CARDIOVASCULAR HORIZON SCANNING Volume 3 Issue 1
Is estimating lifetime cardiovascular risk useful?
Cost-effectiveness of interventions to reduce dietary salt intake
Valvular heart disease: the next cardiac epidemic
Further dissemination
CARDIOVASCULAR HORIZON SCANNING Volume 3 Issue 1
Posted: 14 Jan 2011 08:20 AM PST
Filed under: Cardiovascular diseases, Volume 3 Issue 1
Is estimating lifetime cardiovascular risk useful?
Posted: 12 Jan 2011 05:40 AM PST
Source: BMJ, 2010, 342 (7788) p. 62-63
Follow this link for the abstract
Date of publication: January 2011
Publication type: Editorial
In a nutshell: The QRISK lifetime cardiovascular risk model originates from the QResearch database, which has generated the world’s largest cardiovascular risk prediction cohort study, involvingmore than three million people between the ages of 30 and 84. The new QRISK lifetime risk calculator, which is similar to the heart age forecast tool, incorporates both short and longer term risk in one simple display and has important advantages over separate 10 year and lifetime cardiovascular risk calculators.
Length of publication: 2 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, Volume 3 Issue 1 Tagged: risk prediction tools
Cost-effectiveness of interventions to reduce dietary salt intake
Posted: 12 Jan 2011 03:19 AM PST
Source: Heart, 2010, 96 (23) p. 1920-1925
Follow this link for the abstract
Date of publication: December 2010
Publication type: Press release
In a nutshell: This study found that dietary advice targeting individuals is not cost-effective under any of the modelled scenarios, even if directed at those with highest blood pressure risk. Although the current programme that relies on voluntary action by the food industry is cost-effective, the population health benefits could be 20 times greater with government legislation on moderate salt limits in processed foods.
Length of publication: 6 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, Volume 3 Issue 1 Tagged: nutritional advice
Valvular heart disease: the next cardiac epidemic
Posted: 11 Jan 2011 09:05 AM PST
Source: Heart, 2011, 97 (2) p. 91-93
Follow this link for the abstract
Date of publication: January 2011
Publication type: Press release
In a nutshell: With an ageing population, a rise in the number of patients with more advanced valvular heart disease, requiring valve replacement, is anticipated.
Length of publication: 3 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.
Showing posts with label salt. Show all posts
Showing posts with label salt. Show all posts
Monday, 17 January 2011
Friday, 3 September 2010
CARDIOVASCULAR DISEASE
Cardiovascular disease
Population strategies to decrease sodium intake and the burden of cardiovascular disease: a cost-effectiveness analysis
NHS Economic Evaluation Database
Population strategies to decrease sodium intake and the burden of cardiovascular disease: a cost-effectiveness analysis
NHS Economic Evaluation Database
Wednesday, 28 April 2010
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
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
Wednesday, 10 February 2010
SNIPPETS FROM JOURNAL WATCH
JAMA 3 Feb 2010 Vol 303
If the Good Death Cookbook ever gets compiled from the recipes from Journal Watch, the evidence linking dietary sodium with cardiovascular disease outcomes needs to be confronted. All of it is observational; and according to this article, the studies are in equipoise. That's right: there are some studies showing cardiovascular harm from lowered salt intake; most are neutral; some show benefit. But there has never been a prospective randomised trial.
http://jama.ama-assn.org/cgi/content/extract/303/5/448
BMJ 6 Feb 2010 Vol 340
It's a convenient belief, supported by some systematic reviews of randomised trials, that all blood pressure lowering regimens are equally beneficial in proportion to the degree to which they succeed in reducing BP. This population based case-control study seeks to dispute that, and in particular to blacken the name of calcium-channel blockers compared to ACE inhibitors and ARBs. Again, you won't learn much from the one-page version. In the full on-line article, you can see the confidence intervals in all their unconvincing glory. There may be some differences, but we need better evidence than this.
http://www.bmj.com/cgi/content/full/340/jan25_2/c103
One of the reasons of the Easily Missed series was to find out what I had been missing these last thirty-five years. Long QT syndrome is a definite case in point. If you have a young patient who has fainted during exertion or on being woken by a loud noise, get an ECG at once and make sure it is looked at carefully: the next episode may be sudden death.
http://www.bmj.com/cgi/content/extract/340/jan08_1/b4815
Ann Intern Med 2 Feb 2010 Vol 152
Just as you wouldn't give up and blame the patient if their blood pressure remained at 186/112 despite a short course of treatment, so you mustn't give up treating nicotine addiction until people no longer run the awful cardiovascular and pulmonary risks of smoking. Give them nicotine replacement therapy for as long as it takes, and bin any guidelines which instruct you to do otherwise on grounds of cost. This study unsurprisingly found that a nicotine patches are more effective prescribed for 24 weeks than for 8. Many smokers won't need this length of treatment, others will need more.
http://www.annals.org/content/152/3/144.abstract
Non-invasive coronary angiography sounds like a great idea, but there are problems. Magnetic resonance imaging would be ideal if it worked, because it doesn't involve ionizing radiation. But this head on comparison with computed X-ray tomography shows that it is not nearly as accurate, according to the published studies. This may change as techniques develop, of course. The problem with CT is that it uses big doses of radiation and needs iodine-base contrast material; and so does the gold standard of coronary angiography, which the patient will then have to undergo if the CT shows a lesion requiring intervention. The real-life radiation dosage studies are worrying, though every article predicts that doses will fall in the future.
http://www.annals.org/content/152/3/167.abstract
If the Good Death Cookbook ever gets compiled from the recipes from Journal Watch, the evidence linking dietary sodium with cardiovascular disease outcomes needs to be confronted. All of it is observational; and according to this article, the studies are in equipoise. That's right: there are some studies showing cardiovascular harm from lowered salt intake; most are neutral; some show benefit. But there has never been a prospective randomised trial.
http://jama.ama-assn.org/cgi/content/extract/303/5/448
BMJ 6 Feb 2010 Vol 340
It's a convenient belief, supported by some systematic reviews of randomised trials, that all blood pressure lowering regimens are equally beneficial in proportion to the degree to which they succeed in reducing BP. This population based case-control study seeks to dispute that, and in particular to blacken the name of calcium-channel blockers compared to ACE inhibitors and ARBs. Again, you won't learn much from the one-page version. In the full on-line article, you can see the confidence intervals in all their unconvincing glory. There may be some differences, but we need better evidence than this.
http://www.bmj.com/cgi/content/full/340/jan25_2/c103
One of the reasons of the Easily Missed series was to find out what I had been missing these last thirty-five years. Long QT syndrome is a definite case in point. If you have a young patient who has fainted during exertion or on being woken by a loud noise, get an ECG at once and make sure it is looked at carefully: the next episode may be sudden death.
http://www.bmj.com/cgi/content/extract/340/jan08_1/b4815
Ann Intern Med 2 Feb 2010 Vol 152
Just as you wouldn't give up and blame the patient if their blood pressure remained at 186/112 despite a short course of treatment, so you mustn't give up treating nicotine addiction until people no longer run the awful cardiovascular and pulmonary risks of smoking. Give them nicotine replacement therapy for as long as it takes, and bin any guidelines which instruct you to do otherwise on grounds of cost. This study unsurprisingly found that a nicotine patches are more effective prescribed for 24 weeks than for 8. Many smokers won't need this length of treatment, others will need more.
http://www.annals.org/content/152/3/144.abstract
Non-invasive coronary angiography sounds like a great idea, but there are problems. Magnetic resonance imaging would be ideal if it worked, because it doesn't involve ionizing radiation. But this head on comparison with computed X-ray tomography shows that it is not nearly as accurate, according to the published studies. This may change as techniques develop, of course. The problem with CT is that it uses big doses of radiation and needs iodine-base contrast material; and so does the gold standard of coronary angiography, which the patient will then have to undergo if the CT shows a lesion requiring intervention. The real-life radiation dosage studies are worrying, though every article predicts that doses will fall in the future.
http://www.annals.org/content/152/3/167.abstract
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