Topics covered in this chapter

The danger of neglecting values when you are focusing on the evidence (the danger of becoming “values-blinded by the evidence”) is illustrated by the management of essential hypertension.

Other topics include:

• Cardiovascular risk assessment

• Lifestyle and cardiovascular risk

• Depression, stress and cardiovascular risk Statins

• Erectile dysfunction

• Self-management and cardiovascular risk.

Take-away message for practice

When you are focusing on the evidence, remind yourself to pay attention also to values. So, think evidence, think values too!

This chapter follows the story of Jim Burns, aged 56, a car sales manager recently diagnosed with essential hypertension. Failing to follow the evidence-based advice of his GP, Dr. Jane Hilary, for the management of his hypertension, Jim becomes increasingly anxious and depressed, starts to drink more and puts himself at risk of losing his job, all with a corresponding sharp deterioration in his cardiovascular risk profile.

Jim Burns finds a way out, however, when he is referred through an occupational health scheme to a cardiologist, Dr. Martin Winner, who specializes in cardiovascular risk. Dr. Winner draws on the same evidence base as Dr. Hilary but now with an awareness and understanding of Jim Burns' unique values. Combining values with evidence in this way allows Jim Burns to engage actively with the lifestyle and other preventive strategies proposed.

The clinical context

Jim Burns, a 56-year-old car sales manager, positively bounced out of his latest appointment with “his” cardiologist, Dr. Martin Winner, feeling, as he put it to himself, “turbocharged.”