I’ve noticed a change in my colleague’s behaviour. What should I do? BMJ 2019 June

I’ve noticed a change in my colleague’s behaviour. What should I do? BMJ 2019 June

It can be difficult to approach a colleague if you have concerns about their wellbeing because of a change in their behaviour. Abi Rimmer asks experts how best to handle this situation.     Remember a) small gestures make a BIG difference b) Take your doctor hat off c) Don’t be embarrassed to ask Small gestures make a big difference Lucy Warner, chief executive of the NHS Practitioner Health Programme, says, “If you’ve noticed a change, then this situation has probably been around for some time and may already have become a fairly serious problem. Doctors are very good at focusing

Hypertension guidelines: how much low?

Hypertension guidelines: how much low?

In an era that that ‘evidence-based medicine’ is facing challenges from many fronts, the benefits of blood pressure control have been shown to decrease morbidity and mortality and increase lifespan. The evidence is strong and there is no disagreement among clinicians and researchers. However, there is considerable uncertainty and debate as to how much reduction is needed in systolic blood pressure among the leading guidelines that look at the same evidence. The JNC 2018, AHA/ACC and now NICE guidelines vary with the recommendations. The page below gives the summary of guidelines available from JNC 8 (2014), ACC/AHA (2107) and ESC/ESH

New Cholesterol Guidelines Personalize Risk and Add Treatments – JAMA 2019 Feb 6

New Cholesterol Guidelines Personalize Risk and Add Treatments – JAMA 2019 Feb 6

In the new guidelines, statin treatment targets are back for both primary and secondary prevention. Patients whose 10-year risk of ASCVD is 20% or more should try to reduce LDL-C levels by at least 50%, the same goal as for people with clinical ASCVD. Those with more intermediate risk should aim for at least a 30% decrease. The new update was met with considerably less controversy than the last incarnation, which deemphasized LDL-C treatment targets and introduced the AHA/ACC ASCVD risk calculator. The updated guidelines and a companion AHA/ACC special report on risk assessment tools acknowledge that the calculator estimates risk for an average