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Preventive CVD

Peter Ueda, Thomas Wai-Chun Lung, Yuan Lu, Joshua A Salomon, Kazem Rahimi, Philip Clarke, Goodarz Danaei
BACKGROUND: The updated national guidelines for cardiovascular risk assessment and lipid modification in the UK and US expand the indications for statin therapy in primary prevention to adults with moderate risk of cardiovascular disease (CVD) but many adults at high CVD risk remain untreated in both countries. We set out to identify treatment gaps in English and American adults at moderate and high risk of cardiovascular disease (CVD), and to estimate the number of CVD events that would be prevented from expanding statin therapy to those who are currently untreated...
2018: PloS One
Lidia Capotosto, Francesco Massoni, Simone De Sio, Serafino Ricci, Antonio Vitarelli
Cardiovascular disease (CVD) still remains the main cause of morbidity and mortality and consequently early diagnosis is of paramount importance. Working conditions can be regarded as an additional risk factor for CVD. Since different aspects of the job may affect vascular health differently, it is important to consider occupation from multiple perspectives to better assess occupational impacts on health. Standard echocardiography has several targets in the cardiac population, as the assessment of myocardial performance, valvular and/or congenital heart disease, and hemodynamics...
2018: BioMed Research International
Rasha Babiker, Khalifa Elmusharaf, Michael B Keogh, Amal M Saeed
BACKGROUND: There is a strong association between cardiometabolic risk and adipose tissue dysfunction with great consequences on type 2 diabetic patients. Visceral Adiposity Index (VAI) is an indirect clinical marker of adipose tissue dysfunction. Gum Arabic (GA) is a safe dietary fiber, an exudate of Acacia Senegal. Gum Arabic had shown lipid lowering effect in both humans and animals. The aim of this trial was to determine the effect of GA supplementation on anthropometric obesity marker, Visceral Adiposity Index (VAI) and blood pressure in patients with type 2 diabetes mellitus...
March 20, 2018: Lipids in Health and Disease
Kunal N Karmali, Donald M Lloyd-Jones, Joep van der Leeuw, David C Goff, Salim Yusuf, Alberto Zanchetti, Paul Glasziou, Rodney Jackson, Mark Woodward, Anthony Rodgers, Bruce C Neal, Eivind Berge, Koon Teo, Barry R Davis, John Chalmers, Carl Pepine, Kazem Rahimi, Johan Sundström
BACKGROUND: Clinical practice guidelines have traditionally recommended blood pressure treatment based primarily on blood pressure thresholds. In contrast, using predicted cardiovascular risk has been advocated as a more effective strategy to guide treatment decisions for cardiovascular disease (CVD) prevention. We aimed to compare outcomes from a blood pressure-lowering treatment strategy based on predicted cardiovascular risk with one based on systolic blood pressure (SBP) level. METHODS AND FINDINGS: We used individual participant data from the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC) from 1995 to 2013...
March 2018: PLoS Medicine
Kevin C Maki, Mary R Dicklin
PURPOSE OF REVIEW: The aims of this review are to provide perspective on evaluation of relative and absolute cardiovascular disease (CVD) risk reductions for assessing the efficacy of preventive therapies and to summarize methods for evaluation of CVD risk in clinical practice. RECENT FINDINGS: Major CVD risk factors can be used to stratify patients into risk categories. Results from recent trials reinforce the view that benefits of preventive therapies will be greatest in those with the highest absolute risk and in those with the most severe disturbance in the risk factor targeted...
March 20, 2018: Current Atherosclerosis Reports
Chau Le Bao Ho, Monique Breslin, Jenny Doust, Christopher M Reid, Mark R Nelson
OBJECTIVES: In many current guidelines, blood pressure (BP)-lowering drug treatment for primary prevention of cardiovascular disease (CVD) is based on absolute risk. However, in clinical practice, therapeutic decisions are often based on BP levels alone. We sought to investigate which approach was superior by conducting a post hoc analysis of the Australian National Blood Pressure (ANBP) cohort, a seminal study establishing the efficacy of BP lowering in 'mild hypertensive' persons. DESIGN: A post hoc subgroup analysis of the ANBP trial results by baseline absolute risk tertile...
March 19, 2018: BMJ Open
Ruifang Dong, Zhiling Dong, Hongmei Liu, Fangkun Shi, Junfeng Du
BACKGROUND: Obstructive sleep apnea (OSA) is known to increase the risk of cerebrovascular disease (CVD), and patients with CVD have high incidence of OSA. The study aimed to systematically evaluate the prevalence of OSA in patients with CVD. MATERIALS AND METHODS: Medline, Embase, Science Citation Index, Wanfang, CNKI, and Wiley Online Library were thoroughly searched to identify relevant studies. Random-effects models were used to calculate the pooled rate estimates...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Koon Teo, Salim Yusuf
The cardiovascular polypill or fixed dose combination pill, consisting of three, four or more drugs in a single tablet (or capsule), has been proposed as an effective and convenient therapy in both secondary and primary prevention of cardiovascular disease (CVD). Each of the drugs in the combination has a documented ability to prevent CVD events. The combined effect has been estimated to reduce risk by 75% to 80%.Since the concept was introduced 15 years ago, several polypills are available and their effects on risk factors evaluated...
March 15, 2018: American Journal of Hypertension
Meng Xin, Yang Sun, Haijiao Chen, Quancai Li, Yunlou Dun, Huashi Guan, Jiejie Hao, Chunxia Li
Cardiovascular disease (CVD) is the No. 1 cause of death worldwide. Hyperlipidemia is one of the major risk factors for CVD. Maintaining lipid homeostasis is an effective way to prevent CVD. We prepared propylene glycol guluronate sulfate (PGGS), a sulfated polysaccharide, and investigated its effect on lipid metabolism in HepG2 cells. We found that total cholesterol (TC) and triglycerides (TG) were significantly decreased in the cells after PGGS treatment. We have also shown that the AMPK signaling is activated after PGGS treatment as evidenced by changes in the expression of many AMPK downstream targets including SREBP-1c, SIRT-1, CPT1, PPARα, and FAS...
March 15, 2018: International Journal of Biological Macromolecules
Hayley E Billingsley, Salvatore Carbone
Cardiovascular disease (CVD) is the leading global cause of death. Diet is known to be important in the prevention of CVD. The PREDIMED trial tested a relatively low-fat diet versus a high-fat Mediterranean diet (MedDiet) for the primary prevention of CVD. The resulting reduction of the CV composite outcome resulted in a paradigm shift in CV nutrition. Though many dietary factors likely contributed to this effect, this review focuses on the influence of the MedDiet on endogenous antioxidant systems and the effect of dietary polyphenols...
March 9, 2018: Nutrition & Diabetes
Matthew J Gurka, Stephanie L Filipp, Mark D DeBoer
Cardiovascular disease (CVD) and type 2 diabetes remain significant public health concerns. Targeting of prevention efforts by geographical location has been suggested by the Institute of Medicine to coincide with the presence of area-based risk. The metabolic syndrome (MetS) is a stronger risk factor than is obesity for the prediction of future CVD and diabetes, yet its prevalence has not previously been described geographically. Our objective is to determine geographical variation in the prevalence of obesity, MetS, and diabetes among US adults...
March 13, 2018: Nutrition & Diabetes
Ayesha Fawad, Andreas Bergmann, Joachim Struck, Peter M Nilsson, Marju Orho-Melander, Olle Melander
Context: The gut hormone neurotensin promotes fat absorption, diet-induced weight gain and liver steatosis. Its stable precursor-hormone fragment "proneurotensin" predicts cardiometabolic disease in middle-aged populations, especially in women. Objective: To test if proneurotensin predicts cardiovascular disease (CVD) and diabetes development in an elderly population and whether there are gender differences in this respect. Design, Setting and Participants: Fasting proneurotensin was measured in plasma from 4804 participants (mean age 69±6 years) of the Malmö Preventive Project (MPP) and subjects were followed up for development of CVD and diabetes during 5...
March 13, 2018: Journal of Clinical Endocrinology and Metabolism
Catriona Crossan, Hakim-Moulay Dehbi, Hilarie Williams, Neil Poulter, Anthony Rodgers, Stephen Jan, Simon Thom, Joanne Lord
INTRODUCTION: The 'Use of a Multi-drug Pill in Reducing cardiovascular Events' (UMPIRE) trial was a randomised controlled clinical trial evaluating the impact of a polypill strategy on adherence to indicated medication in a population with established cardiovascular disease (CVD) of or at high risk thereof. The aim of Researching the UMPIRE Processes for Economic Evaluation in the National Health Service (RUPEE NHS) is to estimate the potential health economic impact of a polypill strategy for CVD prevention within the NHS using UMPIRE trial and other relevant data...
March 14, 2018: BMJ Open
Anum Saeed, Vijay Nambi, Wensheng Sun, Salim S Virani, George Taffet, Anita Deswal, Elizabeth Selvin, Kunihiro Matsushita, Lynne E Wagenknecht, Ron Hoogeveen, Josef Coresh, James A de Lemos, Christie M Ballantyne
BACKGROUND: Current prevention guidelines recommend using the Pooled Cohort Equation (PCE) for 10-year atherosclerotic cardiovascular disease (CVD) risk assessment. However, the PCE has serious limitations in older adults: it excludes heart failure (HF) hospitalization, estimates 10-year risk which may not be the most relevant time frame, and is not indicated for individuals aged >79 years. OBJECTIVES: To determine whether adding biomarkers to PCE variables improves global CVD (coronary heart disease [CHD], stroke, and HF) risk prediction in older adults over a shorter time period...
March 3, 2018: Journal of the American College of Cardiology
Chaitanya Gopalrao Chinawale, Dipak V Parmar, Parth Kavathia, Twinkle Rangnani, Jainy Thakkar, Girija Kartha
Background: The metabolic syndrome (MetS) is a complex disorder and a major health concern in developing countries. Data on MetS in Indian population show multiplicity. There are no published reports about the prevalence of MetS in population of Saurashtra region, Gujarat. The aim of this study is to assess the prevalence of MetS and its components in adult population of this region. Methods: This cross-sectional observational study was carried out among 473 participants who attended free health checkup camps...
January 2018: Indian Journal of Community Medicine
Samantha Sabo, Catalina Denman Champion, Melanie L Bell, Elsa Cornejo Vucovich, Maia Ingram, Celina Valenica, Maria Del Carmen Castro Vasquez, Eduardo Gonzalez-Fagoaga, Jill Geurnsey de Zapien, Cecilia B Rosales
INTRODUCTION: Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. METHODS AND ANALYSIS: The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomised clinical behavioural trial based in 22 (n=22) health centres in Sonora, Mexico...
March 12, 2018: BMJ Open
Sedigheh Asgary, Ali Rastqar, Mahtab Keshvari
Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Lifestyle factors, including nutrition, play an important role in the etiology and treatment of CVD. Functional foods based on their basic nutritional functions can decrease the risk of many chronic diseases and have some physiological benefits. They contain physiologically active components either from plant or animal sources, marketed with the claim of their ability to reduce heart disease risk, focusing primarily on established risk factors, which are hyperlipidemia, diabetes, metabolic syndrome, obesity/overweight, elevated lipoprotein A level, small dense low-density lipoprotein cholesterol (LDL-C), and elevated inflammatory marker levels...
March 12, 2018: Journal of the American College of Nutrition
Lutz E Kraushaar, Alexander Dressel, Alexander Maßmann
Undetected high risk for premature death of cardiovascular disease (CVD) among individuals with low-to-moderate risk factor scores is an acknowledged obstacle to CVD prevention. The vasculature's functional robustness against risk factor derailment may serve as a novel discriminator of mortality risk under similar risk factor loads. To test this assumption, we hypothesized that the expected inverse robustness-mortality association is verifiable as a significant trend along the age spectrum of risk factor-challenged cohorts...
March 2018: Preventive Medicine Reports
Xiaolei Xie, Tianhua He, Jian Kang, David S Siscovick, Yan Li, José A Pagán
China has the largest population of adults with hypertension in the world. Recent clinical trials have shown that intensive hypertension control can help patients achieve lower blood pressure and reduce the incidence of major cardiovascular disease (CVD) events, but this level of hypertension control also incurs additional costs to patients and society and may result in a substantial increase in adverse events. The objective of this study is to assess the cost-effectiveness of intensive hypertension control to inform health policymakers and health care delivery systems in China in their decision-making regarding hypertension treatment strategies...
March 8, 2018: Preventive Medicine
Robert A Phillips, Jiaqiong Xu, Leif E Peterson, Ryan M Arnold, Joseph A Diamond, Adam E Schussheim
BACKGROUND: The lower rate of primary outcome events in the intensive treatment group in SPRINT (Systolic Pressure Intervention Trial) was associated with increased clinically significant serious adverse events (SAEs). In 2017, the American College of Cardiology and American Heart Association issued risk-based blood pressure treatment guidelines. The authors hypothesized that stratification of the SPRINT population by degree of future cardiovascular disease (CVD) risk might identify a group which could benefit the most from intensive treatment...
March 2, 2018: Journal of the American College of Cardiology
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