Evidence
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A lifestyle change programme not effective for those at risk of heart disease or stroke

A package of extra support, including motivational interviewing, did not add value in terms of boosting weight loss or physical activity in people at high risk of cardiovascular disease, a new study has found. This NIHR-funded trial recruited 1,220 people deemed at high risk of heart disease or stroke. Researchers compared the clinical and cost-effectiveness …

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NHS health check attendance improves with changes to the invitation letter

Invitation letters improve uptake when they address common concerns and reasons for not attending the free NHS Health Checks. People are invited to attend a check every five years between 40 and 74 years, but uptake has been low. This trial of 6,313 patients from six general practices in Northampton found that presenting reasons for non-attendance …

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Advance care plans improve quality of life for heart failure patients

Advance care planning (ACP) can improve the quality of life of patients with heart failure, especially if it includes follow-up, involves family members and is carried out by trained clinicians working in multidisciplinary teams. This review summarised the evidence about the effect of ACP on quality of life, compared with usual care, for 2,924 patients …

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GLP-1 drug for diabetes gives modest cardiovascular benefits compared with placebo

Taking a glucagon-like peptide-1 receptor (GLP-1) agonist drug lowers the likelihood of having a stroke, heart attack or dying due to cardiovascular causes by 12%. The drugs give a similar 12% reduction in overall mortality. They do not increase the risk of heart failure, very low blood sugar levels or pancreatic disease. Diabetes causes one …

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Taking blood pressure medications at night seems best

People who took their blood pressure medications at bedtime were 45% less likely to experience a major cardiovascular outcome, such as heart attack or stroke, compared with people who took them in the morning. Most blood pressure medications, diuretics aside, do not have a recommended time of administration. A large trial conducted across 40 general …

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Patients, in theory, might prefer GP-led care to self-management for high blood pressure

Patients offered the pros and cons of different monitoring options appear reluctant to self-manage high blood pressure, and prefer frequent monitoring by a GP, pharmacist or via telehealth (where readings are sent to health professionals and medicines managed remotely). The small online survey, completed by 167 patients, was used to explore how patients might feel …

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Short-term dual antiplatelet treatment may be best for most patients after receiving a drug-eluting stent

For patients who have had a drug-eluting stent inserted into the coronary arteries, there is no difference in mortality or cardiovascular outcomes between the standard 12-month dual antiplatelet therapy and shorter six-month courses. Longer courses above 12 months increased risk of bleeding and non-cardiac death compared with short courses. It has been debated whether longer …

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Transcatheter aortic valve implantation may be an option for patients with aortic stenosis at lower surgical risk

Transcatheter aortic valve implantation (TAVI), the less-invasive procedure, may be associated with a reduced risk of death and stroke for up to two years when compared with surgical aortic valve replacement for adults with severe narrowing of the aortic valve, irrespective of the level of surgical risk. TAVI is already an established procedure for those …

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Cardiac rehabilitation for heart failure can improve quality of life and fitness

Exercise-based cardiac rehabilitation may improve the quality of life and physical fitness of people with heart failure but does not reduce their risk of being admitted to hospital or dying. This is irrespective of factors such as age and ethnicity. This NIHR study summarised the outcome data from trials assessing exercise programmes for over 4,000 …

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Routine engagement in end of life planning can improve health outcomes for people with heart failure

Interventions that encourage healthcare professionals to engage in advance care planning with heart failure patients can work more effectively than stand-alone training activities in improving health outcomes. Approaches that involve patients to change clinicians’ professional practice behaviours, the use of reminder systems and educational meetings may offer the best potential. There is no cure for …

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