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Latest & greatest articles for cardiovascular disease
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on cardiovascular disease or other clinical topics then use Trip today.
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Mediterranean-style diet for the primary and secondary prevention of cardiovasculardisease. The Seven Countries study in the 1960s showed that populations in the Mediterranean region experienced lower coronary heart disease (CHD) mortality probably as a result of different dietary patterns. Later observational studies have confirmed the benefits of adherence to a Mediterranean dietary pattern on cardiovasculardisease (CVD) risk factors but clinical trial evidence is more limited.To determine
Transition from metabolically benign to metabolically unhealthy obesity and 10-year cardiovasculardisease incidence: the ATTICA cohort study Metabolically benign obesity remains a scientific field of considerable debate. The aim of the present work was to evaluate whether metabolically healthy obese (MHO) status is a transient condition which propagates 10-year cardiovasculardisease (CVD) onset.A prospective longitudinal study was conducted during 2001-2012, the ATTICA study studying 1514
Predicting Bleeding Risk to Guide Aspirin Use for the Primary Prevention of CardiovascularDisease: A Cohort Study. Many prognostic models for cardiovascular risk can be used to estimate aspirin's absolute benefits, but few bleeding risk models are available to estimate its likely harms.To develop prognostic bleeding risk models among persons in whom aspirin might be considered for the primary prevention of cardiovasculardisease (CVD).Prospective cohort study.New Zealand primary care.The study (...) models included the following predictors: demographic characteristics (age, ethnicity, and socioeconomic deprivation), clinical measurements (systolic blood pressure and ratio of total-high-density lipoprotein cholesterol), family history of premature CVD, medical history (smoking, diabetes, bleeding, peptic ulcer disease, cancer, chronic liver disease, chronic pancreatitis, or alcohol-related conditions), and medication use (nonsteroidal anti-inflammatory agents, corticosteroids, and selective
Fish oil supplements do not reduce cardiovascular deaths in people with diabetes without existing vascular disease Fish oil supplements lack heart benefits in diabetes without existing vascular disease Discover Portal Discover Portal Fish oil supplements do not reduce cardiovascular deaths in people with diabetes without existing vascular disease Published on 4 December 2018 doi: Omega-3 fatty acid supplements make no difference to cardiovascular outcomes in people with diabetes but without (...) established cardiovasculardisease. Serious vascular events like heart attack, stroke or deaths from these occurred in about 10% of people regardless of whether they took daily omega-3 or placebo capsules for seven years. The ASCEND study is a large UK trial assessing primary cardiovascular prevention for people with any type of diabetes. A companion publication assesses the use of aspirin. The results are consistent with a recent large Cochrane review assessing omega-3 fatty acids in any population
The effect of glycemic control on cardiovasculardisease in individuals with type 2 diabetes with pre-existing cardiovasculardisease - a systematic review and meta-analysis The role of intensive glucose control in people with type 2 diabetes and pre-existing cardiovasculardisease (CVD) is controversial. The aim of this systematic review and meta-analysis was to determine in a subset of people with type 2 diabetes and pre-existing CVD, the CV effect of intensive glucose control versus standard
Association of Genetic Variants Related to Gluteofemoral vs Abdominal Fat Distribution With Type 2 Diabetes, Coronary Disease, and Cardiovascular Risk Factors. Body fat distribution, usually measured using waist-to-hip ratio (WHR), is an important contributor to cardiometabolic disease independent of body mass index (BMI). Whether mechanisms that increase WHR via lower gluteofemoral (hip) or via higher abdominal (waist) fat distribution affect cardiometabolic risk is unknown.To identify genetic (...) cholesterol, triglycerides, fasting glucose, fasting insulin, type 2 diabetes, and coronary disease risk (follow-up analyses).Among 452 302 UK Biobank participants of European ancestry, the mean (SD) age was 57 (8) years and the mean (SD) WHR was 0.87 (0.09). In genome-wide analyses, 202 independent genetic variants were associated with higher BMI-adjusted WHR (n = 660 648) and unadjusted WHR (n = 663 598). In dual-energy x-ray absorptiometry analyses (n = 18 330), the hip- and waist-specific polygenic
Finding the Balance Between Benefits and Harms When Using Statins for Primary Prevention of CardiovascularDisease: A Modeling Study. Many guidelines use expected risk for cardiovasculardisease (CVD) during the next 10 years as a basis for recommendations on use of statins for primary prevention of CVD. However, how harms were considered and weighed against benefits is often unclear.To identify the expected risk above which statins provide net benefit.Quantitative benefit-harm balance modeling
Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial. Primary prevention of cardiovasculardisease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves (...) prevention.Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovasculardisease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound
Interim Guidance: Aspirin Use to Prevent CardiovascularDisease and Colorectal Cancer 1 Aspirin Use to Prevent CardiovascularDisease and Colorectal Cancer Interim Guidance from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group October 5, 2018 Three randomized clinical trials (ARRIVE 1 , ASCEND 2 , and ASPREE 3 ) recently published results on aspirin use in patients without known Atherosclerotic CardiovascularDisease (ASCVD). The studies looked at benefits (...) among blacks and Hispanics in the United States) to 100 mg aspirin or placebo. The primary outcome was a composite of death, dementia, or persistent physical disability. Secondary outcomes included major hemorrhage and cardiovasculardisease (defined as fatal coronary heart disease, nonfatal myocardial infarction, fatal or nonfatal stroke, or hospitalization for heart failure). The rate of cardiovasculardisease was 10.7 events per 1000 person-years in the aspirin group vs.11.3 events per 1000
Omega-3 fatty acids for the primary and secondary prevention of cardiovasculardisease. Researchers have suggested that omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this.To assess effects (...) , high-quality evidence), cardiovascular mortality (RR 0.95, 95% CI 0.87 to 1.03, 67,772 participants; 4544 CVD deaths in 25 RCTs), cardiovascular events (RR 0.99, 95% CI 0.94 to 1.04, 90,378 participants; 14,737 people experienced events in 38 trials, high-quality evidence), coronary heart disease (CHD) mortality (RR 0.93, 95% CI 0.79 to 1.09, 73,491 participants; 1596 CHD deaths in 21 RCTs), stroke (RR 1.06, 95% CI 0.96 to 1.16, 89,358 participants; 1822 strokes in 28 trials) or arrhythmia (RR 0.97
Omega-6 fats for the primary and secondary prevention of cardiovasculardisease. Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovasculardisease (CVD) risk is debated.To assess effects of increasing omega-6 fats (linoleic acid (LA), gamma-linolenic acid (GLA), dihomo-gamma-linolenic acid (DGLA) and arachidonic acid (AA)) on CVD and all-cause mortality.We searched CENTRAL, MEDLINE and Embase to May 2017 and clinicaltrials.gov and the World (...) make little or no difference to all-cause mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.88 to 1.12, 740 deaths, 4506 randomised, 10 trials) or CVD events (RR 0.97, 95% CI 0.81 to 1.15, 1404 people experienced events of 4962 randomised, 7 trials). We are uncertain whether increasing omega-6 fats affects CVD mortality (RR 1.09, 95% CI 0.76 to 1.55, 472 deaths, 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997
Polyunsaturated fatty acids for the primary and secondary prevention of cardiovasculardisease. Evidence on the health effects of total polyunsaturated fatty acids (PUFA) is equivocal. Fish oils are rich in omega-3 PUFA and plant oils in omega-6 PUFA. Evidence suggests that increasing PUFA-rich foods, supplements or supplemented foods can reduce serum cholesterol, but may increase body weight, so overall cardiovascular effects are unclear.To assess effects of increasing total PUFA intake (...) on cardiovasculardisease and all-cause mortality, lipids and adiposity in adults.We searched CENTRAL, MEDLINE and Embase to April 2017 and clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform to September 2016, without language restrictions. We checked trials included in relevant systematic reviews.We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults with or without cardiovasculardisease that assessed effects over 12
Ezetimibe for the prevention of cardiovasculardisease and all-cause mortality events. Cardiovasculardisease (CVD) remains an important cause of mortality and morbidity, and high levels of blood cholesterol are thought to be the major modifiable risk factors for CVD. The use of statins is the preferred treatment strategy for the prevention of CVD, but some people at high-risk for CVD are intolerant to statin therapy or unable to achieve their treatment goals with the maximal recommended doses (...) for beneficial effects was mainly obtained from individuals with established atherosclerotic cardiovasculardisease (ASCVD, predominantly with acute coronary syndrome) administered ezetimibe plus statins. However, there is limited evidence regarding the role of ezetimibe in primary prevention and the effects of ezetimibe monotherapy in the prevention of CVD, and these topics thus requires further investigation.
The Role of Physical Activity Prescription in CardiovascularDisease Prevention Amongst South Asian Canadians Unequivocal evidence suggests an increased prevalence of cardiovasculardisease (CVD) amongst South Asian Canadians (SACs) compared to other ethnic cohorts, due to a combination of their unique cardiometabolic profile and environmental factors. This unfavorable CVD profile is characterized by an elevated risk of dyslipidemia, high apolipoprotein B/apolipoprotein A1 ratio, hypertension (...) environments, and their high prevalence of debilitating chronic diseases. Several strategies to improve PA participation rates in this high-risk population have been suggested, and include the implementation of culturally sensitive PA interventions, as well as clinician training in PA prescription through workshops that emphasize knowledge translation into clinical practice. Therefore, the purpose of this mini-review is to highlight and discuss: (1) the burden of heart disease in SACs (2
Vitamin D Supplements and Prevention of Cancer and CardiovascularDisease. It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovasculardisease, and data from randomized trials are limited.We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer (...) and cardiovasculardisease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.A total of 25,871 participants, including
Marine n-3 Fatty Acids and Prevention of CardiovascularDisease and Cancer. Higher intake of marine n-3 (also called omega-3) fatty acids has been associated with reduced risks of cardiovasculardisease and cancer in several observational studies. Whether supplementation with n-3 fatty acids has such effects in general populations at usual risk for these end points is unclear.We conducted a randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (at a dose (...) of 2000 IU per day) and marine n-3 fatty acids (at a dose of 1 g per day) in the primary prevention of cardiovasculardisease and cancer among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes) and invasive cancer of any type. Secondary end points included individual components of the composite cardiovascular end point, the composite
Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovasculardiseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs
Association of Blood Pressure Classification in Korean Young Adults According to the 2017 American College of Cardiology/American Heart Association Guidelines With Subsequent CardiovascularDisease Events. Among young adults, the association of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) High Blood Pressure Clinical Practice Guidelines with risk of cardiovasculardisease (CVD) later in life is uncertain.To determine the association of blood pressure categories (...) person-years [95% CI, 11-18]; adjusted HR, 1.16 [95% CI, 1.08-1.25]), and stroke (incidence, 79 vs 51 per 100 000 person-years; difference, 28 per 100 000 person-years [95% CI, 24-32]; adjusted HR [1.37, 95% CI, 1.29-1.46]). Results for state 2 hypertension were consistent.Among Korean young adults, stage 1 and stage 2 hypertension, compared with normal blood pressure, were associated with increased risk of subsequent cardiovasculardisease events. Young adults with hypertension, defined by the 2017
Evolocumab (Repatha) - In adults with established atherosclerotic cardiovasculardisease (myocardial infarction, stroke or peripheral arterial disease) Published 12 November 2018 Statement of advice SMC2133 evolocumab 140mg solution for injection in pre-filled syringe / 140mg solution for injection in pre-filled pen / 420mg solution of injection in cartridge (Repatha®) Amgen Ltd 5 October 2018 ADVICE: in the absence of a submission from the holder of the marketing authorisation evolocumab (...) (Repatha®) is not recommended for use within NHSScotland. Indication under review: In adults with established atherosclerotic cardiovasculardisease (myocardial infarction, stroke or peripheral arterial disease) to reduce cardiovascular risk by lowering LDL-C levels, as an adjunct to correction of other risk factors: ? in combination with the maximum tolerated dose of a statin with or without other lipid- lowering therapies or, ? alone or in combination with other lipid-lowering therapies in patients