485 research outputs found
Commentary : controversies in NICE guidance on lipid modification for the prevention of cardiovascular disease
Get PDFThe new guidelines from the National Institute for Health and Clinical Excellence (NICE) on lipid modification for the prevention of cardiovascular disease will guide the way we assess cardiovascular risk and treat lipids, both in primary and in secondary care. What are the new aspects, and what is it that might spark controversy in this new publication
Chronotherapy of hypertension: let's not throw the baby out with the bathwater!
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Oral calcium supplementation and blood pressure: an overview of randomized controlled trials.
No full textOver the past few years, several trials on the effect of oral calcium supplementation on blood pressure have been undertaken both in normal subjects and in patients with high blood pressure. Of these, 15 randomized, controlled studies were reviewed: 10 included patients with high blood pressure, three studied normal subjects, and two used a low-calcium diet for comparison. The 15 studies reviewed investigated a total of nearly 400 peoples. No significant evidence for a supine blood pressure-lowering effect of oral calcium supplementation was found in the trials as a whole or in those trials carried out in hypertensives only. However, a small effect on standing blood pressure was detected. Our study indicates that the overall effect of oral calcium on blood pressure, if any, is very small and confined to standing blood pressure, it is, therefore, inappropriate to recommend oral calcium supplementation for the treatment of essential hypertension
'Hospital at night' improves outcomes : does the evidence support opinions?
No full textAddress correspondence to Prof. F.P. Cappuccio, Clinical Sciences Research Institute, University of Warwick, Warwick Medical School, U.H.C.W. Campus, Clifford Bridge Road, Coventry CV2 2DX, UK. email: [email protected]
The Modernization of the National Health Service (N.H.S.) and medical careers have brought over the last 10 years or more growing pressures and demands for radical changes in the way we deliver safe and effective healthcare and train new doctors to fit these changes. At the same time, there has been increasing awareness at a European level that both patients and doctors are exposed to health risks due to excessive working hours of junior doctors. A legislative framework to reduce average working hours to no more than 48 h/week was then introduced in Europe (with the view to be implemented fully on 1 August 2009), which has added to the challenges and has sparked a much heated debate
A community programme to reduce salt intake and blood pressure in Ghana
Get PDFBackground
In Africa hypertension is common and stroke is increasing. Detection, treatment and control of high blood pressure (BP) is limited. BP can be lowered by reducing salt intake. In Africa salt is added to the food by the consumer, as processed food is rare. A population-wide approach with programmes based on health education and promotion is thus possible.
Methods
We carried out a community-based cluster randomised trial of health promotion in 1,013 participants from 12 villages (628 women, 481 rural dwellers); mean age 55 years to reduce salt intake and BP. Average BP was 125/74 mmHg and urinary sodium (UNa) 101 mmol/day. A health promotion intervention was provided over 6 months to all villages. Assessments were made at 3 and 6 months. Primary end-points were urinary sodium excretion and BP levels.
Results
There was a significant positive relationship between salt intake and both systolic (2.17 mmHg [95% CI 0.44 to 3.91] per 50 mmol of UNa per day, p < 0.001) and diastolic BP (1.10 mmHg [0.08 to 1.94], p < 0.001) at baseline. At six months the intervention group showed a reduction in systolic (2.54 mmHg [-1.45 to 6.54]) and diastolic (3.95 mmHg [0.78 to 7.11], p = 0.015) BP when compared to control. There was no significant change in UNa. Smaller villages showed greater reductions in UNa than larger villages (p = 0.042). Irrespective of randomisation, there was a consistent and significant relationship between change in UNa and change in systolic BP, when adjusted for confounders. A difference in 24-hour UNa of 50 mmol was associated with a lower systolic BP of 2.12 mmHg (1.03 to 3.21) at 3 months and 1.34 mmHg (0.08 to 2.60) at 6 months (both p < 0.001).
Conclusion
In West Africa the lower the salt intake, the lower the BP. It would appear that a reduction in the average salt intake in the whole community may lead to a small but significant reduction in population systolic BP
Charachterization of the 12% trichloroacetic acid insoluble oligopeptides of parmigiano reggiano cheese
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