Heart Education Awareness Resource and Training through eLearning (HEARTe)
Consider Bert’s management plan
Nurse Claire and Bert discuss Bert’s lifestyle and management options.
Bert’s Management Plan
Blood pressure target
Glucose target
Ambulatory Blood Pressure monitoring (ABPM):
Correct, ABPM Current recommendation from the British hypertension society is ambulatory BP monitoring or alternatively home BP monitoring.
Treat with a Calcium Channel Blocker (CCB):
Correct, A CCB would be step one for a person over the age of 55.
Check Urea & Electrolytes:
Correct, It is good practice to check a baseline prior to starting treatment.
Treat with ACE inhibitor
Wrong, You may consider adding an ACE inhibitor as a step two treatment.
Glucose tolerance test (GTT)
Wrong, Current SIGN guidelines state if the blood glucose level is greater than 7mmol/L a GTT should be performed.
Fasting blood glucose
Correct, Current SIGN guidelines state if the blood glucose level is between greater than or equal to 6.1 – 7mmol/L a fasting blood glucose sample is obtained.
Dietary advice
Correct, Dietary advice should always be part of any management plan.
Cholesterol target (yellow)
Smoking target
Check LFTs, CK & fasting triglycerides:
Correct, It is good practice to check a baseline prior to starting treatment.
Commence Simvastatin 40mg at night:
Correct, first choice treatment from evidence based guidelines
Low fat diet:
Dietary advice should always be part of any management plan.
Commence Atorvastatin 10mg
Wrong, You may consider using Atorvastatin if Simvastatin is not tolerated
Brief intervention
Correct, you should always establish patients stage of behavioural change.
Commence nicotine replacement therapy (NRT)
Wrong, only prescribed if at the action stage of behavioural change.
