DOCSLIB.ORG

Black Country and West Birmingham STP Hypertension Pathway

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Black Country and West Birmingham STP Hypertension Pathway Black Country and West Birmingham STP Hypertension Pathway Approved for use in Walsall: October 2019 Review Date: October 2022 Scope of Document This pathway will cover screening, diagnosis, treatment and referral options for people with or suspected of having hypertension, the document links to other programmes such as the NHS Health Checks programme and to the Quality and Outcomes Framework. Please note: This document does not cover gestational hypertension, pre- eclampsia, pregnancy or breastfeeding. This guidance does not cover management of hypertension for Type 2 Diabetes (See NICE guideline CG87) or Chronic kidney disease (CKD) (See NICE guideline CG182). Individual CCGs are requested to add their own hyperlinks for local guidelines which are alluded to throughout this document which are yet to be agreed at STP level e.g. hyperlipidaemia guidelines, hypertension guidelines Acknowledgement: South West London Medicines Optimisation Group NHS Dudley CCG Hypertension guidelines NHS Dudley Lipid management guidelines Contents Overview ………………………………………………………………………………………………………………………………………………………………………………………………………………………..…………..1 Definition of Hypertension……………….…………………………………………………………………………………………………………………….……………………………………………………...…..….........2 Factors affecting blood pressure readings.……………………………………………………………….….…………………………………………………………………………………………………………......3 Measuring Blood Pressure….………………………………………………………………………………….………………………………………………………………………………………………..…….……………..4 Investigation and diagnosis of hypertension ……………………………………………….………………………………………………………………………………………………………….………………..5 Non-pharmacological management of hypertension ……………………………………………………………………………………………………………………………….……………………………………6 Complications and referral ……………………………………………………………………………….……………………………………………..……………………………..…………………………………………….7 Pharmacological Management of Hypertension ……………………………….…………………………………………………………………………………………………………………………………….......8 Algorithm – Summary of monitoring for Blood Pressure…………………………………………………………………………………………………………………………………..………………………..9 Summary of Black Country and West Birmingham STP hypertension guidelines algorithm……………………………………………………….……………………………………………………10 References…………………………………….……………………………………………………………………………………………………………………………………………………………………………….……………11 Overview - Black Country and West Birmingham STP Footprint As a sustainability and transformation partnership (STP), data from the NHS England footprint indicates that of the Black Country and West Birmingham STP including Dudley, Sandwell and West Birmingham, Wolverhampton and Walsall, all four CCGs are statistically higher than the national average according to data from 2015/2016 in hypertension prevalence.1 With reference to percentage of patients with hypertension whose BP < 150/90, Dudley, Sandwell and West Birmingham and Wolverhampton have areas for improvement identified from data provided by NHS England 2015/16 STP footprint. Using a population segmentation approach and collaborative working across the Dudley Health Economy over the last decade has seen the Standardised Mortality Rate from hypertension related diseases move from twice the England average to be in line with the England average. Continued work to reduce the hypertension prevalence gap is required. It is anticipated that for every additional 1,000 patients’ Blood Pressure (BP) controlled, there are £469k of savings for the NHS over 5 years, or £469 per patient. This would mean a total potential cost saving of £13m over 5 years for the 27,800 patients missing from hypertension registers in Dudley. In addition to this we know that by reducing BP from 150/90mmHg to 140/90mmHg, the risk of CHD is reduced by 22% and the risk of stroke is reduced by 41%.2 NHS Health Check: Dudley Pathway Vascular Risk Assessment and Management supports the information contained within this document. http://www.dudleyformulary.nhs.uk/download/449/nhs-health-check-pathway 3 Reference: https://www.england.nhs.uk/rightcare/products/stp-footprints/ 1 Definition of Hypertension Definition of Hypertension “When blood pressure remains higher than normal over time (at least several months) it is called variously, high blood pressure, raised blood pressure or hypertension. Hypertension occurs when the heart has to use more energy to pump against the greater resistance of the vascular system” Hypertension in adults: diagnosis and management (2011 updated 2016) NICE guideline CG1274 Blood Pressure = Cardiac Output x Peripheral Resistance Hypertension screening is included in the NHS Health Checks Programme, which seeks to invite people without a vascular condition or hypertension for a health check. If blood pressure is found to be raised at the time of the check, this is highlighted to GP practices who then follow-up these patients following the hypertension diagnostic pathway. NHS Health Check: Clinical Pathway for the Management of Cardiovascular Risk 5 Signs and Symptoms Investigations Hypertension is usually Other symptoms may indicate asymptomatic, but there are • CVD Risk assessment • Lifestyle blood pressure has risen to a some indicators which should • Full lipid Profile • Eye dangerously high level. prompt a blood pressure check. • Manual Pulse • Thyroid function These include: These include: • ECG • Phaeochromocytoma • Chest pain • Headaches • Renal • Hyperaldosteronism • Sweating • Dizziness • eGFR • Cushing’s syndrome • Shortness of breath • Blurred vision • Proteinuria • Obstructive sleep apnoea • Wheeze • Epistaxis • Haematuria • Coarctation of the aorta • Transient vision loss • Tinnitus • HbA1c • Acromegaly • Loss of consciousness • Palpitations • Fasting glucose • Fits • Nocturia Other Determinants Hypertension is more common in BME groups. African-Caribbean groups have a higher risk of hypertension and subsequent stroke or renal failure, but not higher levels of coronary heart disease, whilst South Asians also have a higher risk of hypertension, but tend to have higher levels of coronary heart disease and Type 2 diabetes. Ethnic differences in hypertension and blood pressure control in the UK 6 Black people (as they are referred to in NICE guidance),4 i.e. those people of African or African-Caribbean origin have a much higher prevalence of hypertension. For this reason, many studies have been conducted looking at their response to anti-hypertensive medication. Differences were found in response to drug treatment for black people, indicating treatment with specific anti- hypertensive drugs and combinations. People in lower socioeconomic groups also have a higher risk of hypertension and an increased risk of cardiovascular mortality compared to more affluent groups. Risks of socioeconomic deprivation on mortality in hypertensive patients 7 Factors affecting Blood Pressure Readings High Risk Groups Certain lifestyle behaviours will increase the risk of developing Some co-morbid conditions are more commonly associated hypertension. These include: with hypertension, these are: • Smoking Cardiovascular • Alcohol consumption (where this is over recommended limits) • Obesity • Atrial Fibrillation • Physical inactivity • Coronary heart disease • High salt intake • Hyperlipidaemia • Stroke and TIA Renal Certain drugs may also affect blood pressure control. These include: • Chronic kidney disease • Renal artery stenosis • Combined oral contraceptives • Phaeochromocytoma • Immunosuppressant therapy • NSAIDS • COX-2 inhibitors e.g. Etoricoxib Endocrine • Stimulants (including caffeine products such as coffee, cola) • Mineralocorticoids • Diabetes • Glucocorticoids • • Anti-parkinsonian drugs Hyperaldosteronism • Monoamine oxidase inhibitors • Cushing’s syndrome • Anabolic steroids • Hyperthyroidism • Sympathomimetics • Acromegaly • Illicit drugs use Soluble analgesia and some indigestion remedies have a high salt content and Pulmonary should also be avoided where possible. For further information see the Dudley guideline, Salt Content of Soluble Analgesics and Indigestions Remedies • Chronic obstructive pulmonary disease • Obstructive sleep apnoea Measuring Blood Pressure Devices Mercury Sphygmomanometers continue to provide the reference standard for measurement of blood pressure although, due to their bulk and the fact that they contain mercury their use is currently being phased out. If using a mercury device, then a mercury spillage kit should be available at all times and it should not be taken out of the building. Mercury devices are not available to buy. Hybrid devices are available which resemble the mercury sphygmomanometer but use an LED display in place of a mercury column. They are used in the same way as the mercury devices by auscultation of the brachial artery. Aneroid Sphygmomanometers measure pressure using a bellows system. They can be less accurate than alternatives, especially over time. For this reason it is recommended that they are calibrated every 6 months. Automated devices are recommended for ease of use in clinic and by patients for HBPM. However, as the devices work on oscillometry which needs to be in a regular flow, any irregular pulse will cause an error message on the machine. If error messages are observed, then a manual pulse should be taken to rule out an irregular pulse before attempting to measure blood pressure with the automated device again or with another device. Postural Hypotension If hypertension is not diagnosed, BP should be checked every 5 years . Where BP is borderline, follow-up should be arranged more frequently. Where postural hypotension is suspected, i.e. in those with dizziness on standing,
Load more

Recommended publications
  • Cost-Effectiveness Analysis: Treatment Initiation Threshold for People with Stage 1 Hypertension
    National Institute for Health and Care Excellence FINAL Hypertension in adults: diagnosis and management Cost-effectiveness analysis: Treatment initiation threshold for people with stage 1 hypertension NICE guideline NG136 Economic analysis report August 2019 Final This guideline was developed by the National Guideline Centre Hypertension in adults: FINAL Contents Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and, where appropriate, their carer or guardian. Local commissioners and providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties. NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive.
    [Show full text]
  • Derivation and Validation of QRISK, a New Cardiovascular Disease Risk Score for the United Kingdom: Prospective Open Cohort Study
    RESEARCH BMJ: first published as 10.1136/bmj.39261.471806.55 on 5 July 2007. Downloaded from 8 Bergenstal RM, Gavin III JR. The role of self-monitoring of blood practices and recommendations from the NIH Behavior Change glucose in the care of people with diabetes: report of a global Consortium. Health Psychol 2004;23:443-51. consensus conference. Am J Med 2005;118(9, suppl 1):1-6. 14 Davidson MB, Castellanos M, Kain D, Duran P. The effect of self 9 Gerich JE. Clinicians can help their patients control postprandial monitoring of blood glucose concentrations on glycated hemoglobin hyperglycemia as a means of reducing cardiovascular risk. Diabetes levels in diabetic patients not taking insulin: a blinded, randomized Educator 2006;32:513-22. trial. Am J Med 2005;118:422-5. 10 Farmer A, Wade A, French DP, Goyder E, Kinmonth AL, Neil A. The DiGEM trial protocol—a randomised controlled trial to determine the 15 Guerci B, Drouin P, Grange V, Bougneres P, Fontaine P, Kerlan V, et al. effect on glycaemic control of different strategies of blood glucose Self-monitoring of blood glucose significantly improves metabolic self-monitoring in people with type 2 diabetes [ISRCTN47464659]. control in patients with type 2 diabetes mellitus: the auto- BMC Fam Pract 2005;6:25. surveillance intervention active (ASIA) study. Diabetes Metab 11 Owens DR, Barnett AH, Pickup J, Kerr D, Bushby P, Hicks D, et al. 2003;29:587-94. Blood glucose self-monitoring in type 1 and type 2 diabetes: 16 Schwedes U, Siebolds M, Mertes G. Meal-related structured self- reaching a multi-disciplinary consensus.
    [Show full text]
  • Factors Predicting Statin Prescribing for Primary Prevention: an Historical Cohort Study
    Accepted Manuscript British Journal of General Practice Factors predicting statin prescribing for primary prevention: an historical cohort study Finnikin Samuel; Willis Brian; Ryan Ronan; Evans Tim; Marshall Tom DOI: https://doi.org/10.3399/bjgp20X714065 To access the most recent version of this article, please click the DOI URL in the line above. Received 08 May 2020 Revised 13 August 2020 Accepted 17 August 2020 © 2020 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/). Published by British Journal of General Practice. For editorial process and policies, see: https: https://bjgp.org/authors/bjgp-editorial-process-and-policies When citing this article please include the DOI provided above. Author Accepted Manuscript This is an ‘author accepted manuscript’: a manuscript that has been accepted for publication in British Journal of General Practice, but which has not yet undergone subediting, typesetting, or correction. Errors discovered and corrected during this process may materially alter the content of this manuscript, and the latest published version (the Version of Record) should be used in preference to any preceding versions Factors predicting statin prescribing for primary prevention: an historical cohort study Samuel Finnikin1 MSc, MRCGP, Brian H Willis1 MSc, PhD, MRCP, MRCGP, Ronan Ryan2 MA, MSc, PhD, Tim Evans3 PhD, Tom Marshall1 MSc, PhD, MRCGP, FFPH 1. Institute of Applied Health Research, University of Birmingham, England 2. Devon, UK 3. Public Health England, London, England Corresponding Author Dr Samuel Finnikin bjgp20X714065 – Address: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, England, B15 2TT Telephone: 0121 414 3344 Email: [email protected] BJGP Twitter: @sfinnikin – Manuscript Accepted Abstract Background Initiation of statins for the primary prevention of cardiovascular disease (CVD) should be based on CVD risk estimates but their use is sub-optimal.
    [Show full text]
  • R Package “QRISK3”: an Unofficial Research Purposed Implementation of Clinrisk’S QRISK3 Algorithm Into R [Version 1; Peer Review: 1 Not Approved]
    F1000Research 2019, 8:2139 Last updated: 26 JUL 2021 SOFTWARE TOOL ARTICLE R package “QRISK3”: an unofficial research purposed implementation of ClinRisk’s QRISK3 algorithm into R [version 1; peer review: 1 not approved] Yan Li 1, Matthew Sperrin1, Tjeerd van Staa1-3 1Health e-Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK 2Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands 3Alan Turing Institute, British Library, London, UK v1 First published: 23 Dec 2019, 8:2139 Open Peer Review https://doi.org/10.12688/f1000research.21679.1 Second version: 28 Feb 2020, 8:2139 https://doi.org/10.12688/f1000research.21679.2 Reviewer Status Latest published: 22 May 2020, 8:2139 https://doi.org/10.12688/f1000research.21679.3 Invited Reviewers 1 2 3 Abstract Cardiovascular disease has been the leading cause of death for version 3 decades. Risk prediction models are used to identify high risk patients; (revision) report report the most common model used in the UK is ClinRisk’s QRISK3. In this 22 May 2020 paper we describe the implementation of the QRISK3 algorithm into an R package. The package was successfully validated by the open version 2 sourced QRISK3 algorithm and QRISK3 SAS program. We provide (revision) report report detailed examples of the use of the package, including assigning 28 Feb 2020 QRISK3 scores for a large cohort of patients. This R package could help the research community to better understand risk prediction version 1 scores and improve future risk prediction models. The package is 23 Dec 2019 report available from CRAN: https://cran.r- project.org/web/packages/QRISK3/index.html.
    [Show full text]
  • Baseline Cardiovascular Risk Assessment in Cancer Patients
    European Journal of Heart Failure (2020) POSITION PAPER doi:10.1002/ejhf.1920 Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society Alexander R. Lyon1*, Susan Dent2, Susannah Stanway3, Helena Earl4, Christine Brezden-Masley5, Alain Cohen-Solal6, Carlo G. Tocchetti7, JavidJ.Moslehi8,JohnD.Groarke9, Jutta Bergler-Klein10, Vincent Khoo11,12, Li Ling Tan13,MarkusS.Anker14, Stephan von Haehling15,16, Christoph Maack17, Radek Pudil18, Ana Barac19, Paaladinesh Thavendiranathan20, Bonnie Ky21, Tomas G. Neilan22,YuryBelenkov23, Stuart D. Rosen1, Zaza Iakobishvili24, AaronL.Sverdlov25, Ludhmila A. Hajjar26,ArianeV.S.Macedo27, Charlotte Manisty28, Fortunato Ciardiello29, Dimitrios Farmakis30,31, Rudolf A. de Boer32,HadiSkouri33,ThomasM.Suter34, Daniela Cardinale35, Ronald M. Witteles36, Michael G. Fradley21, Joerg Herrmann37,RobertF.Cornell38, Ashutosh Wechelaker39, Michael J. Mauro40, Dragana Milojkovic41, Hugues de Lavallade42, Frank Ruschitzka43, Andrew J.S. Coats44,45, Petar M. Seferovic46, Ovidiu Chioncel47,48, Thomas Thum49, Johann Bauersachs50, M. Sol Andres1, David J. Wright51, Teresa López-Fernández52, Chris Plummer53, and Daniel Lenihan54 1Cardio-Oncology Service, Royal Brompton Hospital and Imperial College, London, UK; 2Duke Cancer Institute, Duke University,
    [Show full text]
  • An Independent and External Validation of QRISK2 Cardiovascular Disease Risk Score: a Prospective Open Cohort Study
    RESEARCH BMJ: first published as 10.1136/bmj.c2442 on 13 May 2010. Downloaded from An independent and external validation of QRISK2 cardiovascular disease risk score: a prospective open cohort study Gary S Collins, senior medical statistician,1 Douglas G Altman, director, professor of statistics in medicine1 Centre for Statistics in Medicine, ABSTRACT sheet No 317). In the United Kingdom, there are Wolfson College Annexe, Objective To evaluate the performance of the QRISK2 almost 200 000 deaths each year relating to diseases University of Oxford, Oxford OX2 6UD score for predicting 10-year cardiovascular disease in an of the heart and circulatory system, with more than Correspondence to: G Collins independent UK cohort of patients from general practice one in three deaths associated with cardiovascular dis- [email protected] records and to compare it with the NICE version of the ease (www.heartstats.org). General practitioners need Framingham equation and QRISK1. Cite this as: BMJ 2010;340:c2442 an accurate and reliable tool to help them identify doi:10.1136/bmj.c2442 Design Prospective cohort study to validate a patients at high risk of having a cardiovascular event. cardiovascular risk score. Numerous multivariable risk scores have been devel- Setting 365 practices from United Kingdom contributing oped to estimate a patient’s 10 year risk of cardio- to The Health Improvement Network (THIN) database. vascular disease based on certain key known risk Participants 1.58 million patients registered with a factors,12 including the Framingham risk score3 and general practice between 1 January 1993 and 20 June the Reynolds risk score,4 both developed using patient 2008, aged 35-74 years (9.4 million person years) with data from US, the SCORE system using patients from http://www.bmj.com/ 71 465 cardiovascular events.
    [Show full text]
  • Should Your Family History of Coronary Heart Disease Scare You?
    MOUNT SINAI JOURNAL OF MEDICINE 79:721–732, 2012 721 Should Your Family History of Coronary Heart Disease Scare You? Dorairaj Prabhakaran, MD, DM, FRCP1,2 and Panniyammakal Jeemon, MPH, PhD Fellow1,3,4 1Centre for Chronic Disease Control, New Delhi, India 2Centre of Excellence in Cardio-metabolic Risk Reduction in South Asia, New Delhi, India 3Public Health Foundation of India, New Delhi, India 4Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK OUTLINE Family History in Primary Prevention of Coronary Heart Disease FAMILY HISTORY AS RISK FACTOR FOR FUTURE RESEARCH RECOMMENDATIONS CORONARY HEART DISEASE CONCLUSION FAMILY HISTORY AND SUBCLINICAL ATHEROSCLEROSIS OTHER ISSUES RELEVANT TO FAMILY HISTORY AND ABSTRACT ITS ASSOCIATION WITH Traditional risk factors explain most of the risk CORONARY HEART DISEASE Family History and associated with coronary heart disease, and after Risk of Coronary Heart Disease: adjustment for risk factors family history was believed Role of Age of Onset of Disease to contribute very little to population-attributable Are There Differences in risk of coronary heart disease. However, the Risk Associated with Paternal and INTERHEART study demonstrated an independent Maternal History of association of family history of coronary heart Coronary Heart Disease? disease with acute myocardial infarction. To assess this relationship more comprehensively in multiple Family History and Risk of datasets in different populations, we carried out Coronary Heart Disease: Are There a detailed review
    [Show full text]
  • Residual Cardiovascular Risk in Treated Hypertension and Hyperlipidaemia: the PRIME Study
    Journal of Human Hypertension (2010) 24, 19–26 & 2010 Macmillan Publishers Limited All rights reserved 0950-9240/10 $32.00 www.nature.com/jhh ORIGINAL ARTICLE Residual cardiovascular risk in treated hypertension and hyperlipidaemia: the PRIME Study J Blacher1,2, A Evans3, D Arveiler4, P Amouyel5, J Ferrie`res6, A Bingham1, J Yarnell3, B Haas4, M Montaye5, J-B Ruidavets6 and P Ducimetie`re1, on behalf of the PRIME Study Group 1INSERM, Hoˆpital Paul Brousse, Villejuif, France; 2Hoˆtel-Dieu, APHP, Universite´ Paris Descartes, Paris, France; 3Belfast-MONICA, Department of Epidemiology and Public Health, Queen’s University Belfast, Belfast, UK; 4MONICA-Strasbourg, Laboratoire d’Epide´miologie et de Sante´ Publique, Faculte´ de Me´decine, Universite´ Louis Pasteur, Strasbourg, France; 5INSERM, U 744, Institut Pasteur, MONICA-Lille, Lille, France and 6MONICA-Toulouse, INSERM, Faculte´ de Me´decine Purpan, Toulouse, France Although pharmacological treatments of hypertension lowering drug use, after adjusting for classic risk factors and dyslipidaemia are both associated with a reduction (age, smoking, total cholesterol, high-density lipopro- in cardiovascular risk, little is known about the degree of tein cholesterol, systolic blood pressure and diabetes). cardiovascular risk remaining in treated individuals, by Similar results were obtained for coronary heart disease assessing the levels of their risk factors achieved, that is (RR ¼ 1.46, 95% CI: 1.18–1.80), stroke (RR ¼ 1.75, 95% their ‘residual cardiovascular risk’. We then used the CI: 1.14–2.70) and cardiovascular death (RR ¼ 1.62, 95% data from the Prospective Epidemiological Study of CI: 1.02–2.58), but neither for total death (RR ¼ 1.15, 95% Myocardial Infarction (PRIME), which involved 9649 CI: 0.89–1.48) nor for non-cardiovascular death men aged 50–59 years, from France and Northern (RR ¼ 1.00, 95% CI: 0.74–1.36).
    [Show full text]
  • Comparisson of Different Cardiovascular Risk Scores In
    Original Article / Özgün Araştırma DOI: 10.4274/haseki.galenos.2021.6788 Med Bull Haseki 2021;59:74-79 Comparisson of Different Cardiovascular Risk Scores in Newly Diagnosed Hyperlipidemia Patients and Their Relations with Metabolic Syndrome Yeni Tanı Almış Hiperlipidemili Hastalarda Farklı Kardiyovasküler Risk Skorlamalarının Karşılaştırılması ve Bunlarin Metabolik Sendromla İlişkileri Ayşegül İlhan, Sema Uçak*, Nazan Demir**, Okcan Basat***, Yüksel Altuntaş**** University of Health Sciences Turkey, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Clinic of Medical Oncology, Ankara, Turkey * University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Internal Medicine, Istanbul, Turkey **Eskişehir Osmangazi University Faculty of Medicine, Department of Medical Oncology, Eskisehir, Turkey *** University of Health Sciences Turkey, Training and Research Hospital, Clinic of Internal Medicine, Istanbul, Turkey ****University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Endocrinology, Istanbul, Turkey Abs tract Öz Aim: Today, there are many risk calculation methods. In this Amaç: Günümüzde çok sayıda kardiyovasküler risk hesaplama study, we aimed to compare SCORE, QRISK2, BNF, ASSIGN sistemi bulunmaktadır. Biz bu çalışmada ilk kez hiperlipidemi and Framingham risk scorings for patients who have been first saptanan hastalarda SCORE, QRISK2, BNF, ASSIGN, Framingham detected that they have hyperlipidemia and to evaluate the risk skorlamalarını karşılaştırmayı ve aynı grup hastalarda metabolik relation between metabolic syndrome criteria and cardiovascular sendrom kriterlerinin varlığı ile kardiyovasküler risk skorlamaları risk scorings for the same group patients. arasındaki ilişkiyi değerlendirmeyi amaçladık. Methods: We included 216 female, 84 male newly diagnosed Yöntemler: Yeni hiperlipidemi tanısı almış 216 kadın, 84 erkek hastayı hyperlipidemic patients. Lipid levels measured using enzymatic çalışmaya dahil ettik.
    [Show full text]
  • Association Between Lipid Indices and 10-Year Cardiovascular Risk of a Cohort of Black Africans Living with Type 2 Diabetes Mellitus
    JournalOriginal of Advances Article in Internal Medicine | Original Article Association between lipid indices and 10-year cardiovascular risk of a cohort of black Africans living with type 2 diabetes mellitus Taoreed Adegoke Azeez Endocrinology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria Abstract Introduction Diabetes mellitus is an established cardiovascular risk factor. Keywords: Lipid indices, 10-year cardiovascular risk, diabetes, Diabetes mellitus impairs lipid metabolism and enhances lipids, Black Africans atherosclerosis development. Absolute lipid parameter are inadequate in predicting cardiovascular risk and some lipid indices have been reported to circumvent this deficiency. The objective of the study was to determine the association between these lipid indices and 10-year cardiovascular risk among black Africans with diabetes. Methods Seventy individuals (35 males and 35 females) living with diabetes who attended the diabetes clinic of a referral hospital in South-western Nigeria were recruited to the study. Ethical approval and participants’ informed consent were duly obtained. Fasting plasma glucose, fasting lipid profile and glycated haemoglobin were done using appropriate This work is licensed under a Creative Commons Attribution laboratory techniques. Atherogenic index of plasma, 4.0 Unported License. atherogenic coefficient, Castelli’s risk index I, Castelli’s risk index II and CHOLindex were calculated using appropriate formulae. QRISK 3 score was obtained using a validated calculator. The association between QRISK 3 and the lipid indices was determined using Pearson’s correlation. Results The mean age of the participants was 53.34 ± 9.57 years. The mean duration of diabetes mellitus among the participants was 6.29 ± 2.78 years. The mean HbA1c and FPG were 6.98±0.72% and 6.32±0.87 mmol/L respectively.
    [Show full text]
  • Major Adverse Cardiovascular Events Following Simultaneous Pancreas
    Diabetes Care Volume 42, April 2019 665 Petros Yiannoullou,1,2 Angela Summers,1,2 Major Adverse Cardiovascular Shu C. Goh,2 Catherine Fullwood,3 Hussein Khambalia,1,2 Zia Moinuddin,1,2 Events Following Simultaneous Iestyn M. Shapey,1,2 Josephine Naish,4,5 Christopher Miller,4,5,6 Titus Augustine,1,2 Pancreas and Kidney Martin K. Rutter,2,7 and David van Dellen1,2 Transplantation in the United Kingdom Diabetes Care 2019;42:665–673 | https://doi.org/10.2337/dc18-2111 1Department of Renal and Pancreatic Transplan- tation, Manchester University NHS Foundation Trust, Manchester, U.K. 2Division of Diabetes, Endocrinology and Gas- troenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, U.K. 3Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Bi- OBJECTIVE ology, Medicine and Health, University of Man- chester, Manchester Academic Health Science People with type 1 diabetes and kidney failure have an increased risk for major Centre, Research and Innovation, Manchester adverse cardiovascular events (MACE). Simultaneous pancreas and kidney trans- University NHS Foundation Trust, Manchester, plantation (SPKT) improves survival, but the long-term risk for MACE is uncertain. U.K. 4Division of Cardiovascular Sciences, School of RESEARCH DESIGN AND METHODS Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sci- We assessed the frequency and risk factors for MACE (defined as fatal cardiovascular ence Centre, University of Manchester, Man- disease and nonfatal myocardial infarction or stroke) and related nonfatal MACE to chester, U.K. 5 allograft failure in SPKT recipients with type 1 diabetes who underwent trans- Wellcome Centre for Cell-Matrix Research, Di- vision of Cell-Matrix Biology and Regenerative plantation between 2001 and 2015 in the U.K.
    [Show full text]
  • Lipid Modification Cardiovascular Risk Assessment and the Modification of Blood Lipids for the Primary and Secondary Prevention of Cardiovascular Disease
    National Clinical Guideline Centre 1 Draft for Consultation Lipid modification Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease Clinical guideline Methods, evidence and recommendations February 2014 Draft for Consultation Commissioned by the National Institute for Health and Care Excellence Draft for consultation Contents 1 Disclaimer Healthcare professionals are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer. Copyright National Clinical Guideline Centre, 2014 Funding National Institute for Health and Care Excellence National Clinical Guideline Centre, 2014 Draft for consultation Contents Contents National Clinical Guideline Centre ................................................................................................ 1 Guideline update ........................................................................................................................ 10 Guideline Development Group .................................................................................................... 11 Guideline Development Group members [2014] .......................................................................... 11 Technical team members [2014] ..................................................................................................
    [Show full text]