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Summary analyses of screening data were used to ascertain the cardiovascular risk profile in a sample of health care workers in Scotland. A sample of NHS staff (298 women and 78 men) were screened during visits to Perth Royal Infirmary (PRI) in 1996 and 1997. Comparisons were made within subsets and with previous screening studies. Health care workers have been a neglected component of the workforce for receiving education about risk factors. The high prevalence of smokers found in this sample should be a cause for concern.

A randomised trial was undertaken in one hundred patients with heart failure and/or chest infection to determine whether low-dose subcutaneous heparin induced the frequency of deep vein thrombosis (DVT) in the legs. Heparin, (5000 units 8 hourly) significantly reduced the frequency of DVT, diagnosed by the 125I-fibrinogen scan technique, from 26 to 4 per cent (p less than 0.01). Heparin was started within 12 hours of admission to hospital and continued until the patient was fully mobile. Heparin did not cause bleeding problems except for a 20 per cent incidence of injection site bruising. We therefore recommend prophylaxis with low-dose subcutaneous heparin in patients with heart failure or chest infection who require more than three days bed rest.

Finger blood flow is decreased in Raynauds Phenomenon (RP). This may be due not only to vasospasm, but also to blood abnormalities. 40 patients with Raynauds Disease (RD), 28 with suspected RP (SS) and 42 with secondary Raynauds syndrome (RS) were enrolled and compared to 50 controls. Results from base-line samples show that those with RP have abnormal haemostasis and rheology whereas those with mild Raynauds, RD do not. Blood sampled after cold challenge in 15 RS patients and 15 controls show that both groups exhibit platelet activation after emersion. The degree of activation however was much more marked in the RS patients. We have shown that abnormalities of haemostasis and rheology are found in patients likely to have endothelial damage (RS). These changes are probably a consequence rather than a cause of the disease. After cold challenge the results become more abnormal and correlate with severity of disease.