CHD
strategy
NICE guidance on MI:
secondary prevention
- Secondary Prevention - Incorporating the National Service Framework (NSF) guidelines for Coronary Heart Disease
- Breakdown of patients 2001
- Blood test procedures
- Defining hypertension
- Stroke Management (Northumberland guidelines)
Northumberland Heart Health programme
- Atrial fibrillation
- Cardiac rehabilitation
- Desk top guides (doc files)
- Heart attacks
- Heart failure
- Heart Health
- Prevention of CHD in primary care
- Revascularisation
- Stable angina
- Taking a history from patients with chest pain
- Telephone triage of patients with chest pain
Secondary Prevention - Incorporating the National Service Framework (NSF) guidelines for Coronary Heart Disease.
Standard three of the NSF guidelines states:
- GPs and primary care teams should identify all people with established cardiovascular disease and offer them comprehensive advice and appropriate treatment to reduce their risks.
- This includes all patients with Coronary Heart Disease; Angina Pectoris; Myocardial Infarction; heart failure; atrial fibrillation; stroke; atherosclerosis/PVD.
Patients should be seen on at least an annual basis and more frequently if any associated risk factors are not meticulously controlled.
Aims
- To improve the quality of life of patients with CHD.
- To reduce the incidence of heart attacks/strokes.
- To assess patients' health beliefs and enable them to make an informed
choice of healthy lifestyle options.
- smoking
- diet
- weight
- exercise
- alcohol
- To reduce associated risk factors
- Hypertension (Maintain BP below 150/90, but aim for ideal target of 145/85).
- Hyperlipidaemia (Cholesterol less than 5mmol/l; LDL-C below 3)
- Diabetes (check blood glucose)
- To diagnose and treat associated complications
- Cardiac arrhythmias
- end-organ damage eg retinopathy; renal failure; PVD.
- Monitor
- symptom control
- blood pressure
- lipids
- weight (BMI)
- compliance
- exercise
- blood glucose.
- To ensure that recommended therapeutic options have been implemented,
where appropriate.
- aspirin or warfarin
- nitrates
- Beta-blockers for those who have had a MI
- hypotensives
- statins
- ACE inhibitors for those with Left Ventricular systolic dysfunction
- if diabetic - meticulous control of diabetes
Breakdown of patients
Blood test procedures
