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Latest & greatest articles for cardiovascular disease
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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 Dissemination Centre Discover Portal NIHR DC Discover 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
Cardiovascular Risk Reduction in Patients with Type 2 Diabetes and Atherosclerotic CardiovascularDisease EXPERT CONSENSUS DECISION PATHWAY 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic CardiovascularDisease A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways Endorsed by the American Diabetes Association Writing Committee Sandeep R. Das, MD, MPH (...) citedasfollows:Das SR,EverettBM,BirtcherKK,BrownJM,CefaluWT,Januzzi JL Jr, Rastogi Kalyani R, Kosiborod M, Magwire ML, Morris PB, Sperling LS. 2018 ACC expert consensus decision pathway on novel therapies for car- diovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovasculardisease: a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2018;XX:XXX–XXX. Copies:Thisdocumentisavailableonthewebsite oftheAmericanCollegeof
Cardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic CardiovascularDiseaseCardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic CardiovascularDisease Kaiser Permanente Research Affiliates Evidence-based Practice Center Corinne Evans, MPP; Nicholas Emptage, MAE; Megan Rushkin, MPH; and Jennifer S. Lin, MD, MCR Summary Question 1. In persons (...) with type 2 diabetes with or without known atherosclerotic cardiovasculardisease (ASCVD) who cannot attain adequate glucose control with metformin, what is the benefit of GLP-1 agonists or SGLT-2 inhibitors on cardiovascular morbidity and mortality? • Evidence of benefit in persons with known ASCVD on cardiovasculardisease (CVD) outcomes, CVD mortality and all-cause mortality (ACM) o Based on limited evidence in persons without ASCVD, no evidence of benefit on CVD outcomes • Presumed class effect of benefit
Association of Genetic Variants Related to Gluteofemoral vs Abdominal Fat Distribution With Type 2 Diabetes, Coronary Disease, and Cardiovascular Risk Factors. Importance: 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 (...) measured by dual-energy x-ray absorptiometry, systolic and diastolic blood pressure, low-density lipoprotein cholesterol, triglycerides, fasting glucose, fasting insulin, type 2 diabetes, and coronary disease risk (follow-up analyses). Results: 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
Finding the Balance Between Benefits and Harms When Using Statins for Primary Prevention of CardiovascularDisease: A Modeling Study. Background: 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. Objective: To identify the expected risk above which statins provide net benefit. Design
Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial. BACKGROUND: 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. METHODS: 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
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. BACKGROUND: 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 (...) of increasing LCn3 on all-cause mortality (RR 0.98, 95% CI 0.90 to 1.03, 92,653 participants; 8189 deaths in 39 trials, 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
Omega-6 fats for the primary and secondary prevention of cardiovasculardisease. BACKGROUND: Omega-6 fats are polyunsaturated fats vital for many physiological functions, but their effect on cardiovasculardisease (CVD) risk is debated. OBJECTIVES: 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. SEARCH METHODS: We searched CENTRAL, MEDLINE and Embase to May (...) , 4019 randomised, 7 trials), coronary heart disease events (RR 0.88, 95% CI 0.66 to 1.17, 1059 people with events of 3997 randomised, 7 trials), major adverse cardiac and cerebrovascular events (RR 0.84, 95% CI 0.59 to 1.20, 817 events, 2879 participants, 2 trials) or stroke (RR 1.36, 95% CI 0.45 to 4.11, 54 events, 3730 participants, 4 trials), as we assessed the evidence as being of very low quality. We found no evidence of dose-response or duration effects for any primary outcome
Polyunsaturated fatty acids for the primary and secondary prevention of cardiovasculardisease. BACKGROUND: 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. OBJECTIVES: To assess effects of increasing (...) total PUFA intake on cardiovasculardisease and all-cause mortality, lipids and adiposity in adults. SEARCH METHODS: 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. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing higher with lower PUFA intakes in adults
Ezetimibe for the prevention of cardiovasculardisease and all-cause mortality events. BACKGROUND: 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 (...) whether ezetimibe increases the risk of adverse events due to the low and very low quality of the evidence. The evidence 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
The Role of Physical Activity Prescription in CardiovascularDisease Prevention Amongst South Asian Canadians 30488037 2018 11 29 2297-055X 5 2018 Frontiers in cardiovascular medicine Front Cardiovasc Med The Role of Physical Activity Prescription in CardiovascularDisease Prevention Amongst South Asian Canadians. 165 10.3389/fcvm.2018.00165 Unequivocal evidence suggests an increased prevalence of cardiovasculardisease (CVD) amongst South Asian Canadians (SACs) compared to other ethnic cohorts (...) 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) the cardiovascular benefits of PA for SACs; (3) factors affecting PA participation among SACs and how they can be addressed; (4) the impact of culturally sensitive PA prescription on CVD prevention; (5) barriers to culture-specific PA prescription by clinicians, and strategies
Vitamin D Supplements and Prevention of Cancer and CardiovascularDisease. BACKGROUND: It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovasculardisease, and data from randomized trials are limited. METHODS: We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D 3 (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. RESULTS
Marine n-3 Fatty Acids and Prevention of CardiovascularDisease and Cancer. BACKGROUND: 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. METHODS: We conducted a randomized, placebo-controlled trial, with a two-by-two factorial design (...) , of vitamin D 3 (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
Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases 30483414 2018 11 28 2059-7908 3 Suppl 3 2018 BMJ global health BMJ Glob Health Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases. e001092 10.1136/bmjgh-2018-001092 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 for the management of hypertension. We report the lessons learnt from the field. From each of the studies, we obtained information on the types of tasks shifted, the professional level from which the task was shifted, the training provided and the challenges faced. Additionally, we collected more
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. Importance: 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. Objective: To determine the association (...) pressure, were associated with increased risk of subsequent cardiovasculardisease events. Young adults with hypertension, defined by the 2017 ACC/AHA criteria, may be at increased risk of cardiovasculardisease.
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
Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic CardiovascularDisease Risk Calculator 30354651 2018 10 25 1524-4539 138 17 2018 Oct 23 Circulation Circulation Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic CardiovascularDisease Risk Calculator. 1819-1827 10.1161/CIRCULATIONAHA.118.033505 Coronary artery calcium (CAC) is a powerful novel risk indicator for atherosclerotic cardiovascular (...) disease (ASCVD). Currently, there is no available ASCVD risk prediction tool that integrates traditional risk factors and CAC. To develop a CAC ASCVD risk tool for younger individuals in the general population, subjects aged 40 to 65 without prior cardiovasculardisease from 3 population-based cohorts were included. Cox proportional hazards models were developed incorporating age, sex, systolic blood pressure, total and high-density lipoprotein cholesterol, smoking, diabetes mellitus, hypertension
Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention: JACC Health Promotion Series 30286928 2018 10 05 1558-3597 72 15 2018 Oct 09 Journal of the American College of Cardiology J. Am. Coll. Cardiol. Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention: JACC Health Promotion Series. 1829-1844 S0735-1097(18)36953-5 10.1016/j.jacc.2018.07.081 The primary objective of this study was to analyze the most up-to-date evidence regarding whether (...) and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review. Three separate, systematic literature searches identified 2,343 papers in total. Overall, 44 studies were included for data extraction and analysis. The included systematic reviews and meta-analyses published between January 1, 2016, and December 31, 2017, were of good to very good quality (median Overview Quality Assessment Questionnaire score = 17). Identified evidence
Prevalence, Mortality, and Indicators of Health Care Supplyâ€”Association Analysis of CardiovascularDiseases in Germany 30425992 2018 12 07 2297-055X 5 2018 Frontiers in cardiovascular medicine Front Cardiovasc Med Prevalence, Mortality, and Indicators of Health Care Supply-Association Analysis of CardiovascularDiseases in Germany. 158 10.3389/fcvm.2018.00158 Introduction: There are regional differences in the morbidity of major cardiovasculardisease between the 16 federal states of Germany (...) . An association between the morbidity and the health care supply has been described in international studies. The aim of the present analysis was to examine the relationship between the prevalence or mortality of major cardiovasculardisease and several key indicators of health care supply in Germany. Methods: Life expectancy and the proportion of over 65-year old persons were included as characteristics to depict the general health. Indicators of health care supply were the number of general practitioners