Latest Research
Accuracy of Clinic and Home BP Measurements Questioned
August 18, 2011 at 2:05 pm
A systematic review and meta-analysis in the latest BMJ has compared clinic and home-based BP measurements with daytime ambulatory readings. A mean clinic BP of >140/90 had a sensitivity of only 75% and a specificity of 75% for diagnosing hypertension, while a mean home BP of >135/85 had a sensitivity of 85% and a specificity of 62%.
The accuracy of the clinic measurement increased as the patients aged.
Hodgkinson J, et al. BMJ 2011 Jun 24; 342: d3621
Cardiac Screening of Athletes - A Lifesaver?
April 1, 2011 at 2:37 pm
Sudden death on the field tends to make the news and has led calls from some quarters for mandatory screening procedures such as ECGs and stress testing for participants in sporting activities.
A study has compared the incidence of sudden cardiac death in athletes in Israel during the 12 years before mandatory screening with the incidence during the 12 years afterward.
The researchers found no significant difference in sudden cardiac death between the two periods.
Steinvil A, et al. J Am Coll Cardiol 2011; 57: 1291
Bystander CPR – Chest Compression Alone or Full CPR?
August 18, 2010 at 10:22 am
One of the barriers to bystander CPR is the expired air resuscitation component. So it is important to assess comparisons between chest compressions alone and full CPR with regards to survival to hospital discharge.
Researchers did this by randomizing emergency calls for cardiac arrest to either chest compression only or conventional CPR in Washington and London.
There were no significant differences between the two groups with respect to survival to hospital discharge or favourable neurological status at discharge.
This simpler technique may increase the prevalence of bystander CPR.
Rea TD, et al. N Engl J med 2010;363:423
Allopurinol May Be Useful In Chronic Stable Angina
July 15, 2010 at 1:24 pm
UK investigators tested the assumption that allopurinol lowers myocardial oxygen consumption by adding the drug to the usual baseline medications for 6 weeks against placebo and then crossing the groups over to the other treatment for a further 6 weeks.
Allopurinol recipients showed significantly longer mean total exercise time, mean time to symptoms and mean time to ST depression compared with placebo recipients on exercise stress testing which was performed after each arm of the study.
The authors speculated that allopurinol may reduce oxidative stress, making more oxygen available to ischaemic myocardium.
Noman A. Lancet 2010 Jun 19; 375: 2161
Keep Meat Unprocessed to Protect the Heart
June 21, 2010 at 10:43 am
A meta-analysis of observational data has shown the consumption of processed red meat increases the risk of coronary heart disease by 42%, whereas the consumption of unprocessed red meat is not associated with CHD.
Neither type of red meat was associated with increased risk of stroke.
It is thought the relatively high salt and preservative content of processed meat may be a contributing factor to its association with CHD.
Micha R. Circulation 2010 June1; 121: 2271
Fibrates and the Risk for Coronary Events
May 25, 2010 at 8:27 am
According to a meta-analysis in the Lancet, fibrates appear to lower the risk for coronary events. Using data from 18 placebo-controlled trials, involving 45,000 adults, the authors found coronary events were significantly less common in patients taking fibrates than in those on placebo (8.7% versus 11.6%).
The trials included fibrates for both primary and secondary prevention. Fibrates were also associated with significant reductions in coronary revascularization, progression of albuminuria and retinopathy.
Jun M, eta l. Lancet 11 May 2010 doi:10.1016/S0140-6736(10)60656-3
A Promising New Agent To Lower Lipid Levels
March 25, 2010 at 9:15 am
Many patients remain at high risk of cardiovascular events despite being treated with a statin.
It has been known that thyroid hormone has beneficial effects regarding lowering of lipid levels, but up until now adverse effects have proven to be a barrier to the development of effective thyromimetic medications.
A study published in the NEJM showed benefits from taking the thyroid hormone analogue eprotirome in addition to either simvastatin or atorvastatin, with substantially reduced LDL levels.
The medication appeared to be well tolerated.
Whether these reductions in LDL translate into decreased cardiac events remains to be seen.
Ladenson PW, et al. N Engl J Med 2010; 11; 362: 906
http://content.nejm.org/cgi/content/full/362/10/906?linkType=FULL&resid=362/10/906&journalCode=nejm
Updated Guidelines from ACC/AHA
November 20, 2009 at 2:14 pm
The American College of Cardiology and the American Heart Association have released updated guidelines on managing patients with STEMI and those undergoing percutaneous coronary intervention.
The guidelines are based on studies published since 2007.
One of the items of interest is the lack of official recommendation regarding the use of dual antiplatelet therapy with proton pump inhibitors, due to a lack of evidence.
Kushner FG et al. J Am Coll Cardiol; doi: 10.1016/j.jacc.2009.10.015
http://content.onlinejacc.org/cgi/content/full/j.jacc.2009.10.015v1
Adherence to Antihypertensive Medications Lowers CV Risk
November 20, 2009 at 2:07 pm
An Italian study involving nearly 19,000 patients has confirmed what many clinicians have suspected – that adherence to antihypertensive medications lowers the risk for CV disease.
High adherers had significantly lower risk for CV disease than low adherers (hazard ratio 0.62). Factors associated with higher adherence included diabetes, dyslipidaemia, obesity and surprisingly multiple drug therapies.
Mazzaglia G, et al. Circulation 2009; 120: 1598
Statin therapy reduces risk of gallstones
November 11, 2009 at 3:52 pm
Another benefit of statin therapy seems to be their ability to protect patients against developing gallstones.
A study published in the JAMA found that long-term statin users were about 40% less likely to develop gallstones requiring cholecystectomy compared to those who had never used statins.
Short-term statin use (between 1 and 4 scripts) was associated with a 15% reduction in the risk of requiring cholecystectomy.
Bodmer M, et al. JAMA 2009; 301: 2001-7
http://jama.ama-assn.org/cgi/content/short/302/18/2001?home
