Month: October 2024

Cardiovascular risks in people with long-term conditions

People with many long-term conditions are at increased risk of cardiovascular disease. If you or someone you care about is living with a long-term condition, here are some practical steps people can take to reduce their risk:

1. Attend for Scheduled Check-Ups: Make sure you attend for any scheduled check-ups. For example, to check your blood pressure, weight, blood sugar levels and cholesterol; or to review your medication.

2. Healthy Lifestyle Choices: Focus on a healthy diet, regular physical activity and avoiding smoking; all of which can reduce the risk of cardiovascular disease. For exercise, you should aim for at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week. But even small changes – such as a modest increase in the amount of exercise you take each day – can have positive benefits. A diet rich in fruits, vegetables and whole grains and with less intake of processed foods and sugary drinks is also helpful for your health.

3. Medication Management: If you are prescribed drugs for conditions such as hypertension (high blood pressure) or diabetes, make sure to follow the treatment plan closely. Discuss any side effects or concerns with your doctor or another health professional.

4. Stay Informed: Understanding how your own health condition interacts with other diseases helps you stay informed about your health and reduce your risk of cardiovascular disease. This is an example of what health professionals call “health literacy”; which is increasingly important because of the greater focus in health systems on areas such as prevention and self-care.

5. Connect with Others: Joining a support group for people with your condition can provide valuable emotional support and practical advice from people who understand your challenges. These groups can be in-person or online.

Finally, remember that this list is not comprehensive. Every individual has their own health needs and personal circumstances that will affect their health.

Understanding Vascular Risks in People with Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a complex neurological condition that affects the central nervous system. While much of the focus on MS is often on the symptoms related to the nervous system, recent research has shed light on another important aspect: the increased risk of vascular diseases, such as diabetes and hypertension, in people living with MS (PwMS). Let’s take a closer look at what this means and how it impacts overall health based on the findings of a recent paper from my team published in the Multiple Sclerosis Journal.

What the Research Shows

A large study conducted between 1987 and 2018 looked at the health records of over 12,000 people with MS and compared them with over 70,000 individuals without MS. The findings were significant:

  • Increased Risk of Diabetes: People living with MS have a higher risk of developing type 2 diabetes after being diagnosed with MS. Over 10 years, the incidence rate of diabetes was notably higher in people with MS compared to those without. Women with MS, in particular, showed an 18% higher rate of developing diabetes than the general population.
  • Hypertension Management: People living with MS were more likely to start treatments for hypertension (high blood pressure) compared to individuals without MS. Encouragingly, those with MS who started treatment for hypertension were also more likely to meet blood pressure management targets, as set by the National Institute for Health and Care Excellence (NICE).

However, despite better management, the overall burden of vascular diseases in people living with MS  remains higher than in the general population.

Why Is This Important?

People living with MS are already dealing with a condition that affects mobility, cognitive function, and quality of life. Adding the risk of cardiovascular diseases like diabetes and hypertension can worsen these issues, as vascular health plays a key role in overall well-being. Managing vascular risk factors is essential because conditions like high blood pressure or diabetes can lead to more frequent MS relapses, quicker disability progression, and lower quality of life.

Addressing the Risks

The good news from the study is that people living with MS are more likely to receive treatment for vascular conditions post-diagnosis. This reflects a positive shift in the healthcare approach to managing these risks. But there is still much work to be done. Vascular disease management in people with MS needs to be tailored to their specific needs, potentially requiring more stringent treatment targets to prevent further health complications.

What You Can Do

If you or someone you care about is living with MS, it’s essential to keep an eye on vascular health. Here are some practical steps:

  1. Regular Check-Ups: Make sure to have regular check-ups with your healthcare provider to monitor blood pressure, blood sugar levels, and cholesterol.
  2. Healthy Lifestyle Choices: Focus on a healthy diet, regular physical activity, and avoiding smoking, all of which can reduce the risk of vascular diseases.
  3. Medication Management: If you’re prescribed medications for conditions like hypertension or diabetes, make sure to follow the treatment plan closely and keep an open line of communication with your doctor about any side effects or concerns.
  4. Stay Informed: Understanding how MS interacts with other health conditions helps you stay ahead. Don’t hesitate to ask your healthcare provider about any concerns related to cardiovascular health.

Final Thoughts

The relationship between MS and vascular diseases is complex, but this research highlights the importance of proactive care. By focusing on managing vascular risk factors, people living with MS  can work toward reducing the additional health burdens that come with the disease, improving their long-term health and quality of life.

This study reminds us that while MS presents many challenges, there are steps we can take to mitigate its impacts, especially when it comes to vascular health. Stay engaged with your healthcare team and prioritise comprehensive care to address both neurological and cardiovascular health.

Preparing for Future Health Shocks: Lessons from the COVID-19 Pandemic

The COVID-19 pandemic was a profound global health crisis that exposed vulnerabilities in our public health systems and forced rapid adaptations worldwide. In the absence of effective pharmaceutical solutions at the pandemic’s onset, non-pharmaceutical interventions (NPIs) such as physical distancing, mask-wearing, and lockdowns became essential tools to mitigate the spread of SARS-CoV-2. While NPIs were crucial in reducing transmission and preventing healthcare system overload, their implementation came with significant social, economic, and psychological costs. Reflecting on these measures – as we do in our recent article in the British Medical Journal – offers valuable insights into preparing for future health shocks.

Evaluating the Effectiveness of Non-Pharmaceutical Interventions

NPIs aim to limit person-to-person contact and control the spread of infectious diseases, but they are not without challenges. The simultaneous application of multiple interventions during the pandemic made it difficult to assess their individual effectiveness. Additionally, variations in implementation, cultural differences, and public trust in government policies affected adherence and outcomes. The urgency to act quickly often outpaced the ability to generate robust evidence, highlighting a tension between evidence-based policy and the need for immediate action.

Moving forward, a more flexible research infrastructure is necessary to enable rapid evaluations of NPIs during health crises. Observational studies, although valuable, come with limitations like biases and confounding factors. Enhancing real-time data collection and creating robust systems for sharing this data is essential to guide policymakers effectively during a health emergency.

The Socioeconomic and Psychological Impact of NPIs

The consequences of NPIs extended far beyond controlling infection rates. School closures disrupted children’s education, exacerbating inequalities, especially for those without access to digital resources. Economic hardships disproportionately affected low-income workers who could not work remotely, while those in high-paying positions often retained job security.

Mental health impacts were also significant. Isolation, financial stress, and health concerns led to increased rates of anxiety, depression, and domestic violence. These effects underline the importance of integrating mental health support and economic relief measures into pandemic preparedness plans. Future strategies should prioritize data on socioeconomic factors and mental health needs to ensure a holistic response to health shocks.

The Role of Healthcare Data in Pandemic Preparedness

Healthcare data, particularly electronic health records, proved invaluable during the COVID-19 pandemic. In the UK, these records facilitated rapid data analysis, aiding in decision-making and public health communication. However, the reliance on existing data infrastructure highlighted gaps in data linkage, particularly regarding social care data. Addressing these gaps can improve responses to future health crises by allowing policymakers to identify and support vulnerable populations more effectively.

Establishing a national pandemic preparedness body could further enhance data-sharing and rapid response capabilities. Such an entity could map potential health threats, design secure data-sharing environments, and streamline ethical approval processes, ensuring that essential data is available and ready for immediate use.

Cost-Effectiveness and International Collaboration

Although NPIs can be effective, they come with substantial economic costs. Early evaluations of the cost-effectiveness of these kind of interventions could help policymakers implement the most impactful measures while minimizing negative outcomes. Moreover, the interconnected nature of modern health challenges emphasizes the need for international collaboration. The COVID-19 pandemic highlighted the benefits of global data sharing and coordination through organizations like the World Health Organization. Countries should continue to strengthen global health agreements and partnerships, as sharing knowledge and resources can optimize response efforts and minimize the impact of future pandemics.

Building Public Trust and Involving Stakeholders

Public trust is critical for the success of NPIs. During the COVID-19 pandemic, transparent communication and engagement with the public helped improve adherence to public health measures. For future health shocks, involving stakeholders, especially those from vulnerable communities, in decision-making processes will be essential. Public engagement can foster a sense of collective responsibility and resilience, which are vital for overcoming health crises.

Conclusion

As we prepare for future health shocks, the lessons from the COVID-19 pandemic are clear. Investing in data infrastructure, ensuring rapid evaluation capabilities, and prioritizing the mental health and socioeconomic well-being of affected populations can build a more resilient society. By fostering international collaboration and public trust, we can strengthen our ability to respond to whatever health challenges lie ahead. The next pandemic may not be preventable, but by learning from the past, we can be better equipped to mitigate its impact on global health.