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New one-stop guideline takes a 360-degree approach to managing heart disease in Canadians

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A new one-stop guideline takes a 360-degree approach to managing heart disease in Canadian patients, with 83 recommendations in one easy-to-use reference. The guideline is published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.220138.

“Clinicians are rightly concerned that there are too many guidelines with too many individual recommendations to be practical and useful for daily use, particularly in primary care. Typical patients with multiple illnesses require the access to many guidelines at the same time, and some recommendations are not harmonized and often seem contradictory,” says Dr. Peter Liu, chief scientific officer at the University of Ottawa Heart Institute, and a senior author of the latest C-CHANGE guideline. “We hope this fourth update to the very popular C-CHANGE guideline will further meet the needs of health professionals and patients, to prevent and treat cardiovascular conditions and associated brain health with a simple harmonized approach.”

An update to a 2018 publication, the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) resource includes 48 new or revised recommendations out of the 83, from 11 cardiovascular-focused guideline groups across the country.

Aimed at primary care and other health care providers, the C-CHANGE guideline contains actionable recommendations for Canadian adults with or at risk of cardiovascular disease, including

  • people with obesity, diabetes or hypertension;
  • people with dyslipidemia, atherosclerotic vascular disease or heart failure; and
  • people with atrial fibrillation, stroke or dementia.

It also includes health behavior recommendations for all Canadians to address risk factors for these conditions, such as dietary, smoking and physical activity considerations.

C-CHANGE is all about singing from the same song sheet. Our goal is to help health care providers understand the evidence for best practices, and if they can follow the guidelines, the health of the Canadian population could substantially improve.”

Dr. Sheldon Tobe, Co-Chair of C-CHANGE and Nephrologist at Sunnybrook Health Sciences Centre

What’s different from before?

More than 50% of the guideline contains new or revised recommendations from the previous 2018 version. This guideline is also more comprehensive and holistic in caring for patients with multimorbidity.

Partnership has expanded to include Health Canada’s Dietary Guideline, the Canadian Consensus Conference on Diagnosis and Treatment of Dementia, and the Canadian Cardiovascular Society/Canadian Heart Rhythm Society guideline for the management of atrial fibrillation. It also includes a subsection on depression given its frequent co-existence and impact on cardiovascular disease.

“In the past 4 years, many of the national guideline organizations have launched new, evidence-based recommendations -; from changes in medication management to new thresholds for lipid levels in secondary prevention,” says Dr. Rahul Jain, co-chair of C-CHANGE and family physician at Sunnybrook Health Sciences Centre. “We hope this resource helps primary care clinicians stay up to date with many constantly evolving cardiovascular guidelines, so their patients can get the best care possible.”

Journal reference:

Jain, R., et al. (2022) Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update. Canadian Medical Association Journal. doi.org/10.1503/cmaj.220138.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

The Canadian Press. All rights reserved.

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Bizarre Sunlight Loophole Melts Belly Fat Fast!

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