Screening for abnormal heart rhythms: can we protect more people from stroke?

It’s Action on Stroke Month here in the UK and the Stroke Association hope to raise awareness of stroke and particularly its emotional impact, through the many events taking place during May. They’ve also produced a really helpful guide to making information accessible for people with aphasia, which you can download from the link here. But what can be done to prevent people from having a stroke in the first place? Screening has moved in and out of favour for various conditions in recent years, but something that might be useful is to look for people with abnormal heart rhythms (atrial fibrilliation) that put them at higher risk of stroke and offer them treatment. Continue reading


Do selenium supplements reduce heart attacks?

Probably not, but it could increase your chance of baldness! Selenium is a trace element which is involved with thyroid hormone metabolism, the immune system and also glass making and electronics! It is available to buy as a supplement over the counter, but it is also found naturally in brazil nuts, fish, shellfish and grains. It has become popular in recent years as it has been thought to work as an antioxidant. A new review from the Cochrane Heart Group assessed the effect of this supplement on healthy adults, to test whether it prevented heart attacks. Continue reading

Intervention reduces atrial fibrillation after heart surgery

Atrial fibrillation (AF) is the most common rhythm disturbance of the heart. It involves the top two chambers of the heart quivering (fibrillating) rather than beating effectively. This can lead to three potential problems: Firstly, without the top two chambers pumping properly the heart becomes less effective at pumping. This can make some patients feel tired or more breathless during exercise. Secondly, in some cases, the bottom two chambers of the heart try their best to keep up with the fast quivering of the top two chambers, leading them to beat faster than they normally would. This can make some people feel their heart pounding in their chest (palpitations), or tired or breathless on exertion. Thirdly, patients are more likely to have a stroke. This is because the blood moves more sluggishly through the quivering chambers and has an increased tendency to form blood clots. These can lodge in arteries in the brain, starving that area of blood and oxygen. Continue reading

Statins save lives in patients undiagnosed with heart disease

Given that February is National Heart Month (cue Valentine’s Day), I thought I would blog about a recent Cochrane review by the Cochrane Heart Group which has just been published, all about statins. Statins are a family of medicines prescribed for lowering cholesterol. They are one of the most commonly prescribed medicines, particularly by us cardiologists and our GP colleagues. The number of prescriptions and cost to the NHS of these drugs has grown significantly in the last few years, from £20 million in 1993 to £500 million in 2006. They are frequently prescribed for preventing further heart attacks and strokes when a patient has already had one (called secondary prevention by us doctors) but the evidence of benefit when given to patients to prevent a first heart or stroke (called primary prevention) is less clear. This review aimed to assess the effects, both harms and benefits, of statins in people with no history of cardiovascular disease. Continue reading

Loading with warfarin, what’s the quickest and safest dose?

Key message: There is not enough evidence to show whether 10mg or 5mg loading dose of warfarin is safer or quicker. It may be more appropriate to use smaller doses in elderly patients. Continue reading

Top dose Atorvastatin cuts bad cholesterol by 50%, but what about smaller doses?

Key message: The effect of atorvastatin on lowering total cholesterol, LDL-cholesterol and triglyceride was proportional to the dose given. HDL-cholesterol was not significantly affected. Continue reading