Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update | Canada News Media
Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update
Competing interests: James Stone reports receiving consulting fees and honoraria from Bayer Canada and Sanofi Canada. Dr. Stone is senior medical director, Cardiovascular Health and Stroke Strategic Clinical Network, Alberta Health Services; and member at large, Governing Council, College of Physicians and Surgeons of Alberta. Jason Andrade reports receiving payment or honoraria from Medtronic, Biosense-Webster, Abbott, Bio-tronik, Bayer, Servier and BMS-Pfizer. Simon Bacon reports receiving grants from Moderna, paid through Respiplus for the development of vaccine hesitancy education modules, and consultancy and speaker fees from Respiplus. Dr. Bacon has served on advisory boards for Bayer, Sanofi, Respiplus and Lucilab, none of which are related to the current article. Dr. Bacon also holds a Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research Mentoring Chair (SMC-151518) and Fonds de recherche du Québec Chair (251618 and 309815). Harpreet Bajaj reports receiving grants from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Gilead, Janssen, Kowa Pharmaceuticals, Merck, Novo Nordisk, Pfizer, Sanofi and Tricida; and honoraria for lectures from Eli Lilly and Novo Nordisk. Mark Gelfer reports receiving consulting fees from Telus Health Care Centres and holding an unpaid role as board chair of GenXys Health Care Systems, in which Dr. Gelfer also holds stock options. Jeffrey Habert reports receiving consulting fees from MDBriefcase, Liv, MedPlan, Master Clinician Alliance, Academy, Bridge, Seacourses, Thrombosis Canada, Meducom, Antibody, the Canadian Heart Research Centre, CTC Communications, STA Healthcare Communications, Canadian Collaborative Research Network, CPD Network, Telus Health, EOCI Pharmacomm and Operatic. Dr. Habert has also received honoraria from Pfizer, Amgen, BMS, Bayer, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, Purdue, Bausch, Allergan, AbbVie, AstraZeneca, Novartis, Lundbeck, Canadian Cardiovascular Health Education Program (CHEP+), Novo Nordisk, Janssen, Eisai, HLS, Otsuka, Sunovion and Jazz. Dr. Habert was the previous co-chair of the Thrombosis Canada Clinical Guides (2018–2021). Karim Keshavjee reports receiving consulting fees from McMaster University, Demers Professional Corporation and Normative. Darlene Kitty reports receiving teaching stipends from the University of Ottawa Faculty of Medicine and the McGill University Faculty of Medicine for occasional lectures, and travel support as director for the Indigenous Program of the University of Ottawa Faculty of Medicine. Dr. Kitty is the chair of the Indigenous Health Committee, College of Family Physicians of Canada. David Lau reports receiving grants from Novo Nordisk; consulting fees from Amgen, Bayer, Boehringer Ingelheim, CME at Sea, HLS Therapeutics, Eli Lilly, Novo Nordisk and Viatris; honoraria from Amgen, Bayer, Boehringer Ingelheim, CME at Sea, HLS Therapeutics, Eli Lilly and Novo Nordisk; and payment for expert testimony from the Canadian Medical Protective Association. Dr. Lau has served in leadership roles with Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons. Laurent Macle reports receiving grants and honoraria from BMS-Pfizer, Servier and Bayer. Michael McDonald reports receiving consulting fees from Boehringer Ingelheim, and honoraria from Novartis and Servier. Dr. McDonald also participated in the data safety monitoring board for the IVVE Trial. Kara Nerenberg reports membership with the clinical practice guideline committees for the Heart and Stroke Foundation, Obesity Canada, Hypertension Canada, Diabetes Canada and the Society of Obstetricians and Gynaecologists of Canada. Glen Pearson reports receiving consulting fees from Novartis Canada as an advisory board participant. Alexandre Poppe reports receiving a research grant from Stryker and an honorarium from Pfizer-BMS. Dr. Poppe has also participated on a data safety monitoring board for the FLOW trial of fluoxetine after stroke and the safety committee for the Alteplase Compared to Tenecteplase in Patients With Acute Ischemic Stroke (AcT trial) of tenecteplase for acute stroke. Dr. Poppe has received fellowship program support from Servier. Diana Sherifali reports receiving personal funding through her Heather M. Arthur Population Health Institute/Hamilton Health Sciences Chair in Interprofessional Health Research. Peter Selby reports receiving grants from the Ontario Ministry of Health and Pfizer (Global Research Awards for Nicotine Dependence). Dr. Selby has also participated on the C-CHANGE guideline panel since 2010. Eric Smith reports receiving consulting fees from Bayer, Biogen, Alnylam and Cyclerion. Sol Stern reports receiving consulting fees and honoraria from MDBriefcase.com and Sea Courses Inc. George Thanassoulis reports receiving grants, consulting fees and honoraria from Amgen, Sanofi, Novartis and Silence. Dr. Thanassoulis has also been a member of the CCS Dyslipidemia Guideline committee. Kristin Terenzi reports receiving consulting fees for advisory boards of, honoraria for speaking events for, and support for attending meetings from AstraZeneca, Boehringer Ingelheim, Astellas, Allergan, Amgen, Aspen, Bayer, Lilly, Lundbeck, AbbVie, Aralez, GSK, Merck, Novo Nordisk, Pfizer and Novartis. Karen Tu reports receiving grants (payments to institution) from CIHR, St. Michael’s Hospital Foundation, The College of Family Physicians of Canada, Foundation for Advancing Family Medicine, Canadian Medical Association Foundation, North York General Hospital Exploration Fund, Heart and Stroke Foundation of Canada, Heart and Stroke Foundation of Ontario, United States Department of Defense, University of Toronto — Department of Family and Community Medicine, MaRS Innovation Fund, Canadian Dermatology Foundation, Canadian Rheumatology Association (Canadian Initiative for Outcomes in Rheumatology Care), PSI Foundation, Cancer Care Ontario, Toronto Rehab Institute Chair Fund, UTOPIAN, Arthritis Society, MS Society of Canada, The Canadian Vascular Network, Ontario SPOR Support Unit Targeted IMPACT Award and Rathlyn Foundation. Dr. Tu holds a Research Scholar Award from the Department of Family and Community Medicine at the University of Toronto. Jacob Udell reports receiving grants from Boehringer Ingelheim, Janssen, Sanofi and Novartis; and honoraria from AstraZeneca, GlaxoSmithKline and Sanofi. Dr. Udell has also participated on advisory boards for Boehringer Ingelheim, Sanofi and Novartis. Sean Virani reports receiving grants from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Bayer, Novartis, Servier, Otsuka and Medtronic; consulting fees from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Bayer, Novartis, Seriver and Otsuka; and honoraria from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bayer, Novartis, Servier, Otsuka and Medtronic. Dr. Virani has also participated in data safety monitoring boards or advisory boards for Abott and Medtronic. Richard Ward reports receiving consulting fees from Eisai and Lilly-Boehringer Ingelheim, and payment or honoraria from Boehringer Ingelheim, AstraZeneca, Janssen, Amgen, Lilly, Pfizer and Takeda. Dr. Ward also serves as director of the Alberta Medical Association. Sean Wharton reports receiving grants and honoraria from Novo Nordisk, Eli Lilly, Bausch Health Canada and Boehringer Ingelheim; has participated in data safety monitoring boards for Novo Nordisk, Eli Lilly, Bausch Health Canada and Boehringer Ingelheim; and has received equipment, medical writing or other services from Novo Nordisk, Eli Lilly and Bausch Health Canada. Dr. Wharton has also played a leadership role in The Obesity Society and Obesity Canada. Jennifer Zymantas reports receiving an honorarium from Pfizer for a moderator role during speaking engagements related to anticoagulation. Diane Hua-Stewart holds the role of director of CHEP+. Peter Liu reports receiving grants from Genome Canada, the Heart and Stroke Foundation and CIHR. Dr. Liu holds a patent for IGFBP7 as a biomarker for heart failure and is chief scientific officer with the University of Ottawa Heart Institute. Sheldon Tobe reports receiving a KMH clinic unrestricted grant and in-kind support for the Zero to Five study, paid to Sunnybrook Research Institute; consulting fees from AstraZeneca; and payment for the CHEP+ education program from Amgen, Astra-Zeneca, BMS, Bayer, Boehringer Ingelheim, Janssen, Lilly, Novartis, Novo Nordisk, Pfizer and Sanofi Genzyme. Dr. Tobe also holds a volunteer role with the American Hypertension Specialists Certification Program. No other competing interests were declared.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
