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Key role for nurses in CVD prevention

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Practice nurses should actively identify patients at high-risk of cardiovascular disease (CVD) and offer lifestyle and pharmacological interventions, states NICE guidance published last week.

The guidelines recommend nurses and GPs should check the medical records of patients aged 40–75 to identify those likely to have a cardiovascular event in the next 10 years.

High-risk patients should be offered a formal risk assessment and advice on managing modifiable risk factors such as smoking, hypertension and raised cholesterol. Adults considered to have a 20% or greater 10-year risk of developing CVD – based on Framingham risk scores – should be offered drug therapy with generic simvastatin 40mg.

The institute said CVD ‘systematic identification’ of high-risk patients would prevent 15,000 cardiovascular events in England and Wales every year.

Guideline development group member Maureen Hogg, coronary heart disease lead nurse for Lanarkshire NHS Trust, said: ‘Much of this work is already carried out by nurses but the guideline provides a systematic rather than opportunistic approach to the care and treatment of people at increased risk of CVD.’

Jan Proctor-King, cardiovascular tutor at the primary care training centre in Bradford, and Primary Care Cardiovascular Society board member, said: ‘Prevention of CVD is a fundamental role of primary care nursing and I urge practice nurses to participate in any opportunities that arise in cardiovascular assessment.’

The guidelines come a few months after the government announced plans for a vascular screening programme for 40 to 74-year-olds, due to start next year (NT News, 8 April, p4).

Californian research published last week revealed nearly half of patients with history of CVD have poor knowledge about their symptoms and risk levels.

In a survey of 3,522 patients with history of CVD, 44% were judged to have low knowledge levels and 43% inappropriately assessed their risk as less than or the same as others their age.

Archives of Internal Medicine (2008) 168: 1049–1054

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