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QJM 2007 100(2):121-124; doi:10.1093/qjmed/hcm002
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© The Author 2007. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The JBS-2 guidelines on prevention of cardiovascular disease in clinical practice: an opportunity missed

S. Jessani, G.Y.H. Lip, A. Barnett2 and T. Millane1

From the University Department of Medicine and 1Department of Cardiology & Vascular Medicine, Sandwell and West Birmingham NHS Trust, and 2Department of Diabetes and Endocrinology, Heart Of England NHS Foundation Trust and the University of Birmingham, Birmingham, UK

Address correspondence to Dr S. Jessani, City Hospital, Birmingham B18 7QH, UK. email: shahirose.jessani@swbh.nhs.uk

The first 10% of the full text of this article appears below.


   Introduction
 
In December 2005, a Working Party for the Joint British Societies (JBS-2) published guidelines on the prevention of cardiovascular disease in clinical practice ‘to promote a consistent multi-disciplinary approach to the management of people with established atherosclerotic cardiovascular disease and those at high risk of developing symptomatic atherosclerotic disease’.1 The Working Party has produced a comprehensive document that addresses most aspects of cardiovascular risk prevention. However important issues arise from the JBS-2 guidance in relation to: (i) screening for new diabetes and (ii) the investigation of impaired glucose tolerance.


   Screening for new diabetes: the role of fasting glucose measurement
 
In the section on risk factor assessment, JBS-2 recommends: ‘if non-fasting glucose is >=6.1 mmol/l then measure fasting glucose for evidence of impaired glucose regulation or new diabetes. If this fasting glucose measurement is . . . [Full Text of this Article]

Fasting glucose is a poor indicator of impaired glucose regulation
Unrecognized diabetes is common in cardiovascular disease

   JBS-2 and oral glucose tolerance testing
 
Impaired glucose tolerance: a ‘marker of risk’ or a ‘risk factor’ requiring modification?
Logistics of oral glucose tolerance testing

   Conclusion
 

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