Therapeutic Guidelines: Cardiovascular. Version 6
- Ranessa Sebastian
- Aust Prescr 2013;36:131
- 1 August 2013
- DOI: 10.18773/austprescr.2013.054
Melbourne: Therapeutic Guidelines Limited; 2012.
These guidelines provide the reader with an overview of salient cardiovascular topics, from the management of risk factors to acute management of chest pain and arrhythmias.
The guidelines are sensibly structured into succinct and manageable sections, and flow diagrams and tables effectively support written text. Most useful are the clinical pearls in highlighted boxes, which for example, remind the reader that life-threatening hyperkalaemia can occur when adding an aldosterone antagonist to an ACE inhibitor or angiotensin II antagonist in patients with renal impairment.
The new features of the current edition are the standout. ‘Type 2 diabetes and cardiovascular disease risk’ is a new focus that explores the assessment and management of risk factors in patients with diabetes, while new information has been included on the management of antithrombotic therapy in patients with cardiac implanted electronic devices undergoing non-cardiac procedures or operations. This section is valuable for answering that often difficult question of what to do with a patient’s anticoagulation before surgery. Revised information on bariatric surgery has been included, which is important for GPs tackling the rising problem of obesity.
Particularly useful is the section on antithrombotic therapy, which summarises the various types of anticoagulants and antiplatelets and includes the newer drugs such as dabigatran, rivaroxaban and ticagrelor. It provides a short summary of salient points such as clinical utility, monitoring, determinants and management of bleeding and over-anticoagulation. This is great for the busy GP needing quick access to concise information during a consult, particularly as the newer drugs are used with increasing frequency.
Overall, the Cardiovascular Therapeutic Guidelines is a comprehensive and useful resource for GPs, medical students and other health professionals.
Academic registrar, Department of General, Practice Sydney Medical School, Westmead, The University of Sydney