Biomedical subjects
Publications and source records attributed to Julie Foxton.
The recognition that coronary heart disease, stroke and peripheral vascular disease have a common origin in atherothrombosis is helping at-risk patients to be identified and helped. This paper looks at primary and secondary prevention strategies and describes an initiative to document the health status and treatment of all those at risk.
Coronary heart disease (CHD) is the major cause of death worldwide (Murray and Lopez, 1997) and confers a significant socio-economic burden on all populations. The careful identification and optimal treatment of all individuals at risk of CHD is necessary for significant reductions in morbidity and mortality to be realized. This strategy demands an integrated approach by healthcare teams, with nurses playing a significant role at all stages of patient care. Guidelines advocate lipid lowering as a central component of all treatment regimens. Identification by nurses of all individuals who would benefit from lifestyle and therapeutic interventions to normalize lipid profiles, as well as the recognition of the impact of increasing prevalances of diabetes and obesity on the risk of developing CHD, are clearly critical. Nurses also have an important role to play in the implementation of drug regiments and lifestyle changes, including appropriate ways to minimize the treatment gap and maximize patient concordance.
Obesity has been calculated traditionally by body mass index, but measuring waist circumference might be a more accurate way of identifying people at risk of cardiovascular disease. Excess visceral fat predisposes to several diseases, including diabetes and cardiovascular disease. The total cost to the NHS of obesity in 2001 was pounds sterling 2.5 billion. Waist circumference correlates well with visceral fat content.
Coronary heart disease is the leading cause of mortality and morbidity in the UK. Nurses have a pivotal role in the management of high-risk patients and the modification of risk factors.