OK, you can put your hand down, Jeff Aronson) will remember that there are actually three such receptors and that previous anti-obesity drugs such as fenfluramine and dexfenfluramine targeted them non-specifically. They worked fairly well for appetite suppression but were withdrawn because they could cause valvular heart defects and pulmonary hypertension. This is because cells around the heart valves and in the pulmonary vasculature contain 5HT2B receptors whereas the receptor you need to hit for appetite suppression is 5HT2C. Lorcaserin is powerfully specific for this receptor and Arena went out of their way to check their trial subjects regularly with echocardiograms which prove that it doesn't cause heart valve problems in the first two years. Whereas it certainly does help people lose weight and will be advertised as blooming wonderful if and when it gets it licence. http://content.nejm.org/cgi/content/abstract/363/3/245

266 In reviews of acute pulmonary embolism I look for two things: mention of it as a common cause of exacerbations in heart failure and COPD, and guidance about which patients need long-term anticoagulation. This article by two Italian authors doesn't fully satisfy either criterion. There's little mention of HF or COPD and although they say that "extended treatment requires a reassessment of the patient's risk-benefit ratio at periodic intervals" they fail to tell us how to calculate these risks and benefits.
http://content.nejm.org/cgi/content/extract/363/3/266

Lancet 17 July 2010 Vol 376
163 Droves of healthy people come to see doctors all year round to have blood pressure checks. If it's off target, their GP sees them every few weeks to make adjustments. Neither the timing, the place nor the health professional involved reflects any real logic. This ground-breaking study (TASMINH2) addresses these realities by passing management to the patient whose blood pressure is monitored at home with a reliable automatic device linked by an automated modem to the GP practice. If it remains high, the patient is given advice and if necessary additional drug treatment to reduce it. The group randomised to this intervention showed usefully better control of systolic BP at the end of a year. If this technology became widespread, we would save many GP appointments and improve control in most of our hypertensive patients.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60964-6/abstract

Lancet 10 July 2010 Vol 376
112 Exercise will also help you avoid a stroke; alcohol alas will not. Most of the other risk factors for stroke identified by the INTERSTROKE study are the ones you might expect, and the ten main ones account for nearly 90% of the risk. The oddest feature is the role of body mass index: when corrected for other factors, a high BMI actually seems protective, whereas a high waist-to-hip ratio is a substantial risk factor.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60834-3/abstract

NEJM 1 Jul 2010 Vol 363
36 Implantable cardioverter-defibrillators often go wrong due to lead failure, and they can lead to shockingly bad ends in heart failure. This trial assesses a new type of ICD which does not rely on venous access but is entirely subcutaneous, delivering shocks to the thorax close to the heart. Its success depended a lot on accurate positioning, and over the ten months of the trial it worked well and appropriately, though it's too soon of course to say anything about long-term reliability, let alone long-term mortality benefit.
http://content.nejm.org/cgi/content/abstract/363/1/36

1037 The well-conceived new Archives series called LESS IS MORE here lives up to its radical credentials: we are giving diabetic patients too many drugs for cardiovascular protection. Again, this flies in the face of what we have been taught over the last few years. It also seems to fly in the face of the calculation done by these authors that treating to targets for LDL-cholesterol and blood pressure results in gains of 1.5 and I.35 quality-adjusted years respectively. But they demonstrate that these overall gains are largely accounted for by the treatment of a small number of very high-risk individuals, and that the more drugs you put in, the more you are likely to achieve minimal benefit or actual harm. A key paper in the continuing debate about targets in type 2 diabetes.
http://archinte.ama-assn.org/cgi/content/abstract/170/12/1037

Arch Intern Med 28 Jun 2010 Vol 170
1024 If in doubt prescribe statins. Among patients with known cardiovascular disease, it is very hard to find any benefit once heart failure has set in. But prescribing statins to high-risk patients for primary prevention may be futile, according to this literature-based meta-analysis. It is a very hard paper to follow, however, with a fairly heterogeneous mix of studies which are not adequately characterised or analysed in these six pages: to do that would require twice the length, or ideally an entire database, which could then be analysed on an individual patient basis...
http://archinte.ama-assn.org/cgi/content/abstract/170/12/1024

1032 The JUPITER trial of rosuvastatin was stopped early and has been a source of controversy ever since. The acronym stands for Justification for the Use of Statins in Primary Prevention, but when JUPITER's data are fed into a meta-analysis like the one we've just seen, there is no such Justification. In fact the data of this trial are internally contradictory in a way that strongly suggests manipulation, according to this critical reappraisal, which suggests that Jove's ire should be directed at the role of commercial sponsors.
http://archinte.ama-assn.org/cgi/content/abstract/170/12/1032

1037 The well-conceived new Archives series called LESS IS MORE here lives up to its radical credentials: we are giving diabetic patients too many drugs for cardiovascular protection. Again, this flies in the face of what we have been taught over the last few years. It also seems to fly in the face of the calculation done by these authors that treating to targets for LDL-cholesterol and blood pressure results in gains of 1.5 and I.35 quality-adjusted years respectively. But they demonstrate that these overall gains are largely accounted for by the treatment of a small number of very high-risk individuals, and that the more drugs you put in, the more you are likely to achieve minimal benefit or actual harm. A key paper in the continuing debate about targets in type 2 diabetes.
http://archinte.ama-assn.org/cgi/content/abstract/170/12/1037

NICE GUIDELINES

Prevention of cardiovascular disease

http://guidance.nice.org.uk/PH25

PUBLIC HEALTH ARTICLES

Cardiovascular disease

Prevention of cardiovascular disease at population level NICE

Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey BMJ

ETHNICITY and CARDIOVASCULAR ISSUES

Cardiovascular Disease:
Out-of-hospital cardiac arrest in South Asian and white populations in London: database evaluation of characteristics and outcome
A comparison of out-of-hospital cardiac arrest (OOHCA) characteristics in white and south Asian populations in Greater London.

Emergence of ethnic differences in blood pressure in adolescence: the determinants of adolescent social well-being and health study
Blood pressure is known to track from late childhood to adulthood and this may give some indication to the cause of ethnic differences in cardiovascular disease (CVD). This study explores ethnic differences in changes to blood pressure between early and late adolescence in the UK. A related study investigating the relationship between inflammatory markers and ethnic differences in CVD conducted with infants is available here.
Ethnic differences in blood pressure begin in adolescence
A recent study published in ‘Hypertension’ has discovered that divergences in blood pressure between white and ethnic minority groups begin in adolescence and are “particularly striking” for boys. The study also found that socioeconomic disadvantage had a “disproportionate effect” on blood pressure for ethnic minority girls. The results signal the need for the early prevention of cardiovascular diseases that could have adverse effects in later life, especially for young people of minority ethnic origin.

PUBLIC HEALTH E-ARTICLES

Cardiovascular disease

The contribution of local policies to cardiovascular and other non-communicable diseases
Liverpool First for Health and Wellbeing Partnership

WEBSITES UPDATE

As well as those websites already listed here are some more...

National Heart Forum
http://www.heartforum.org.uk/
Membership organisation bringing together organisations dealing with all areas and
risk factors in the field of chronic disease prevention. Information on NHF position
statements and policy work areas is available from the site, along with publications
such as the Healthy weight, Healthy lives toolkit, and the NHF modelling team’s
reports on obesity trends.

Heartstats
http://www.heartstats.org/
The British Heart Foundation’s regularly updated statistics website. Includes a wide
range of statistics on risk factors for chronic disease such as blood cholesterol,
smoking, physical activity and diet.

Blood Pressure Association
http://www.bpassoc.org.uk/
A charity supporting patients as well as healthcare professionals managing
hypertension. The site includes guides to the effects of high blood pressure, available
medication for its treatment and monitoring.

British Hypertension Society
http://www.bhsoc.org/
The British Hypertension Society acts as a medical and research forum for
hypertension. The Society produces guidelines on management of hypertension,
which are available from their site, and also links to NICE guidance.

Heart UK
http://www.heartuk.org.uk/
Website includes resources such as a cardiovascular disease prediction chart, JBS
risk assessor, and links to NICE guidelines and various publications.

JOURNAL SNIPS

Ann Intern Med 20 Apr 2010 Vol 152
481 The evidence around population salt intake and the burden of cardiovascular disease is much debated, especially in the USA, where the UK is seen as a successful model for sodium intake reduction - nearly 10% since 2003, according to this article. It presents a cost-effectiveness analysis that concludes : "Strategies to reduce sodium intake in the United States are likely to substantially reduce stroke and MI incidence, which would save billions of dollars in medical expenses." I see, these people would save money by living longer and dying from less expensive diseases? A pinch of salt is called for, I think.
http://www.annals.org/content/152/8/481.abstract

MIGRAINE AND CVD

Migraine and cardiovascular disease: A population-based study
Link to abstract
Bibliographic details:
Neurology. 2010 Feb 23;74(8):628-35. Epub 2010 Feb 10.
Migraine and cardiovascular disease: A population-based study.
Bigal ME, Kurth T, Santanello N, Buse D, Golden W, Robbins M, Lipton RB.

OBJECTIVES: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls.
METHODS: In this case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed.
RESULTS: In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98-3.23).
CONCLUSION: Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established.

Neurology is the official journal of the American Academy of Neurology. The publication is aimed at clinical neurologists.

Access:
Full text is only available to subscribers; ask your local healthcare library if they have a local subscription. Abstracts and tables of contents are free for all to view.

Publication Date: 01 Feb 2010
Publication Type: News
Publisher: American Academy of Neurology

PUBLIC HEALTH E-ARTICLES CARDIOVASCULAR DISEASE

Cardiovascular disease

Cardiovascular health disparities: a systematic review of health care interventions
Centre for Reviews and Dissemination

Health service interventions targeting relatives of heart patients: a review of the literature
Centre for Reviews and Dissemination

Making chronic conditions count: Hypertension, stroke, coronary heart disease, diabetes. A systematic approach to estimating and forecasting population prevalence on the island of Ireland.
Institute of Public Health in Ireland (IPH)

QIPP intelligence report : cardiovascular disease prevention strategies - improving quality & productivity in the NHS through partnerships
NHS North West

Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review
Centre for Reviews and Dissemination

PUBLIC HEALTH ARTICLES

Cardiovascular disease

Modelled estimates and projections of CVD for Local Authorities in England Eastern Region Public Health Observatory (ERPHO)
Modelled estimates and projections of CVD for PCTs in England Eastern Region Public Health Observatory (ERPHO)
Modelled estimates and projections of CVD: technical document Eastern Region Public Health Observatory (ERPHO)

CARDIOVASCULAR DISEASE IN ETHNIC GROUPS

Cardiovascular Diseases:
Ethnic disparities in coronary heart disease management and pay for performance in the UK
The affect of a major pay for performance initiative in April 2004 on coronary heart disease management and intermediate clinical outcomes in a multiethnic population is examined.

CARDIOVASCULAR DISEASE PUBLIC HEALTH ARTICLES

Cardiovascular disease

Economic evaluation of the direct healthcare cost savings resulting from the use of walking interventions to prevent coronary heart disease in Australia
International journal of health care finance and economics
Evidence based cardiovascular disease screening and treatment
Department of Health
Yorkshire and Humber Cardiovascular Disease (CVD) Commissioning Health Intelligence Toolkit Yorkshire and Humber Public Health Observatory (YHPHO)