Liraglutide significantly reduces body weight and improves metabolic control in people who are obese or overweight and have dyslipidaemia or hypertension, a randomised trial reported in the New England Journal of Medicine has shown.
Pharmacy-based screening for cardiovascular risk
A systematic review suggests that pharmacy-based screening for cardiovascular risk factors may be possible. However, many people do not act on the advice to visit their GP, and the effect of screening on new diagnoses has not been robustly shown.
Self-management of hypertension in people at high risk of cardiovascular events
An open-label randomised controlled trial finds that people with hypertension who self-monitor their blood pressure and up-titrate their antihypertensive medication experience a greater reduction in systolic blood pressure than people who manage hypertension with usual care.
Mental health after stopping smoking
A meta-analysis finds that stopping smoking is associated with reductions in anxiety, depression and stress, and improvements in quality of life and mood.
Alpha-blockers for expulsion of ureteral stones
A Cochrane review reports that alpha-blockers are more effective at expelling ureteral stones less than 10 mm in diameter than standard therapy or calcium channel blockers.
Haemoglobin thresholds for blood transfusion
Two meta-analyses report that restricting transfusion of red blood cells to people with a haemoglobin level of either less than 7.0 g/dl or 6.4 g/dl to 9.7 g/dl reduces mortality and serious infection, but does not significantly affect the overall risk of infection.
NICE has recently published Evidence Updates on:
- Spasticity in children and young people with non-progressive brain disorders
- Ectopic pregnancy and miscarriage
- Hyperphosphataemia in chronic kidney disease
Today’s ‘Relax in the Library’ event was very well attended. The purpose was to encourage staff and students to think about their blood pressure, have it measured (before and after relaxation therapy) and get to know more about what those all important numbers mean – 120/80.
Visitors could choose from a mixture of services – head, neck, shoulder or foot massage whilst others chose instruction on ‘the Alexander Technique’.
Leigh Haslam from Occupational Health took over a quiet corner at the rear of the Library and was kept busy recording peoples’ BP. It was very interesting to note that there was 100% improvement after relaxation.
A big ‘thank you’ to all the therapists, (Diana Grant, Tracy Mills, Jenny Fox-Eades, Gillian Pierce, Leigh Haslam and to Lynda Cotterill for providing a range of tasty, healthy snacks.
Don’t worry if you missed today’s event, there may be others in the future plus we stock a selection of books on Hypertension, useful leaflets and published research findings on how you can look after yourself through lifestyle, exercise and diet.
Guidance by topic: the following guidance topics matching your health area preferences have been published or updated
- Acute coronary syndrome – rivaroxaban [ID532]
- Antenatal and postnatal mental health (update)
- Antenatal care
- Arrythmias – ICDs & Heart failure – cardiac resynchronisation [ID481]
- Arthritis of the hip (end stage) – hip replacement (total) and resurfacing arthroplasty (Rev TA2, TA44) [ID540]
- Asthma – diagnosis and monitoring
- Atrial fibrillation (stroke prevention) – rivaroxaban
- Atrial fibrillation – dabigatran etexilate
- BMI and waist circumference – black, Asian and minority ethnic groups
- Breast cancer (HER2 negative, oestrogen receptor positive, locally advanced or metastatic) – everolimus (with an aromatase inhibitor) [ID538]
- Colorectal cancer (metastatic) – regorafenib [ID593]
- EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing
- Familial breast cancer
- Gene expression profiling and expanded immunohistochemistry tests to guide the use of adjuvant chemotherapy in early breast cancer management: MammaPrint, Oncotype DX, IHC4 and Mammostrat
- Intrapartum care
- Lung cancer (non-small-cell, anaplastic lymphoma kinase fusion gene, previously treated) – crizotinib [ID499]
- Mega Soft Patient Return Electrode for use during monopolar electrosurgery
- Multiple myeloma – bortezomib (induction therapy) [ID610]
- Non Hodgkin’s lymphoma (relapsed refractory) – pixantrone monotherapy [ID414]
- Prostate cancer (hormone relapsed, metastatic) – enzalutamide (after docetaxel)
- Psoriatic arthritis (active, progressive) – ustekinumab [ID607]
- Pulmonary embolism (acute treatment, VTE prevention) – rivaroxaban [ID569]
- Pulmonary embolism and recurrent venous thromboembolism – rivaroxaban
- Self-monitoring coagulometers (CoaguChek XS system, INRatio2 PT/INR monitor and ProTime Microcoagulation system), for self-testing or self-managing coagulation status in people for whom long-term vitamin K antagonist therapy is intended.
- Systemic lupus erythematosus (autoantibody-positive) – belimumab [ID416]
- Tuberculosis (update)
- Ulcerative colitis
- WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension
- Hypertension: CG127
- Type 2 diabetes (partially updated by CG87): CG66
- Intrapartum care: CG55
- Hypertension: QS28
Analysis of data from a large randomised controlled trial suggests that intensive glucose control in critically ill patients is associated with moderate to severe hypoglycaemia, and a higher risk of death.
At its January meeting the NICE Accreditation Advisory Committee accredited 2 guidance programmes.
NICE recently published Evidence Updates on:
- Strategies to prevent unintentional injuries among children and young people aged under 15
- Hyperglycaemia in acute coronary syndromes
- Common mental health disorders
- Biofeedback training for the management of faecal incontinence in children.
- Non-pharmacological interventions for breathlessness.
The worldwide increase in diabetes is focusing more attention on all aspects of treatment, including associated hypertension. Untreated hypertension in people with diabetes is linked to high rates of cardiovascular and microvascular disease. Our update examines new evidence questioning the effectiveness of angiotensin II receptor antagonists for this co-morbidity. In addition, while the evidence supports the idea of aggressive blood pressure targets, we highlight the uncertainty surrounding the exact level of those targets.
Visit the Clinical Evidence website to see the full review.
Other useful links: