Heart Matters Vol 14 No 3 - 2023

Introduction

Uncontrolled hypertension – is it truly resistant to treatment? 

Hypertension is the world’s leading risk factor for cardiovascular disease (CVD), stroke, disability, and death. In sub-Saharan Africa (SSA) it is the number one cause of death, and the prevalence has risen dramatically to approximately 40% of the adult population.  Despite a steady improvement in control rates over the past 30 years, this has been mainly confined to developed nations. In SSA overall control remains dismally low at 9% and the number of treated patients achieving blood pressure (BP) control has failed to improve.

Statin-associated muscle symptoms – real or nocebo?

The importance of statin based lipid-lowering therapy in reducing cardiovascular risk is undoubted for all physicians who practice evidence-based medicine. Unfortunately, study after study has shown that patients are not deriving the optimal benefit from these highly effective and safe drugs, with only a minority of patients reaching their LDL-cholesterol goals.

Reportback: European Society of Cardiology (ESC) Conference 2023

Just like it would be impossible to cross all the canals in Amsterdam in four days, so it would be impossible to summarise ESC 2023 in a single article. Allow me, rather, to take you on a journey through some of the late breaking trials, updated guidelines and fascinating topics that were discussed.

Criminal law and how it can affect healthcare practitioners

The primary purpose of criminal law is to protect the public, punish offenders and deter future criminal conduct. Unlike a civil trial, where the burden of proof is set at the balance of probabilities (i.e. 51% probability), a criminal trial’s burden of proof is substantially higher. The state must convince the judge that the issues at stake have been proven beyond a reasonable doubt. If the accused’s legal representatives believe that the state has failed to prove the matter beyond a reasonable doubt they may, prior to embarking on their defense, apply for a discharge. The judge is obliged to consider such an application for a discharge but, if they are not convinced, may order the trial to continue.