Primary care-based dietary and lifestyle intervention leads to remission of T2DM

Literature 11-12-2017 • Lean MEJ et al., The Lancet 2017
The randomised DIRECT trial evaluated a practical weight management program. On average, weigh reduced by 10 kg and almost half achieved and maintained remission of T2DM at 12 months after starting the intervention.

Higher risk of vascular dementia, but not Alzheimer’s disease, in post-MI patients

Literature 4-12-2017 • Sundbøll J et al., Circulation 2017
Patients with a history of MI have a higher risk of vascular dementia, particularly if they additionally have a history of stroke, probably due to common risk factors for both diseases.

ESC/EAS statin eligibility in primary prevention may be expanded to high TG levels

Literature 29-11-2017 • Madsen CM et al., Eur Heart J 2017
In a large population-based study, high TG levels identified individuals at high CVD risk, who would not be definite eligible for statin treatment according to the 2016 ESC/EAS guidelines.

Increased mortality risk if initiation of HF therapy is delayed

Literature 27-11-2017 • Zaman S et al., Eur J Heart Fail 2017
Deferral of therapy with ACE inhibitors, beta-blockers, and aldosterone antagonists for 1 year carries an absolute mortality risk of around 1% per month, which is higher than the mortality risk due to therapy mentioned in patient information leaflets.

Lower risk of Parkinson’s Disease seen with statin therapy

Literature 27-11-2017 • Poly TN et al., Neuroepidemiology 2017
In a meta-analysis of 13 observational studies, statin use was associated with a modest reduction in the risk of developing Parkinson’s Disease compared with not using statins.

Slow self-reported walking pace could be used for risk stratification

Literature 22-11-2017 • Yates T et al., Eur Heart J 2017
In the UK Biobank, a slow self-reported walking pace was associated with a higher risk of all-cause and CV mortality in women and men, particularly in those with a low BMI.

LDL-c lowering for primary prevention at high LDL-c may be initiated without risk assessment, according to WOSCOPS analysis

Literature 21-11-2017 • Vallejo-Vaz AJ et al., Circulation 2017
Men with LDL-c levels ≥190 mg/dL without atherosclerotic CVD, have a 2-fold higher risk of major CV events than would be predicted with a risk calculator.

Lower risk of dementia in AF patients treated with oral anticoagulation

Literature 15-11-2017 • Friberg L et al., Eur Heart J 2017
In a large retrospective cohort study, the risk of dementia was higher without oral anticoagulant treatment in patients with AF, compared with AF patients receiving oral anticoagulation.

Omega-3 carboxylic acids can benefit patients with severe hypertriglyceridemia

Literature 13-11-2017 • Stroes ESG et al., J Clin Lipidol 2017
Patients with SHTG treated with OM3-CA 2 g daily had a statistically significant reduction in TG and non-HDL-c concentrations compared with those treated with olive oil 2 g daily.

Cognitive dysfunction in diabetic patients partly explained by hyperglycemia

Literature 1-11-2017 • Geijselaers SLC et al., Diabetes Care 2017
Differences in cognitive performance between diabetic patients and individuals with normal glucose levels can be explained by hyperglycemia and by BP-related variables, but not by insulin resistance.

Rationale and effect of targeting IL-1beta to lower inflammation and thereby CV events

Literature 31-10-2017 • Libby P. J Am Coll Cardiol. 2017
This review summarizes the rationale to specifically target IL-1beta to lower residual inflammatory risk, now shown to be effective in the CANTOS trial. Other potential targets are also discussed.

Early lipid changes ≥5% during psychotropic therapy as a warning sign of future clinically relevant dyslipidemia

Literature 30-10-2017 • Delacrétaz A et al., J Clin Lipidol 2017
These data underscore the importance of prospectively monitoring lipid parameters in all patients starting psychotropic treatment, as these drugs may induce or exacerbate dyslipidemia.

Hypertension in midlife associated with higher risk of dementia in women

Literature 18-10-2017 • Gilsanz P et al., Neurology 2017
Although midlife hypertension is more common in men, it was only associated with the risk of dementia in women, suggesting that hypertension is a modifiable risk factor for dementia in women.

Lipid parameters vary depending on age and sex

Literature 16-10-2017 • Balder JW et al., J Clin Lipidol. 2017
Based on data of the large Dutch Lifelines cohort, reference values have been developed for lipid parameters.

More adverse events with generic ARBs compared with branded ARBs

Literature 13-10-2017 • Leclerc J et al., Circ Cardiovasc Qual Outcomes 2017
The use of generic ARBs resulted in higher rates of hospitalizations and emergency room consultations, particularly in the first month and with candesartan.

More atherosclerosis seen in those who skip breakfast

Literature 9-10-2017 • Uzhova I et al., J Am Coll Cardiol 2017
Skipping breakfast was associated with a higher risk of non-coronary and generalized atherosclerosis in a sample of asymptomatic individuals in thee prospective PESA study.

Diabetic patients at high CV risk benefit from intensive BP control

Literature 5-10-2017 • Buckley LF et al., Diabetes Care 2017
In a SPRINT-eligible ACCORD-BP population, a high-risk cohort of diabetic patients, intensive BP control at a goal of <120 mmHg, reduced CVD outcomes.

Non-statin LDL-lowering drug plus statin protects against stroke in post-ACS patients

Literature 3-10-2017 • Bohula EA et al., Circulation 2017
In the IMPROVE-IT study, the addition of ezetimibe to simvastatin in stabilized post-ACS patients reduced the frequency of ischemic stroke, particularly in patients with a history of prior stroke.

Discontinuation of long-term aspirin use for CVD prevention associated with higher CV risk

Literature 3-10-2017 • Sundström J et al., Circulation. 2017
The discontinuation of low-dose long-term aspirin use for CVD prevention in the absence of major surgery or bleeding, was associated with a >30% increased CV risk, shortly after discontinuation.

Benefit of physical activity to lower risk of mortality and CVD is seen worldwide

Literature 2-10-2017 • Lear SA et al. Lancet 2017
Physical activity is a low-cost approach to reduce deaths and CV disease that is applicable globally with a potential large impact.

Suboptimal adherence to secondary prevention post-MI increases mortality

Literature 26-9-2017 • Korhonen MJ et al. J Am Coll Cardiol 2017
Post-AMI patients who are adherent to ACE inhibitors/ARBs and statins, but not to beta-blockers, had a similar mortality risk compared with those adherent to all 3 therapies.

Obesity without metabolic abnormalities still associated with increased CV risk

Literature 25-9-2017 • Caleyachetty R et al., J Am Coll Cardiol 2017
Individuals previously considered “metabolically healthy obese” are still at higher CV risk compared with normal weight metabolically healthy persons, according to a large UK health record dataset.

Statin treatment effective in pediatric patients with homozygous FH

Literature 13-9-2017 • Stein EA et al. J Am Coll Cardiol. 2017
In children and adolescents with HoFH, rosuvastatin 20 mg alone or in combination with ezetimibe and/or apheresis led to an effective LDL-C reduction, and was well tolerated.

Patients with cerebrovascular disease benefit from BMI 27-28 kg/m2 and little abdominal obesity

Literature 24-8-2017 • Jaspers NEM, et al. Int J Obes 2017
In clinically stable patients with cerebrovascular disease, the lowest risk of mortality and morbidity was associated with a BMI of 27-28 kg/m 2 , combined with little abdominal obesity.

Early statin discontinuation associated with higher risk of recurrent stroke

Literature 23-8-2017 • Lee M et al., J Am Heart Assoc. 2017;6:e005658
The discontinuation of statin therapy 3 to 6 months after an index ischemic stroke event, was associated with a higher risk of recurrent stroke within 1 year after statin discontinuation.

More than 3.7 g sodium per day has a negative effect on cardiac mechanics

Literature 22-8-2017 • Selvaraj S, et al, JACC 2017
Daily sodium intake of more than 3.7 g is associated with abnormal cardiac mechanics, and this relationship is only partially mediated by systolic blood pressure and serum aldosterone levels.

CVD risk factors enhanced by air pollution and traffic noise

Literature 10-8-2017 • Cai Y, et al, Eur Heart J 2017
In two large European cohorts, long-term exposure to road traffic noise and ambient air pollution were significantly associated with increased hsCRP, blood glucose and lipids. 

Risk of atrial fibrillation increased in those who work over 55 hours per week

Literature 19-7-2017 • Kivimäki M et al., EHJ 2017
In a large-scale meta-analysis, participants working over 55 h/week were 40% more likely to develop AF compared with those working standard hours, independently of known AF risk factors.

To estimate an individual’s sodium intake, a single 24-hour urine collection does not suffice

Literature 18-7-2017 • Olde Engberink RHG et al., Circulation. 2017
Multiple 24-hour urine collections are needed for reliable estimation of individual sodium intake and the associated CV and renal risk.

Most active athletics present most frequently with CAC, but have a more beneficial plaque composition

Literature 18-7-2017 • Aengevaeren VL, et al, Circulation 2017
Athletics with >2000 MET-min/week had a higher prevalence of CAC and atherosclerotic plaques, but these were more often composed of calcified plaque and not mixed plaques.

Improved hypertension control with quarter-dose combinations of BP-lowering agents

Literature 17-7-2017 • Bennett A, et al.
In a meta-analysis, dual quarter-dose combinations of BP-lowering agents were as effective as standard-dose monotherapy, whereas a quadruple quarter-dose combination was twice as efficacious. 

Causal association BMI and cardio-metabolic disease confirmed by genetic studies

Literature 14-7-2017 • Lyall DM, et al, JAMA Cardiol 2017
In a large population-based cohort study, BMI was associated with risk of hypertension, CHD, T2DM, elevated SBP and DBP based on causal mendelian randomization estimates, but not with stroke or pulse rate. 

CHD risk reduced by breastfeeding in Chinese women

Literature 12-7-2017 • Peters S.A.E, JAHA 2017
In China, where breastfeeding practice is almost universal across the country, parous women who had ever breastfed had a lower risk of CHD compared to parous women who never breastfed. 

Decline in sudden death in heart failure over last two decades

Literature 11-7-2017 • Shen L, et al, NEJM 2017
A meta-analysis showed that the rate of sudden death in HFrEF patients has fallen over the past two decades, suggesting a cumulative benefit of evidence-based medications on sudden death.

Herpes zoster enhances risk of stroke and myocardial infarction

Literature 11-7-2017 • Kim M, et al. JACC, 2017
After rigorous adjustment for confounding factors, a propensity scoring analysis of a large Korean cohort revealed increased risk for stroke and myocardial infarction after herpes zoster infection. 

Interrupting sitting with short activity breaks improves postprandial trigyceride levels

Literature 10-7-2017 • Homer AR et al., J Clin Lipidol 2017
Measuring a full day after activity, a randomized crossover trail showed that short breaks with activity improve postprandial triglycerides, which is further increased by physical activity.

Long-term increased CV risk in mutation-carrying relatives of patients with FH

Literature 3-7-2017 • Kjærgaard KA et al., J Am Heart Assoc. 2017
Relatives of individuals with heterozygous familial hypercholesterolemia carrying LDLR mutations are at increased long-term risk of adverse CV events than non-carrier relatives and a general population cohort.

Reaching lower than recommended dose ACEi/ARBs or beta-blockers associates with lower survival chance

Literature 28-6-2017 • Ouwerkerk W, et al, Eur Heart J, 2017
In the BIOSTAT-CHF study, reaching less than 50% of the ESC guideline recommended dose of ACE-inhibitor/ARB or beta-blocker doses was associated with worse survival in HF patients. 

Adequate effectivity long-acting statins with morning intake

Literature 27-6-2017 • Awad K, et al. J Clin lipidol, 2017
Short-acting statins are significantly more effective in lowering LDL-C and total cholesterol when taken in the evening, but long-acting statins are equally effective when taken in the morning or evening.

CV risk factors early in life associated with worse midlife cognitive performance

Literature 21-6-2017 • Rovio SP et al, JACC 2017
In a population-based cohort, the cumulative burden of BP, serum total- and LDL-C, and smoking from childhood and adolescence, were independently associated with worse midlife cognitive performance.

NOACs confer lower bleeding risk than VKA in low-risk AF patients

Literature 21-6-2017 • Lip GYH et al., JAMA Cardiol. 2017
In AF patients with a single non-gender-related stroke risk factor, the risk of any bleeding was lower for apixaban and dabigatran compared with warfarin, while no difference in stroke prevention was seen.

Tooth brushing at least twice a day for 2 min or more associated with better endothelial function

Literature 19-6-2017 • Matsui S et al., Int J Cardiol 2017
High frequency and long duration of tooth brushing were associated with a better endothelial function, implying that adequate tooth brushing may contribute to the prevention of CV events.

Certain traditional Chinese medicines may help improve CV risk or even CVD

Literature 14-6-2017 • Hao P et al., JACC 2017
Systematic review of RCT evidence suggests that some TCM medications might improve CV risk factors and some may exert beneficial effects on ASCVD and chronic HF. Not all studies are of high methodological quality.

In children with heterozygous FH, progression of carotid atherosclerosis slowed by statin treatment

Literature 13-6-2017 • Braamskamp MJAM et al., Circulation 2017
Children with heterozygous FH treated with rosuvastatin showed lower progression of carotid atherosclerosis as compared with unaffected und untreated siblings

Risk stratification in diabetic patients can be improved by considering SBP variability

Literature 8-6-2017 • Ohkuma T et al., Hypertension 2017
In diabetic patients, the SBP visit-to-visit variability was an independent predictor of vascular complications and death, and improved the predictive ability of traditional risk factors.

Long-term metformin seems to protect against coronary atherosclerosis in prediabetic men

Literature 8-6-2017 • Goldberg RB et al., Circulation 2017
In a large Diabetes Prevention Program, men with prediabetes treated with metformin for an average duration of 14 years had lower coronary calcium scores compared with the placebo group.

Meta-analyses confirms CVD and all-cause mortality benefit of intensive SBP reduction

Literature 7-6-2017 • Bundy JD et al., JAMA Cardiol. 2017
A large meta-analysis demonstrated that treating patients to reduce SBP below currently recommended targets was associated with a significantly reduced risk of CVD and all-cause mortality.

Mortality risk metabolic syndrome increased by short sleep duration

Literature 31-5-2017 • Fernandez-Mendoza J, et al, 2017
Risk of mortality associated with the metabolic syndrome was significantly higher with objective short sleep duration, particularly in those with high blood pressure and elevated fasting glucose. 

Eating more fruit and vegetables associated with less peripheral artery disease

Literature 29-5-2017 • Heffron SP et al., ATVB 2017
In a large community-based study, there was an inverse association between F&V consumption and prevalent PAD, suggesting that the increase of F&V consumption may contribute to PAD prevention.

Statins not beneficial for primary prevention in the elderly

Literature 24-5-2017 • Han BH, et al, JAMA intern med, 2017
In a secondary analysis of the ALLHAT-LLT trial, mortality and coronary heart disease events were not lower with pravastatin compared to usual care for primary prevention in the elderly. 

Lean body mass only anthropometric risk factor for atrial fibrillation

Literature 23-5-2017 • Fenger-Grøn M, et al, JACC 2017
Compared to 8 other anthropometric risk factors, lean body mass was the predominant and independent anthropometric driver for AF risk.

Mendelian randomisation shows causal relation adiposity with CHD and T2DM

Literature 18-5-2017 • Dale C, et al, Circulation, 2017
Mendelian analysis confirms a causal relationship of both central and general adiposity with the risk of CHD and T2DM, whereas central adiposity was stronger linked to ischemic stroke. 

FORTA classifies all DOACs and warfarin as beneficial for older AF patients

Literature 17-5-2017 • Wehling M, et al, Drugs & Aging 2017
Based on FORTA classification, all DOACs and warfarin were classified as beneficial or very beneficial for older AF patients, while there was lack of evidence for other vitamin K antagonists.

Guideline adherence physician improves heart failure outcomes

Literature 16-5-2017 • Komajda M, Eur J Heart Fail 2017
Good adherence to treatment guidelines, in particular prescription of appropriate classes and doses of medications for heart failure, is associated with improved clinical outcomes. 

Training GPs to treat screen-detected diabetes intensively also benefitted normoglycemic individuals

Literature 15-5-2017 • Simmons RK, Diabetologia, 2017
In the ADDITION-Denmark trial, a spillover effect was observed from intensive treatment of screen-detected diabetes with normoglycemic levels on biochemical testing.

Long-term gluten consumption does not affect CHD risk in non-coeliac population

Literature 15-5-2017 • Lebwohl B et al. BMJ 2017
In a large study, based on 4-yearly questionnaires during at least 20 years, gluten intake did not significantly affect the risk of CHD, but avoidance may increase the risk via reduced whole grain intake.

Stroke subtypes show different risk factors that depend on age

Literature 13-5-2017 • Hauer AJ et al., JAHA 2017
Various stroke subtypes have different risk profiles particularly in younger individuals, supporting a more tailored primary and secondary stroke prevention strategy in younger patients.

Significance and recommendations AF-screening

Literature 10-5-2017 • Freedman B, et al, Circulation, 2017
Expert members of AF-SCREEN propose systematic or opportunistic screening approaches for AF based on known published data, to reduce the number of strokes and death. 

Statin-related adverse events only observed in unblinded and not in blinded trials; a nocebo effect?

Literature 9-5-2017 • Gupta A, The Lancet, 2017
In the ASCOT-LLA trial, adverse events, such as muscle pain, were more common with atorvastatin treatment in the unblinded phase, but not in de blinded phase of the trial. 

Risk of stroke and dementia increased by artificially sweetened beverages

Literature 4-5-2017 • Pase MP, et al, Stroke 2017
Artificially sweetened soft drink consumption was associated with an increased 10-year risk of stroke and dementia in prospective data from the Framingham Offspring Cohort. 

At young age, classic risk factors related to recurrent cardiovascular events

Literature 3-5-2017 • Van de Berg MJ, et al, J Am Cardiol 2017
Smoking, blood pressure and lipid levels increase risk of recurrent cardiovascular events in young patients or within a short time span in patients of the Dutch SMART cohort. 

Incidence atrial fibrillation increased over last decade, which is expected to continue

Literature 3-5-2017 • Lane DA, et al, J Am Heart Assoc. 2017
Using a primary care population, it was observed that the incidence of AF increased in patients >75 yrs during the last decade, whereas mortality in these patients did not decrease as it did in younger patients. 

Prevention of acute decompensated HF by intensive BP-lowering

Literature 24-4-2017 • Upadhya B, et al, Circ Heart Fail.
In the SPRINT trial, targeting an SBP of <120 mmHg, as compared with <140 mmHg, significantly reduced the risk of developing ADHF by 36% in all predetermined subgroups. 

Limited discriminative power ACC/AHA criteria in identifying very high-risk CVD patients

Literature 24-4-2017 • van den Berg MJ, Eur Heart J, 2017
Single very high-risk factors or simple criteria, such as the ACC/AHA very high-risk criteria, have limited discriminative power to identify patients at highest risk of recurrent MACE. 

Lower risk of diabetes with regular consumption legumes

Literature 19-4-2017 • Becerra-Tomás N, et al, Clin nutr, 2017
In a Mediterranean population at high cardiovascular risk, the frequent consumption of legumes and particularly lentils, was associated with a lower risk of type 2 diabetes mellitus. 

Lower achieved SBP and DBP associated with more CV events

Literature 18-4-2017 • Böhm M, et al, Lancet 2017
In high CV risk patients, lowering SBP to less than 130 mmHg or DBP to less than 75 mmHg, associates with increased rates for CV death, myocardial infarction and heart failure, but not stroke.

Statin use in the elderly: meta-analysis of JUPITER and HOPE-3

Literature 17-4-2017 • Ridker PM, et al, Circulation, 2017
A new meta-analysis provide insights in statin use for primary prevention of the elderly, however, it also leaves critical questions unanswered that are relevant for clinical practice.

Higher risk for any type of stroke in heart failure patients

Literature 12-4-2017 • Adelborg K, et al, Stroke 2017
In a large cohort study of 30 years, heart failure was associated with an increased risk of ischaemic stroke, intracerebral and subarachnoid haemorrhage, especially in the short term. 

Doubled risk of acute MI in real world AF patients receiving DOACs or aspirin vs. VKA

Literature 11-4-2017 • Stolk LM et al., Br J Clin P harmacol 2017
Analysis of new users of rivaroxaban or dabigatran, aspirin and VKAs in CPRD reveals a two-fold increased risk of AMI in current users of DOAC or aspirin, as compared with VKA.

Physical activity important to lower CVD risk in overweight or obese individuals

Literature 6-4-2017 • Koolhaas CM, Eur J Prev Cardiol 2017
CVD risk in middle aged/older individuals with overweight and obesity was only increased in those with low physical activity levels, suggesting that regular physical activity reduce the CVD risk in these patients.

Undercoagulation was common in AF patients who suffered from stroke and impacts outcome

Literature 5-4-2017 • Xian Y et L., JAMA. 2017
In a contemporary registry, 84% of patients with a history of AF received no or subtherapeutic anticoagulation, which affected severity of stroke and in-hospital mortality.

Very low LDL-C levels are safe and effective in high-risk post-ACS patients

Literature 29-3-2017 • Giugliano RP, et al. JAMA Cardiol. 2017
LDL-C levels <30 mg/dL at 1 month were associated with a similar safety profile and with numerical reductions in CV events compared with higher LDL-C levels in high-risk post-ACS patients.

Number of major cardiovascular events lower with ARBs than with ACEi

Literature 28-3-2017 • Potier L, et al, Heart 2017
Rate of major cardiovascular events was lower in high cardiovascular risk outpatients of the REACH registry on ARBs compared to these on ACEi, particularly in those with established atherosclerosis.  

Gastrointestinal safety profiles differ among direct oral anticoagulants

Literature 28-3-2017 • Abraham NS, et al, Gastroenterology 2017
In a large population-based cohort of AF patients on DOACs, apixaban had most favourable gastrointestinal safety profile among all age groups, and rivaroxaban the least favourable. 

Triglyceride plus HDL-C level identifies subpopulations at increased risk of CHD or stroke

Literature 27-3-2017 • Lee JS, et al, Diabetes Care 2017
High fasting triglyceride levels plus low HDL-C levels were associated with increased risks of incident CHD and ischaemic stroke, particularly in diabetic patients and those with LDL-C ≥130 mg/dL.

Physical activity and BMI show dose-response association with risk of heart failure

Literature 13-3-2017 • Pandey A J Am Coll Cardiol. 2017
In a pooled analysis of individual-level data from 3 prospective studies, a dose–response association between physical activity, BMI, and risk of HF was observed, particularly in HFpEF patients.

More arterial stiffness in heavy alcohol consumers

Literature 2-3-2017 • O’Neill D, et al, JAHA, 2017
Using alcohol consumption data of 25 years, it was found that especially male heavy drinkers have increased arterial stiffness, and over time, pulse wave velocity of non-drinkers increased most. 

Preterm delivery associated to maternal CVD risk

Literature 1-3-2017 • Tanz LJ, et al, Circulation, 2017
Preterm delivery is independently predictive of CVD which is only partially explained by postpartum development of traditional CVD risk factors. 

E-cigarette use may not be harmless

Literature 1-3-2017 • Moheimani RS, et al, JAMA Cardiol, 2017
Habitual e-cigarette use was associated with a shift in cardiac autonomic balance toward sympathetic predominance and increased oxidative stress, both associated with increased CV risk. 

57% decrease in ischaemic stroke incidence by changing risk factors

Literature 21-2-2017 • Vangen-Lønne AM, et al, Stroke, 2017
In an analysis from data between 1995 to 2012, changes in risk factors accounted for 57% of the decreased IS incidence and most important contributors were decline in SBP and prevalence of smoking.

Reduced doses NOAC show similar efficacy and bleeding risk but possibly higher mortality risk

Literature 20-2-2017 • Nielsen PB et al., BMJ. 2017
Real-world data show lower dose NOACs associated with similar risk of thromboembolic events and similar or lower rates of bleeding as compared with warfarin in AF, but mortality risk seems higher with NOACs.

Strict BP control did not improve or worsen gait speed in elderly SPRINT participants

Literature 20-2-2017 • Gilstrap LG et al., J Am Heart Assoc. 2017
No differences in gait speed decline or mobility limitations were seen in individuals of 75 years and older were seen between those receiving intensive BP-lowering therapy vs. standard therapy.

Functions of HDL particles better with Mediterranean diet

Literature 16-2-2017 • Hernáez Á, et al.
In a subgroup of PREDIMED study patients it was shown that a Mediterranean diet, especially the one enriched with olive oil, improved biological functions of HDL particles. 

Healthy relatives of CAD patients have high coronary plaque burden

Literature 15-2-2017 • Christiansen MK et al. JACC Cardiol Img 2017
CT angiograms in 88 healthy relatives of patients with CAD onset before the age of 40, displayed high plaque burden and more unfavourable plaque features compared to controls.

Severely elevated blood pressure predicts cognitive impairment

Literature 13-2-2017 • Muela HCS et al., JAHA 2017
New data show that cognitive impairment is more frequent in patients with more severe hypertension and that this severity is a good predictor for cognitive impairment.

Cholesterol levels in midlife predict Alzheimer disease with ASCVD

Literature 8-2-2017 • Rantanen K et al. Ann Med. 2017
After 49 years follow-up, the HBS study found that high cholesterol levels predict Alzheimer disease with atherosclerotic vascular disease (ASCVD), but not without ASCVD or with vascular dementia.

Intervening on meal timing and frequency may be beneficial for cardiovascular disease prevention

Literature 7-2-2017 • St-Onge MP, et al, Circulation 2017
Irregular eating patterns appear less favourable for maintaining body weight and optimal cardiometabolic health.

Intensive BP control in the elderly associated with decreased MACE but may increase risk of renal failure

Literature 6-2-2017
In elderly hypertensive patients, intensive BP control decreased the risk of MACE, including CV mortality and HF, and increased the potential risk of renal failure.

Depression and exhaustion as risk factor for CVD mortality

Literature 2-2-2017 • Ladwig KH, et al, Atherosclerosis, 2017
Depression and exhaustion predict lower life expectancy and higher CVD mortality risk with an effect size comparable to traditional major risk factors. 

Risk ischemic heart disease Chinese adults reduced by drinking tea daily

Literature 1-2-2017 • Li X, et al, Heart, 2017
In a prospective cohort of ~0.5 million Chinese adults, daily tea consumption was associated with a decreased risk of ischaemic heart disease. 

Interrupting sitting time can improve glucose and insulin metabolism in T2DM

Literature 30-1-2017 • Duvivier BM et al., Diabetologia. 2016
Breaking up sitting time by promoting time spent standing and light-intensity walking had a more pronounced beneficial effect on insulin resistance than an exercise regimen.

Red yeast rice as dietary supplement may yield adverse events similar to statins

Literature 25-1-2017 • Mazzanti G et al., Br J Clin Pharmacol. 2017
Surveillance System of Natural Health Products suggests that over half of adverse events, including muscle related and serious reactions, after consumption of RYR had at least a probable causal association.

Risk of VTE cannot be predicted by traditional CVD risk factors

Literature 24-1-2017 • Mahmoodi BK, et al, Circulation, 2017
An individual-level data meta-analysis of prospective studies assessed that except for smoking, traditional CVD risk factors were not associated with venous thromboembolism risk.

Platelet reactivity increased in HIV patients with ACS on dual antiplatelet therapy

Literature 21-1-2017 • Hauguel-Moreau M et al., Eur Heart Jl 2017
In HIV-ACS patients of the EVERE 2 ST-HIV study, platelet reactivity and residual platelet reactivity were increased with P2Y12 receptor inhibitors and aspirin, compared to non-HIV ACS patients.

Inadequate treatment in many post-ACS patients

Literature 19-1-2017 • Eisen A et al., J Am Heart Assoc. 2017
In a large, multinational, post-ACS population, most patients were not treated with high-potency statin regimens early and late after the event which is contradictory to protocols.

Weekend sports may suffice to reduce mortality risk

Literature 12-1-2017 • O’Donovan G et al., JAMA Intern Med 2017
In a large analysis of 11 population-based cohorts, different physical activity patterns were associated with reduced risks for all-cause-, CVD-, and cancer mortality.

Lower risk of liver injury hospitalisation with DOACs as compared to warfarin

Literature 10-1-2017 • Alonso A et al., Heart. 2017
Dabigatran, rivaroxaban and apixaban users were less often associated with liver injury hospitalisation compared to warfarin and several variables could predict this.

HFpEF patients with diabetes are worse off than are those without diabetes

Literature 10-1-2017 • Kristensen SL et al., Circulation 2017
HFpEF patients with diabetes have worse quality of life, higher NT-proBNP levels, more echocardiographic abnormalities and worse outcomes compared with those without diabetes.

Frequency of off-label dosing of NOACs and its consequences

Literature 22-12-2016 • Steinberg BA et al., JACC 2016
Many AF patients on NOAC therapy do not receive recommended doses for stroke prevention, and are at increased risk for CV hospitalisation and all-cause mortality.

Higher risk of developing atrial fibrillation with moderate alcohol consumption

Literature 19-12-2016 • Voskoboinik A et al., JACC 2016
The cardioprotective effects attributed to alcohol do not apply to AF, as regular moderate consumption (~7-21 drinks/week), predisposes to AF, with an increase in AF recurrence in those who continue to drink.

CVD risk-associated inflammatory markers increased with smoking heaviness

Literature 14-12-2016 • King CC, Arterioscler Thromb Vasc Biol, 2017
Inflammatory markers urinary F2:Cr ratio, myeloperoxidase and WBC counts correlated with smoking heaviness. F2:Cr ratio and WBC reduced after cessation. 

Risk of CAD in individuals with genetic risk can be reduced with healthy lifestyle

Literature 8-12-2016 • Khera AV, et al, NEJM, 2016
A healthy lifestyle contributed to a substantial risk reduction of CAD in people with low, intermediate or high genetic risk for CAD.

Young current smokers highest chance of experiencing an acute STEMI

Literature 7-12-2016 • Lloyd A, Heart, 2016
Compared to ex- or never-smokers, current smokers had a 3 times higher chance of acute STEMI, and this chance was even higher among the younger.

All-cause and CVD mortality reduced with certain sports

Literature 7-12-2016 • Oja P, et al, Br J Sports Med, 2016
Motivate individuals to participate certain sports, as swimming, racquet sports and aerobics reduced all-cause and CVD mortality and also cycling reduced all-cause mortality. 

In 30 seconds, GP stimulated obese individual to lose weight

Literature 23-11-2016 • Aveyard P Lancet 2016
A 30 seconds opportunistic intervention by physicians to motivate weight loss in unselected obese patients led to weight loss when combined with supportive systems.

Smokers and never-smokers show only modest differences in cardiovascular risk factors

Literature 1-11-2016 • Keto J, et al, Open heart, 2016
Differences in lipid profile, blood pressure and CVD risk score between smokers and never-smokers at the age of 46, were too small to result in clinical impact, but there was also hardly difference between former- and never-smokers 

Physical exertion and anger or emotional upset often precede acute MI

Literature 24-10-2016 • Smyth A et al., Circulation 2016
Findings of INTERHEART study support the clinical practice of advising patients to minimise exposure to extremes of anger or emotional upset or vigorous physical exertion.

No arrhythmias triggered in heart failure patients upon caffeine intake

Literature 20-10-2016 • Zuchinali P, et al, JAMA, 2016
The acute ingestion of high doses of caffeine in 51 HF patients did not induce arrhythmias neither at rest, nor during exercise. 

CV morbidity and mortality enhanced with higher pulse pressure

Literature 18-10-2016 • McEvoy JW, et al, JACC, 2016
Particularly when DBP was <60 mmHg and SBP above 120 mmHg, patients had higher troponin levels, more frequent CHD events and mortality.

DOACs also beneficial for elderly AF and VTE patients

Literature 11-10-2016 • Sadlon AH, Swiss Med Wkly, 2016
Rivaroxaban, apixaban, dabigatran and edoxaban were superior to VKAs in a meta-analysis of 8 studies comprising elderly patients with atrial fibrillation or venous thromboembolism.

Lower mortality rate with 25 years of intensive lipid-lowering therapy of CAD

Literature 10-10-2016 • Zhao XQ et al., J Clin Lipidol 2016
Intensive lipid-lowering therapy for 25 years was associated with significant reductions in CV and total mortality in men with increased LDL-C levels and established coronary artery disease.

Recurrent risk varies substantially in vascular patients: risk stratification can be improved

Literature 10-10-2016 • Kaasenbrood L, et al., Circulation 2016
There is substantial variation in the estimated 10-year risk of recurrent vascular events in patients with vascular disease that supports the need for optimisation of risk stratification of these patients.

Patients at very high CV risk would benefit from stricter monitoring and adherence to guidelines

Literature 26-9-2016 • Heintjes E, et al., Curr res med opin 2016
Despite lipid-lowering therapy, a large proportion of patients with CV events and/or T2DM did not meet the less stringent Dutch LDL-c target (2.5 mmol/L), BP and HbA1c targets.  

CV incidence decreased with tea consumption

Literature 26-9-2016 • Miller PE, et al, Am J Med, 2016
Both prevalence and progression of coronary artery calcium and number of CV events were decreased when drinking more than one cup of tea a day. 

Metabolic factors may identify individuals prone to develop statin-related diabetes

Literature 19-9-2016 • Kohli P et al., Am J Cardiol 2016
The diabetogenic impact of statin treatment is relatively modest, but is aggravated if plasma glucose, TG concentrations and BMI increase.

Established risk factors cannot explain gender differences in MI risk

Literature 15-9-2016 • Albrektsen G et al., JAMA Intern Med 2016
Compared with women, men have approximately twice the risk of MI. This difference cannot be explained by established CHD risk factors, it persists throughout life but declines with age.

Very low BP in CAD patients associated with increased CV morbidity and mortality

Literature 12-9-2016 • Vidal-Petiot E et al., Lancet 2016
In the large observational CLARIFY cohort of patients with hypertension and CAD, SBP< 120 mmHg and DBP<70 mmHg were associated with increased CV outcomes, even after multiple adjustments.

Different risks of HF, CVD, and mortality associated with use of different antidiabetic drugs

Literature 24-8-2016 • Hippisley-Cox J, et al. BMJ 2016
In an open cohort study of 469 688 diabetic patients in 1243 UK primary care practices, clinically relevant differences between diabetes drugs and the risk for heart failure, cardiovascular disease, and all-cause mortality were observed.

Real-world safety data show differences between anticoagulants in AF patients

Literature 23-8-2016 • Lip GYH et al., Thromb Haemost 2016
In a real-world observational study using propensity score matched cohorts, apixaban initiation was associated with significantly lower risk of major bleeding compared to warfarin and rivaroxaban.

To screen or not to screen for FH in childhood

Literature 18-8-2016 • Lozano et al., JAMA 2016
Identification of and lipid-lowering treatment of familial hypercholesterolemia in childhood reduces lipid concentrations in the short term, with little evidence of harm. Long-term evidence is lacking.

Harmful effect of prolonged sitting can be eliminated if active enough, on a daily basis

Literature 11-8-2016 • Ekeland et al., The Lancet 2016
A harmonised meta-analysis of data of over 1 million individuals shows that more daily physical activity (60-75 min) than recommended by guidelines cancels out mortality effect of long sitting time (>8h).

Cognitive function in elderly patients at CV risk affected by LDL-c variability

Literature 8-8-2016 • Smit RAJ et al., Circulation 2016
In elderly PROSPER study patients at high CV risk, a high variability of LDL-c levels was associated with lower cognitive scores, based on 4 cognitive tests.

No evidence for superiority of gliclazide over other sulphonylureas in reducing hypoglycaemia in general practice

Literature 18-7-2016 • van Dalem J et al., BMJ. 2016
In GPRD data, current use of sulphonylureas only (with active or inactive metabolites) was associated with an increased risk of hypoglycaemic events, as compared with current use of metformin.

Whole grain consumption associated with lower mortality risk

Literature 7-7-2016 • Zong G et al., Circulation 2016
In a meta-analysis of 786,076 individuals, the consumption of whole grain products was inversely and significantly associated with mortality, especially CVD mortality, in a dose-response manner.

New heart failure type-specific risk prediction models

Literature 5-7-2016 • Ho JE et al., Circ Heart Fail. 2016
Separate risk prediction models for heart failure with preserved and reduced ejection fraction were developed and validated that may facilitate targeted treatment strategies in the future.

Visit-to-visit variability in blood pressure associated with cognitive decline

Literature 4-7-2016 • Qin B et al., Hypertension 2016
In contrast to mean values, the variability in SBP and DBP between visits was associated with cognitive and verbal decline.

More people quit taking statins soon after media debates on their side-effects

Literature 4-7-2016 • Matthews A et al., BMJ 2016
In the 6 months following an intense media coverage of adverse effects of statins, more patients discontinued statin therapy, prescribed as primary or secondary prevention in UK primary care.

Many AF patients inappropriately on aspirin monotherapy rather than on anticoagulation

Literature 1-7-2016 • Hsu JH et al., J Am Coll Cardiol 2016
Approximately one third of AF outpatients at moderate to high risk for stroke treated by a cardiovascular specialist, received aspirin monotherapy, in spite of the lack of data supporting this practice.

Using 5 or more drugs concomitantly increases risk for comorbidity and complications in AF

Literature 29-6-2016 • Jaspers Focks J et al., BMJ 2016
In the ARISTOTLE trial population, polypharmacy was common and associated with higher comorbidity, mortality, and higher event rates of thromboembolic complications and major bleeding.

Soft drinks increase the risk for coronary atherosclerosis

Literature 27-6-2016 • Chun S et al., Am Heart J 2016
In Korean people, higher sugar-sweetened carbonated beverage consumption was associated with asymptomatic coronary atherosclerosis as measured by coronary artery calcium.

Electronic cigarette smoking exerts unfavourable effect just like tobacco cigarette smoking

Literature 21-6-2016 • Vlachopoulos C et al. JACC 2016
Research letter shows that smoking of an electronic cigarette affects BP and aortic stiffness to a similar extent as does tobacco cigarette smoking.

Statin treatment effective and safe in very young HeFH subjects

Literature 20-6-2016 • Langslet G et al., J Clin Lipidol. 2016
Open-label prospective 3-year study of atorvastatine in HeFH subjects aged 6-15 years showed that treatment was safe, effective and did not affect growth or maturation.

HF diagnosis often unjustified in primary care

Literature 20-6-2016 • Valk MJ et al., BJGP 2016
An expert panel that retrospectively identified HF patients according to ESC guidelines could not confirm one-third of the cases that were HF-diagnosed by the general practitioner.

Maternal and pregnancy factors affect risk of future T2DM in women with gestational diabetes

Literature 20-6-2016 • Rayanagoudar G et al., Diabetologia 2016
Several maternal and pregnancy factors are associated with a higher risk of developing T2DM in women with gestation diabetes. They can be used for personal risk quantification.

CV event reduction with GLP-1 analogue in patients with type 2 diabetes

Literature 16-6-2016 • Marso SP et al., N Engl J Med 2016
ADA 2016 In T2DM patients at high CV risk, liraglutide on top of standard therapy was associated with lower rates of CV events and mortality, compared with placebo in the LEADER outcome trial.

Higher risk of hypertension associated with exposure to air pollutants

Literature 10-6-2016 • Cai Y et al., Hypertension. 2016
In a systematic review and meta-analysis of 17 studies, the short-term and long-term exposure to air pollutants was significantly associated with increased risk for hypertension.

Cardiac function and structure improved by vitamin D supplementation in heart failure patients

Literature 9-6-2016 • Witte KK, et al. J Am Coll Cardiol 2016
In patients with chronic HF and vitamin D deficiency, high-dose vitamin D3 supplementation is safe, well tolerated, and associated with a favourable effect on cardiac function and structure.

Direct oral anticoagulants result in lower risk of dementia in atrial fibrillation patients

Literature 9-6-2016 • Jacobs V, et al. Am J Cardiol. 2016
Treatment with direct oral anticoagulants was associated with a lower risk of cerebral ischemic events and new-onset dementia, in a retrospective analysis of 5,254 patients with atrial fibrillation.

Lower-risk AF patients also benefit from oral anticoagulation, new data show

Literature 9-6-2016 • Fauchier L et al., Stroke. 2016
Among AF patients with only 1 nongender-related stroke risk factor, OAC was associated with a positive net clinical benefit for the prevention of stroke and thromboembolic events.

Type 2 diabetic patients significantly benefit from light exercises

Literature 7-6-2016 • Dempsey PC et al., Diabetes Care 2016
Sitting interrupted by light-intensity walking or simple resistance activities contributes to better postprandial metabolic levels in T2D patients and may reduce the risk for complications.

Common side effects observed with statin therapy

Literature 2-6-2016 • Thomson PD et al., JACC 2016
Statin-associated muscle symptoms, diabetes mellitus and central nervous system complaints are often seen with statin therapy. This review gives an overview.

Lower absolute number of bleeding events in the elderly with NOAC than with warfarin

Literature 1-6-2016 • Kato S et al., J Am Heart Assoc. 2016
In a pre-specified analysis from the ENGAGE AF-TIMI 48 trial, given the higher rates of bleeding in the elderly, a greater absolute reduction in safety events was seen with edoxaban as compared with warfarin than in younger patients.

Statins safely provide maintained survival benefit in long-term follow-up LIPID trial

Literature 18-5-2016 • Hague WE et al., Circulation. 2016
In 7721 statin-treated patients who participated the extended follow-up of the LIPID study, a sustained survival benefit was confirmed, without an increase of cancer incidence or non-CV-death.

Underweight BMI independently predicts mortality post AMI

Literature 17-5-2016 • Bucholz EM et al., PLoS Med 2016
In a large cohort of AMI patients, underweight BMI was an important risk factor for mortality, independent of comorbidities, frailty measures, and laboratory markers of nutritional status.

Consuming healthy food may be more important for CV benefit than avoiding less healthy food

Literature 4-5-2016 • Stewart et al., Eur Heart J 2016
In a large cohort of high-risk patients with stable CHD, a Mediterranean diet was associated with a lower risk of MACE and all-cause death, while a Western diet score was not associated with MACE.

Vascular brain injury may be prevented by adherence to AHA ideal CVHealth advice

Literature 2-5-2016 • Pase MP et al., Stroke 2016
In the Framingham Heart Study Offspring cohort, adherence to the AHA ideal CVH factors and behaviors, did protect against all forms of vascular brain injury, including dementia.

Dancing good element of cardiac rehabilitation programme by improving lower limb function

Literature 20-4-2016 • Vordos Z et al., Eur J CV Nurs 2016
The implementation of a CRP using Greek traditional dances as exercise training in elderly CHF patients was safe and effective at improving lower limb function.

Prediction model developed to identify young individuals eligible for FH screening

Literature 14-4-2016 • Besseling J et al., Eur Heart J Lipids 2016
A new web-based prediction model might add value for the selection of individuals eligible for DNA analysis for an FH mutation, particularly at young age.

At any LDL-c level, FH mutation increases CAD risk as compared with non-carriers

Literature 13-4-2016 • Khera AV et al., JACC 2016
For any given observed LDL-C level, FH mutation carriers are at substantially increased risk for CAD compared with non-carriers.

Addition of ezetimibe to statin therapy does not affect glucose metabolism

Literature 12-4-2016 • Barkas F et al., J Clin Lipid 2016
High-intensity statin treatment in prediabetics is associated with an increased risk of incident diabetes but the addition of ezetimibe to statin had a neutral effect on glucose metabolism.

Morning home BP measurement better predicts CAD events than clinic BP

Literature 12-4-2016 • Kario K et al., J Am Coll Cardiol. 2016
Morning home BP measurements were strong predictors of both CAD risk and stroke in HONEST study. Clinic SBP and evening SBP may underestimate risk, as well as diastolic BP in either setting.

Substantial variability in response to statin treatment

Literature 6-4-2016 • Karlson BW, et al. Eur Heart J Cardiovasc Pharmacother
There is considerable individual variation in LDL-C reduction at all doses of simvastatin, atorvastatin and rosuvastatin, which is important to consider in daily clinical practice.

Response to statin therapy is directly related to CVD incidence

Literature 30-3-2016 • Ridker PM, et al. Eur Heart J 2016
The magnitude of the percentages reduction in LDL - C , non-HDL - C, and apoB following statin therapy is highly variable between individuals , and is directly related to the reduction in CV risk.

High blood pressure can effectively be controlled with some diets

Literature 17-3-2016 • Gay HC et al., Hypertension. 2016
A large meta-analysis shows that dietary interventions lead to clinically significant net BP reductions, but effects vary between types of diet, and within different patient subgroups.

Diabetic patients with SBP < 140 mmHg may be harmed by BP-lowering treatment

Literature 16-3-2016 • Brunström M et al., BMJ 2016
Large systematic review and meta-analysis shows that antihypertensive treatment provides no benefit and increases the risk of CV death in diabetic patients with SBP<140 mm Hg.

Differential importance of risk factors for various CV disease manifestations

Literature 14-3-2016 • Stoekenbroek RM et al., Eur Heart J 2016
In a large cohort study, the strength of associations between LDL-C, SBP, smoking and CVD manifestations occurring in various vascular beds was highly variable.

LDL-c levels of adult children associated with maternal LDL-c levels before pregnancy

Literature 9-3-2016 • Mendelson MM et al., JAMA Cardiol 2016
Dyslipidaemia in young adults may affect lipid levels of their offspring, possibly through epigenetic mechanism. More insight in these processes may yield population-based lifestyle strategies.

Immediately after moderate and heavy alcohol consumption acute CV risk is increased

Literature 8-3-2016 • Mostofsky E et al., Circulation 2016
Moderate alcohol consumption was associated with a higher CV risk in the hour after alcohol intake, and a lower CV risk after 24 hours, while heavy drinking yields continuous CV risk.

Many CHD patients inadequately treated, statins not prescribed according to guidelines, says EUROASPIRE IV

Literature 2-3-2016 • Reiner Ž et al., Atherosclerosis 2016
Data from 6648 CHD patients from 24 countries were analysed to see how well statins are prescribed at discharge and after at least 6 months. Compliance to guidelines varies greatly and is suboptimal.

After stroke, focus on active BP management rather than a specific SBP target

Literature 1-3-2016 • Mant et al., BMJ 2016
In patients with a history of stroke or TIA, the SBP target of <130 mmHg rather than 140 mmHg yielded only a small additional reduction in BP.

Adherence to oral anticoagulation affects outcomes in AF patients at high stroke risk

Literature 29-2-2016 • Yao et al., J Am Heart Assoc. 2016
In patients with atrial fibrillation, adherence to oral anticoagulation for stroke prevention was modestly improved by the use of NOACs, which impacts mainly the outcomes of high-risk patients.

Primary CV prevention with statins has long term benefit in men with elevated LDL-c

Literature 16-2-2016 • Ford I et al., Circulation 2016
Statin treatment as primary prevention of men with elevated LDL-C for 5 years was associated with reduced mortality and cumulative morbidity after 20 years in the WOSCOPS trial.

Women have worse outcomes associated with atrial fibrillation than men

Literature 9-2-2016 • Emdin CA, et al. BMJ 2016
A meta-analysis shows that atrial fibrillation is associated with an increased risk of morbidity and mortality in women compared with men.

Women who have difficulty sleeping are at higher risk of developing type 2 diabetes

Literature 8-2-2016 • Li Y et al., Diabetologia 2016
This finding can only be partially explained by associations with hypertension, BMI and depression, and supports the need to manage sleep disorders for the prevention of type 2 diabetes.

Polypharmacy in patients with AF can increase bleeding risk

Literature 2-2-2016 • Piccini JP et al., Circulation 2016
The risk of major bleeding with rivaroxaban compared with warfarin was reduced in patients in ROCKET-AF taking fewer than 5 medications, but not in patients taking 5 or more medications, whereas the risk of stroke was not influenced by multiple medications.

Pulse pressure may be useful in CV risk stratification

Literature 1-2-2016 • Selvaraj S et al., J Am Coll Cardiol 2016
High pulse pressure was associated with increased risk for CV death, MI, stroke, and CV hospitalisation, in subjects with established atherosclerosis or at risk, irrespective of mean arterial pressure.

Prediction of readmissions of heart failure patients not improved by self-reported risk factors

Literature 27-1-2016 • Krumholz HM et al. J Am Coll Cardiol HF 2016
Self-reported socioeconomic, health status, adherence, and psychosocial variables, on top of traditional demographic and clinical variables, failed to improve the predictive accuracy of readmission risk for patients with heart failure.

Reason to question guideline recommendations regarding sodium restriction in HF patients

Literature 25-1-2016 • Doukky R et al., J Am Coll Cardiol HF 2016
In patients with chronic heart failure, low dietary sodium intake (<2,500 mg/d) was associated with increased risk of heart failure hospitalisation.

HFpEF patients benefit from dietary intervention and exercise

Literature 18-1-2016 • Kitzman DW et al., JAMA. 2016
A comprehensive caloric restriction and weight loss program with or without exercise training is beneficial for older and obese patients with heart failure with preserved ejection fraction.

Selective heart rate slowing worsens exercise capacity in HFpEF patients

Literature 16-1-2016 • Pal N et al., Circulation. 2015
Heart rate reduction with ivabradine had a detrimental effect on peak oxygen uptake and on submaximal exercise capacity in patients with heart failure with preserved ejection fraction

What to choose: ACE inhibitors or ARBs to lower CV risk?

Literature 13-1-2016 • Bangalore S et al., Mayo Clin Proc. 2016
While ACE inhibitors are associated with a mortality benefit, ARBs exhibit better tolerability, leading to higher adherence. This meta-analysis provides explanatory data that clarify outcome differences in older individual studies.

Preventing ASCVD events: which risk assessment strategy to initiate primary prevention is best?

Literature 11-1-2016 • Mortensen MB et al., JACC 2015
Clinical performance of risk-based approach for treatment eligibility as primary prevention was better than trial-based or hybrid approaches, while treating fewer individuals.

CV benefit of BP-lowering seen also with low baseline BP and with varying comorbidities

Literature 7-1-2016 • Ettehad et al., The Lancet 2015
The beneficial effect of BP-lowering on various CV outcomes, also in individuals with lower baseline systolic BP, was broadly similar among populations with different comorbidities, in a large meta-analysis.

High risk elderly AF patients benefit from good quality anticoagulation control

Literature 21-10-2015 • Senoo K and Lip GYH, Stroke 2015
Elderly patients are at high risk of CV death and stroke/systemic embolism, but age does not increase risk of any clinically relevant bleeding. High TTR negatively correlated with adverse outcomes.

In CVD-free individuals, risk of diabetes increases with elevated blood pressure

Literature 7-10-2015 • Emdin CA et al., J Am Coll Cardiol. 2015
Risk of new onset diabetes increased with higher SBP and DBP. Relative risk increase was lower in older people and those with BMI>35, but absolute risk remained substantial in those individuals.

Risk prediction with SCORE model not improved by addition HDL-C

Literature 6-10-2015 • Mortensen MB et al., Eur Heart J 2015
The newly recommended SCORE-HDL model did not improve discrimination between cases and non-cases in a ‘low-risk’ country, and both models overestimate risk of fatal CVD in this population.

The role of nonstatin lipid-modifying agents in CV risk management

Literature 28-9-2015 • Hegele RA et al., ATVB 2015
Recent data show that similar CV benefits can be achieved with nonstatin agents, as with statins, suggesting that pleiotropic effects of statins are not central to their effects.

Glucose-lowering agent shows CV benefit in outcome trial, for the first time

Literature 21-9-2015 • Zinman B et al., NEJM 2015
Treatment with SGLT2 inhibitor empagliflozin in addition to standard care reduces CV mortality, nonfatal MI and stroke in T2DM patients at high CV risk, shows the EMPA-REG OUTCOME trial.

Self-injectable PCSK9 antibody well accepted by patients and prescribers

Literature 24-8-2015 • Roth EM et al., Clin Ther. 2015
Willingness of patients to self-inject and of physicians to prescribe alirocumab using a prefilled pen or syringe was high. Specialists estimated acceptance by patients higher than primary care physicians.

More CV health risks with industrial trans fats than with saturated fats

Literature 23-8-2015 • De Souza RJ et al., BMJ 2015
Meta-analysis of the association between fat intake and CV health reports higher CV morbidity and mortality with increased trans fat intake (mostly industrially produced), but not with saturated fats.

In T2DM patients with CAD, achieving multiple risk factor goals yields more CV benefit

Literature 19-8-2015 • Bittner et al, JACC 2015
Patients with T2DM and CHD in whom risk factors were managed with protocol-guided therapy, showed lower risks of CV events and mortality when more risk factors were in control.

Good adherence to antihypertensive treatment important to limit hypertension-associated HF risk

Literature 17-8-2015 • Corrao G et al. Hypertension 2015
A population-based case control study confirms low adherence to antihypertensive therapy. Improving adherence is important to lower risk of hospitalisation for heart failure.

Cardio-metabolic benefits with standing or stepping instead of sitting

Literature 11-8-2015 • Healy GN et al., Eur Heart J. 2015
Replacing sitting time with standing or stepping beneficially impacts glucose and lipid metabolism, at volumes that seem feasible in workplace-setting interventions.

Protection from stroke and ICH with edoxaban vs placebo, aspirin, or aspirin plus clopidogrel

Literature 4-8-2015 • Blann AD et al., Thromb Haemost. 2015
Network meta-analysis compared edoxaban with placebo, aspirin alone, or aspirin plus clopidogrel in AF in both clinical trial populations and unselected community populations.

Patients with type 2 diabetes should not skip breakfast

Literature 30-7-2015 • Jakubowicz et al., Diabetes Care 2015
Eating breakfast is important for patients with type 2 diabetes, because it improves glucose homeostasis throughout the day, and postprandial hyperglycaemia can be prevented.

Most, but not all women have better prognosis than men after acute myocardial infarction

Literature 29-7-2015 • Redfors et al., J Am Heart Assoc. 2015
While women have better adjusted prognosis than men after AMI, this benefit was not seen in younger women and women with STEMI and women are less likely to be prescribed evidence-based treatment.

Stroke detection and prevention in atrial fibrillation

Literature 23-7-2015 • Prof. Richard Hobbs - Br. J. Gen. Prac. 2015
Professor Richard Hobbs, Chairman of EPCCS Scientific Organising Committee, wrote an editorial in the July issue of Br J Gen Prac, in which three articles on stroke and its better prevention are published.

Shift work that interferes with preferred sleep timing may increase risk of type 2 diabetes

Literature 29-6-2015 • Vetter C et al., Diabetes Care 2015
Type of shift work affects the risk of type 2 diabetes, depending on whether someone is an early vs. late chronotype. When the preferred sleep timing is disrupted, risk of T2DM may increase.

Fewer heart failure hospitalisations with statins as primary or secondary prevention

Literature 24-6-2015 • Preiss D et al., Eur Heart J 2015
In primary and secondary prevention trials, statins lowered risk of the composite of non-fatal hospitalisation and HF death by ~10%, mostly driven by a fewer non-fatal hospitalisations.

Physical activity can lower PCSK9 levels in 3 months time

Literature 24-6-2015 • Kamani et al., Eur J Clin Invest. 2015
Promoting to use the stairs instead of the elevator during 3 months lowered PCSK9 levels in a healthy population, implying that small lifestyle changes can improve PCSK9 levels.

Non-statin drug also lowers LDL-c and CV events, even below target LDL-c levels

Literature 8-6-2015 • Cannon et al., NEJM 2015
The IMPROVE-IT trial shows that lowering LDL-c with addition of the cholesterol absorption inhibitor ezetimibe to simvastatin further lowers CV events, in ACS patients with LDL-c levels within recommendations.

Digoxin treatment possibly harmful, particularly when used to treat atrial fibrillation

Literature 6-5-2015 • Vamos et al., Eur Heart J. 2015
Large meta-analysis indicates that digoxin treatment is associated with higher all-cause mortality risk in patients with atrial fibrillation and with congestive heart failure.

Type 2 diabetes incidence increases with higher intake of sugary drinks

Literature 4-5-2015 • O’Connor et al., Diabetologia 2015
Lowering consumption of sweet beverages such as soft drinks and sweetened-milk beverages and substitution with water and unsweetened tea or coffee may help lower the incidence of T2DM.

Mortality benefit with PCSK9 inhibition for treatment of dyslipidaemia seen in meta-analysis

Literature 29-4-2015 • Navarese EP et al., Ann Intern Med 2015
Use of anti-PCSK9 monoclonal antibodies was associated with reduced odds of mortality and myocardial infarction and reduced atherogenic lipid fractions, without an increase in adverse events.

What next-generation DNA sequencing can and cannot do in identifying CV conditions

Literature 20-4-2015 • Mogensen J et al., Eur Heart J 2015
A current opinion article discusses the advantages and challenges of use of new genetic screening methods in daily clinical practice and correct interpretation of NGS-generated data.

Finnish men who eat more eggs have lower risk of incident type 2 diabetes

Literature 15-4-2015 • Virtanen J et al., Am J Clin Nutr 2015
Inverse relation seen of higher egg intake with fasting plasma glucose and serum CRP, not explained by cholesterol, suggesting that other nutrients in eggs play a role.

Evidence from genetic study that diabetes has a causal role in CAD risk

Literature 1-4-2015 • Ross S et al., Eur Heart J 2015
Mendelian randomisation approach that adjusts for effect of diabetes-associated SNPs on other CV risk factors suggests that therapy targeting either β-cell function or insulin resistance may reduce CAD events.

Novel CV risk equation takes into account age and country-specific risk conditions

Literature 31-3-2015 • Hajifathalian K et al., Lancet Diabetes Endocrinol 2015
Using the Globorisk model suggests a substantially increased prevalence of people at high CV risk in low- and middle-income countries, as compared with high-income countries.

Consensus guidance on management of statin-associated muscle symptoms (SAMS)

Literature 19-2-2015 • Stroes ES et al., Eur Heart J 2015
EAS Consensus Panel reviews what is known about mechanism of statin-induced myopathy and gives recommendations to ensure optimal LDL-lowering therapy in patients experiencing SAMS.

Lowering BP beyond guideline recommendations may be beneficial in type 2 diabetes

Literature 11-2-2015 • Emdin CA et al., JAMA. 2015
Meta-analysis suggests that lowering blood pressure beyond the often recommended systolic BP of 140 mmHg, to below 130 mmHg may reduce the risk of stroke, retinopathy and albuminuria.

LDL-c lowering effect lower when switching from high-efficacy to generic lipid-lowering therapy

Literature 9-2-2015 • Cao et al., Clin Ther. 2015
In high-risk CVD patients, an increase of LDL-c and lower LDL-c goal attainment rates were seen when patients switched from simvastatin/ezetimibe or rosuvastatin to simvastatin monotherapy.

Adverse perinatal outcomes not different between tight or less-tight BP control during pregnancy

Literature 5-2-2015 • Magee LA et al., NEJM 2015
Randomised trial shows that risk of adverse perinatal outcomes or serious maternal complications does not differ between tight or less-tight control of maternal hypertension.

More longevity benefit with light than with intensive jogging

Literature 2-2-2015 • Schnohr et al., JACC 2015
A U-shaped relationship was found between jogging and mortality, with the lowest mortality seen among light joggers (1-2.4 hours per week, maximum 3 days per week, at a slow or average pace).

Incidence of major bleedings with rivaroxaban in real world similar to trial setting

Literature 28-1-2015 • Tamayo S et al., Clin Cardiol 2015
The incidence of major bleeding in patients with NVAF taking rivaroxaban in standard clinical practice was similar to randomised trials. Most bleedings were of gastrointestinal or intracranial origin and fatal bleedings were rare.

Glycaemic control in T2DM patients with renal failure may improve with DPP4-inhibitor

Literature 27-1-2015 • Laakso et al., Diabetes Care 2015
In patients with type 2 diabetes and moderate to severe renal impairment, the DPP4-inhibitor linagliptide lowered HbA1c , with an acceptable side-effect profile and without affecting eGFR.

Biomarker as a guide in choosing the optimal treatment for smoking cessation

Literature 24-1-2015 • Lerman C et al., Lancet Respir Med 2015
Treating normal nicotine metabolisers with varenicline and slow metabolisers with nicotine patch could optimise quit rates while minimising side-effects.

Cognitive dysfunction predicted by variation in blood pressure and high heart rate

Literature 20-1-2015 • Böhm M et al., Hypertension 2014
In patients with high CV risk, visit-to-visit variation in systolic blood pressure and high resting heart rate were independent predictors of cognitive decline, dysfunction and deterioration.

Self-reported memory complaints in highly educated individuals indicates higher risk of stroke

Literature 12-1-2015 • Sajjad A et al., 2015
Individuals with subjective memory complaints, especially those with a high level of education, showed a higher risk of stroke than those who did not report memory complaints.

FAMCAT prediction model can help identify familial hypercholesterolaemia in primary care

Literature 8-1-2015 • Weng SF et al., 2015
Using the Clinical Practice Research Datalink, a prediction model for primary care was developed and validated to identify individuals with high probability of having familial hypercholesterolaemia.

Healthy lifestyle in young women greatly reduces CHD and development of CVD risk factors

Literature 6-1-2015 • Chomistek et al., J Am Coll Cardiol. 2015
Young women who maintained a healthy lifestyle had substantially lower risk of coronary heart disease and development of CVD risk factors after 20 years of follow-up.

Pilates to lower blood pressure

Literature 7-12-2014 • Martins-Meneses DT et al., Int J Cardiol. 2014
16 weeks of mat pilates practice improved blood pressure, waist and hip circumference and increased height, flexibility and strength in women who had not engaged in exercise training for over 6 months.

Short nights impair endothelial function

Literature 4-12-2014 • Calvin AD et al., J Am Heart Assoc. 2014
Moderate sleep restriction during 8 days in healthy volunteers was associated with a significant impairment in flow-mediated vasodilation.

In elderly without diabetes, insulin resistance seems no risk factor for vascular outcomes

Literature 10-11-2014 • Welsh P et al., Diabetologia. 2014
Insulin resistance and hyperinsulinaemia predispose to diabetes in the elderly, but do not increase the risk of mortality or CVD events.

Statins appear diabetogenic, but benefits outweigh risks

Literature 9-11-2014 • Erqou S et al., Diabetologia. 2014
Particularly in patients with type 2 diabetes, statin treatment was associated with a modest increase of HbA1c. Life style modifications may offset this dysglycaemia risk.

Safety and efficacy of dabigatran confirmed in elderly real-world atrial fibrillation patients

Literature 4-11-2014 • Graham DJ et al., Circulation. 2014
FDA analysis of over 67.000 Medicare patients with non-valvular AF receiving dabigatran confirms efficacy- and safety profile as observed in RE-LY trial, as compared with warfarin.

Vitamin D supplementation does not lower blood pressure in hypertension

Literature 3-11-2014 • Arora P et al., Circulation Oct. 30 2014
The DAYLIGHT trial randomised individuals with pre-hypertension or hypertension to high- or low-dose vitamin D supplementation. No effect of vitamin D on blood pressure was seen.

High dietary linoleic acid intake associated with lower risk of coronary heart disease events

Literature 2-11-2014 • Farvid MS et al., Circulation. 2014
Lower CHD event and mortality risk when replacing carbohydrates or saturated fat with n-6 PUFA linoleic acid. Previously postulated harmful effects of high LA were not supported by these data.

Hyperglycaemia can damage myocardium, even before diagnosis of diabetes

Literature 28-10-2014 • Selvin E et al., Circulation. 2014
Both prediabetes and diabetes showed a higher incidence of subclinical myocardial damage, as assessed by hs-cTnT, associated with higher CV event risk.

Anticoagulation superior to antiplatelets or no treatment for improving survival in elderly AF patients

Literature 22-10-2014 • Wändell PE et al., Age Ageing. 2014
Men and women with AF aged > 75 years show increased survival with anticoagulants as compared to no treatment or treatment with antiplatelets. Not all pharmaceutical groups were associated with lower mortality and some sex differences were observed.

Olive oil-supplemented Mediterranean useful to reverse metabolic syndrome

Literature 20-10-2014 • Babio N et al., CMAJ. 2014
Longer-term follow-up data suggest that a Mediterranean diet supplemented with extra-virgin olive oil is associated with reversal of metabolic syndrome, specifically regarding central obesity and high fasting plasma glucose.

Randomised trial disproves general believe that gradual weight loss is more sustainable than rapid diet

Literature 19-10-2014 • Purcell et al., Lancet Diabetes & Endocrinology 2014
Regain of lost weight was similar in obese individuals randomised to a rapid or a gradual weight loss intervention. More participants in the rapid weight loss programme achieved weight loss of 12.5%.

Atherosclerotic disease limited with high-intensity statins, regardless of baseline lipid status

Literature 13-10-2014 • Puri R et al., Am J Cardiol. 2014
High-intensity statins attenuate coronary atherosclerosis irrespective of baseline levels of atherogenic or protective lipoproteins or CRP.

Relationship between sodium intake and CV diseases more complex than previously thought

Literature 18-8-2014 • Mente et al., NEJM 2014
Three studies published in the NEJM examine the relationships between sodium or potassium intake and blood pressure and CV outcomes and find that current recommendations may not be adequate.

Perceived treatment burden is important factor determining net benefit of lowering HbA1c

Literature 7-8-2014 • Vijan S et al., JAMA Intern Med. 2014
If moderate control of HbA1c level (9%) is achieved, a patient’s view of treatment burden is the most important factor determining the net benefit of glucose-lowering treatment.

Targeting LDL particle numbers may give better clinical outcome than targeting LDL-c levels

Literature 5-8-2014 • Toth et al., Atherosclerosis. 2014
Increases of LDL-P levels are associated with higher risk of CHD events, after accounting for LDL-c levels and patients in whom LDL-P was measured, received more potent statin therapy.

Visiting a known physician improves outcomes of HF patients after ED discharge

Literature 5-8-2014 • Sidhu RS et al., JACC Heart Fail. 2014
Follow-up with a familiar physician was associated with a lower risk of death or hospitalisation, as compared with HF patients who see different or no physicians after treatment and release from ED.

Main biological function of HDL enhanced after 3 weeks of olive oil polyphenol consumption

Literature 30-7-2014 • Hernáez A et al., ATVB 2014
A study in healthy volunteers showed that consumption of high polyphenol content olive oil enhanced HDL biological function and biochemical properties.

Screening for atrial fibrillation in stroke patients may be done by self-monitoring of pulse

Literature 29-7-2014 • Kallmünzer B et al., Neurology. 2014 Jul 23
The majority of stroke patients or their relatives can be trained in self-measurement of peripheral pulse, which can be an effective screening tool if combined with subsequent ECG.

Reassuring news on sport and health

Literature 28-7-2014 • Lee DC and Yankelson et al., J Am Coll Cardiol. 2014
Two publications in JACC report on sports: mortality benefits already start at only 5-10 min/day of running, and the risk of heat stroke during endurance sports outnumbers that of cardiac events.

Lower CV risk in resistant hypertension with intensive lipid-lowering therapy

Literature 27-7-2014 • Bangalore S et al., Eur Heart J. 2014
In the TNT trial, atorvastatin 80 mg significantly decreased the risk of the primary outcome in patients with treatment-resistant hypertension, as compared with atorvastatin 10 mg.

Consuming probiotics to lower blood pressure

Literature 23-7-2014 • Khalesi S et al., Hypertension. 2014
Meta-analysis shows that consumption of probiotics can yield a modest reduction of systolic and diastolic blood pressure, thus probiotics may be used to improve BP control.

HDL-raising agents do not reduce CV morbidity and all-cause morbidity

Literature 21-7-2014 • Keene D et al., BMJ. 2014
A meta-analysis of studies evaluating niacin, fibrates and CETP inhibitors shows that none of these HDL-raising agents significantly affects mortality and CV morbidity.

Stress and adverse emotions linked to higher stroke or TIA risk

Literature 15-7-2014 • Everson-Rose SA et al., Stroke. 2014
Increased stroke/TIA risk seen with depressive symptoms, chronic stress or hostility, which could not be explained by traditional stroke risk factors, inflammatory markers or subclinical atherosclerosis.

Not all forms of sitting are equally bad for you

Literature 13-7-2014 • Basterra-Gortari FJ et al., J Am Heart Assoc. 2014
Television watching, but not computer use and time driving, were associated with all-cause mortality in the SUN cohort of Spanish University Graduates.

Improving health lifestyle in middle age pays off

Literature 7-7-2014 • Spring B et al., Circulation. 2014
Even after a person reaches young adulthood and independent of the health lifestyle at this stage, improving lifestyle can lower the odds of coronary atherosclerosis.

Children with ADHD treated with psychostimulants have increased CV risk

Literature 2-7-2014 • Dalsgaard S et al., J Child Adolesc Psychopharmacol. 2014
Although CV events were rare, after stimulant treatment they were 1.8-fold more likely in the general population and 2.2-fold more likely in children and adolescents with ADHD.

Higher risk of CHD and diabetes associated with wide range of chronic inflammatory disorders

Literature 1-7-2014 • Dregan A et al., Circulation. 2014
Population-based study shows that diverse chronic inflammatory disorders were associated with an increased risk of at least two of the CHD, stroke and diabetes outcomes, possibly in a dose-responsive fashion.

Higher incident CHD and stroke in women with more stressful life events and social strain

Literature 29-6-2014 • Kershaw KN et al., J Am Heart Assoc. 2014
The Women’s Health Initiative observational study showed that these associations were explained by mediating behavioural and biological factors. Insights can help target stress management strategies.

Mortality almost halved by quitting smokeless tobacco post-MI

Literature 25-6-2014 • Arefalk G et al., Circulation 2014
The benefit of quitting snus use after a myocardial infarction was similar to the undisputed benefit of smoking cessation.

Rivaroxaban also effective at reducing stroke in AF patients over 75 years

Literature 16-6-2014 • Halperin JL et al., Circulation 2014
Factor Xa inhibition is as effective as adjusted-dose warfarin to anticoagulate patients of over 75 years old with nonvalvular AF, tor the prevention of stroke and systemic embolism.

Older men on statins engage in less physical activity than nonusers

Literature 12-6-2014 • Lee et al., JAMA Intern Med. 2014
Physical activity declined at a similar rate in prevalent users and non-users, but more rapidly in new statin users. Statin users engaged in about 40 minutes more sedentary behaviour per week.

HF-Recovered: a third HF phenotype with better prognosis than HF-REF and HF-PEF

Literature 10-6-2014 • Basuray A et al., Circulation. 2014
HF-Recovered represents a distinct phenotype on the HF continuum, since this population has a different biochemical profile and symptom severity than those with HF-PEF and HF-REF.

No uniform effect of air pollution on CV outcomes

Literature 10-6-2014 • Milojevic A et al., Heart 2014
Nationwide study finds no evidence for an acute effect of ambient air pollution on STEMI or stroke. NO2 and PM2.5 influenced selected non-MI mortality and hospital admission.

Worse heart failure associated with higher risk of developing diabetes

Literature 4-6-2014 • Demant MN et al., Diabetologia. 2014
Danish nationwide study shows that risk of developing diabetes increases with HF severity, as assessed by prescribed dosage of loop-diuretics.

Blood pressure differentially affects development of various CV outcomes

Literature 2-6-2014 • Rapsomaniki E et al., Lancet. 2014 May 31
Different CV disease outcomes correlate in different ways with blood pressure and at different ages, and systolic hypertension appears more important than DBP. BP-lowering strategies need improvement.

Hospitalisation for atrial fibrillation increased in the USA between 2000 and 2010

Literature 26-5-2014 • Patel NJ et al., Circulation. 2014
While admissions for AF increased over time, as well as associated health care costs, AF-associated mortality decreased, except in patients with heart failure.

Wine drinking does not make you live longer and healthier

Literature 14-5-2014 • Semba et al., JAMA Intern Med. 2014
No association found between urinary concentration of polyphenol resveratrol and longevity, markers of inflammation, and CV disease.

Guided but unsupervised diet and exercise interventions improve inflammatory profile in type 2 diabetes

Literature 10-5-2014 • Thompson D et al., J Am Heart Assoc. 2014
Unsupervised motivational diet and diet plus physical activity interventions, integrated into healthcare, lowered the proportion of type 2 diabetes patients with high CRP levels.

Marijuana may be trigger for CV complications in young adults

Literature 10-5-2014 • Jouanjus E et al., J Am Heart Assoc. 2014
Increased reporting of serious cannabis-related CV complications in a French registry may indicate that cannabis use may trigger CVD in young adults, in line with previous findings.

Physical activity in childhood associated with better arterial health

Literature 7-5-2014 • Pälve et al., J Am Heart Assoc. 2014
In 9- to 15- year old males and young adults, physical activity was associated with improved measures of arterial elasticity in adulthood, but not carotid intima media thickness.

Daily consumption of pulses can lower LDL-cholesterol levels

Literature 5-5-2014 • Ha V et al., CMAJ. 2014
Meta-analysis suggests that daily consumption of 1 serving of legumes for a median of 6 weeks lowers LDL-c levels.

Statin users increased their caloric and fat consumption over time, but nonusers did not

Literature 4-5-2014 • Sugiyama T et al., JAMA Intern Med. 2014
Calorie and fat intake, and BMI increased in statin users over a decade of observation, while  nonusers did not show a similar trend. Importance of dietary modification needs reemphasis in statin users.

Promising stem cell therapy for heart disease: too good to be true

Literature 28-4-2014 • Nowbar et al., BMJ. 2014 Apr 28
A critical analysis shows that trials with fewer discrepancies tend to find progressively smaller effects of BMSC therapy on ejection fraction. The few trials with zero discrepancies had a stem cell effect size of zero.

Time in therapeutic range does not affect treatment benefits of rivaroxaban vs. warfarin

Literature 28-4-2014 • Piccini JP, J Am Heart Assoc. 2014
A wide range of centre TTRs were seen in ROCKET-AF, but the relative efficacy of rivaroxaban over warfarin did not vary with cTTR, for stroke prevention in atrial fibrillation.

German primary care physicians invest a lot of time in CVD prevention

Literature 28-4-2014 • Schneider S et al., Int J Environ Res Public Health. 2014
While general practitioners appreciate the importance of advising patients on improving lifestyle, they do not feel that they succeed in motivating patients to change lifestyle factors.

Ankle-brachial index not often used in general practice

Literature 27-4-2014 • Davies JH et al., BMC Fam Pract. 2014
ABI is infrequently and often incorrectly employed to diagnose peripheral arterial disease. Before using ABI as a screening tool, training is needed to correctly perform the procedure.

Higher bleeding risk even with brief use of NSAID or aspirin, when on anticoagulation

Literature 23-4-2014 • Davidson BL et al., JAMA Intern Med. 2014
A clinically important increase in bleedings was observed in patients treated for VTE, who are simultaneously using anticoagulation and NSAIDs or aspirin.

Metabolic health in obese affects risk of diabetes, but not of incident CVD

Literature 20-4-2014 • Hinnouho GM et al., Eur Heart J. 2014
Metabolically healthy obese individuals have a lower risk of type 2 diabetes than the metabolically unhealthy obese, but the metabolically healthy remain at high risk for incident CVD.

Women with heart failure benefit from exercise training

Literature 17-4-2014 • Piña IL et al. JACC Heart Fail. 2014
In HF-ACTION, an exercise program plus optimal medical therapy (OMT) was associated with a lower risk of all-cause mortality and hospitalisation than OMT alone, in women, but not men with HF.

ACE inhibitors and ARBs differentially affect CV morbidity and mortality in diabetics

Literature 15-4-2014 • Cheng J et al., JAMA Intern Med. 2014
Meta-analysis shows that ACEIs and ARBs differentially influence the risk of all-cause mortality, CV deaths and CV events in patients with DM. ACEIs reduce the risk, while ARBs do not.

Better prognosis for overweight and obese patients with CVD (the "obesity paradox")

Literature 10-4-2014 • Lavie CJ, et al. JACC 2014
Overweight and obese patients with CV diseases have a better prognosis than do their leaner counterparts, largely in patients with low fitness.

Control of atherosclerotic plaques improved during last decade

Literature 8-4-2014 • Van Lammeren GW et al. Circulation 2014
Over time, less unstable plaques and more frequently stable plaques were found in study of University Medical Center Utrecht.

Prediction of incident CVD is hardly improved by addition of HbA1c to conventional risk factors in non-diabetics

Literature 31-3-2014 • The Emerging Risk Factors Collaboration
In adults without a known history of diabetes of CVD, adding information on glycaemic measures does not yield clinically relevant improvement of CVD risk assessment.

Diabetes during pregnancy is a risk factor for subclinical atherosclerosis later in life

Literature 20-3-2014 • Gunderson EP et al., J Am Heart Assoc. 2014
Women with a history of GDM had greater carotid artery  IMT, already before the onset of diabetes and the metabolic syndrome, irrespective of pre-pregnancy obesity, race, parity and age.

Single-patient n-of-1 trials can improve assessment of statin-related myalgia

Literature 19-3-2014 • Joy TR et al., Ann Intern Med. 2014
This proof-of-concept study supports the use of n-of-1 trials in motivated patients to identify truly statin-caused myalgia. This study found no clinically significant difference in myalgia between statins and placebo.

With each minute earlier start of thrombolysis in stroke, a disability-free day is won

Literature 19-3-2014 • Meretoja A et al. Stroke. 2014
Patients with acute ischaemic stroke gain at least a day of healthy life for each minute faster delivery of intravenous tPA for stroke thrombolysis. 

Large majority of side-effects on statins are not pharmacologically mediated by the drug

Literature 18-3-2014 • Finegold JA et al. Eur J Prev Cardiol. 2014
New onset diabetes was the only potentially symptomatic side-effect that occurred more frequently on statins than on placebo; only 1 in 5 cases are truly caused by statins.

Exposure to parental smoking has irreversible, long-term effects on arterial health

Literature 10-3-2014 • Gall et al., Eur Heart J. 2014
Carotid intima media thickness greater in adults exposed to both parents smoking in their childhood or adolescence. This effect was independent of CV risk factors in adulthood.

Higher prevalence of homozygous hypercholesterolaemia in the Netherlands than anticipated

Literature 9-3-2014 • Sjouke B et al. Eur Heart J. 2014
Substantial phenotypic variability seen among patients with molecularly diagnosed homozygous autosomal dominant hypercholesterolaemia, and the majority does not meet phenotypic diagnostic criteria.

In patients with acute VTE, NOACs are equally effective, but with a more favourable bleeding profile than VKA

Literature 9-3-2014 • Van der Hulle T et al. J Thromb Haemost. 2013
Meta-analysis shows that NOACs are as effective in the prevention of recurrent VTE, and give a lower risk of most types of bleedings, in patients with acute VTE.

Vitamin D status may be important for immune function in elderly hypertensive people

Literature 4-3-2014 • Laird et al., J Clin Endocrinol Metab 2014
Negative associations were seen between vitamin D and pro-inflammatory cytokines, and a more pro-inflammatory IL-6 to IL-10 ratio was more often seen in vitamin D deficient individuals.

Poor glucose control a stroke risk factor for women but not men

Literature 27-2-2014 • Zhao et al, Diabetologia 2014
HbA1c is positively associated with risk of stroke in female patients with type 2 diabetes, particularly when over 55 years of age, irrespective of use of glucose-lowering medication and race.

More major CV events in months after loss of partner

Literature 26-2-2014 • Carey IM et al., JAMA Intern Med. 2014
Large primary care database study showed a marked increase in the incidence of MI, stroke, ACS and PE in the months after the death of the partner.

Vegetarians have lower blood pressure

Literature 25-2-2014 • Yokoyama Y et al., JAMA Intern Med. 2014
Meta-analysis of both clinical trials and observational studies show that consumption of vegetarian diets is associated with lower systolic and diastolic blood pressure.

Sugar-sweetened beverage consumption associated with high blood pressure

Literature 20-2-2014 • Malik et al., Am J of Cardiol, 2014
Systematic review suggests that intake of over 1 serving per day is associated with an increased risk of developing hypertension.

Also brief episodes of atrial fibrillation associated with increased risk of ischaemic stroke

Literature 19-2-2014 • Boriani G et al.Eur Heart J 2014
Measuring burden of atrial fibrillation with implanted device may be clinically relevant, and specific thresholds of daily AF burden may identify a substantial increase in the risk of ischaemic stroke.

Individualised treatment effect prediction models to improve care

Literature 17-2-2014 • van der Leeuw J et al., Eur Heart J. 2014
An outline of the value of and methods to calculate individual treatment effects in CV disease prevention.

Statin treatment often not intensive enough after acute myocardial infarction

Literature 12-2-2014 • Arnold SV et al. Circulation. 2014
Statin initiation after AMI in statin-naïve patients is uniformly prevalent across hospitals, while rates of statin intensification were low and variable among different sites.

Subclinical atherosclerosis can be predicted by blood pressure changes over time

Literature 10-2-2014 • Allen NB et al. JAMA. 2014
BP trajectories, starting in early adulthood, even when in the prehypertensive range, are associated with presence of coronary artery calcifications later in life.

Memory impairment often missed in patients with heart failure

Literature 6-2-2014 • Hanon O et al. Am J Cardiol 2014
Almost half of community-dwelling HF patients over 70 years old have impaired memory function, while cardiologists judged their patients to be cognitively impaired in only 12%.

No increased risk of drug-induced liver injury with NOACs

Literature 5-2-2014 • Caldeira D et al. Heart. 2014
Meta-analysis of large NOAC RCTs shows that NOACs are not associated with elevations of transaminases over 3x ULN and bilirubin >2x ULN.

Risk of CV death increases with added sugar consumption

Literature 4-2-2014 • Yang Q et al. JAMA Intern Med. 2014
For most American adults the amount of calories derived from added sugar is higher than recommended. This is associated with increased risk of CVD death.

Progesterone therapy has no adverse CV effects in healthy postmenopausal women

Literature 29-1-2014 • Prior JC PLoS One. 2014
12 weeks of oral micronized progesterone was mostly neutral on CV markers, metabolic, inflammatory and coagulation markers. While HDL-c decreased slightly, endothelial function may be improved.

Antiplatelet therapy is still too often, inappropriately given in atrial fibrillation

Literature 29-1-2014 • Lip GYH et al. The American Journal of Medicine 2014
Improved use of oral anticoagulation in atrial fibrillation since last EuroHeart Survey, although antiplatelet therapy is still too often prescribed, specifically in the elderly.

If your spouse has diabetes, you are at increased risk of developing diabetes

Literature 28-1-2014 • Leong A et al., BMC Med. 2014
A study into spousal diabetes concordance shows that the risk of (pre)diabetes increases if the spouse has a history of (pre)diabetes.

Prepregancy obesity increases risk of MI and stroke in healthy young women

Literature 28-1-2014 • Schmiegelow MD et al. Circulation. 2014
Although the absolute risks are low, obesity-related health risks are also apparent in the short-term in young women, without previous CV disease, who gave birth.

Increased cardiovascular risk in patients with HIV-infection

Literature 20-1-2014 • Hemkens LG, Bucher HC
This review summarises what is known about the increased cardiovascular risk seen in HIV-positive patients, and how this may be limited and treated.

No evidence for an increased CVD risk with very low sodium intake

Literature 14-1-2014 • Cook NR et al. Circulation 2014
A lower risk of CVD seems to be associated to lower sodium exposure as measured by multiple urine collections, as low as 1500 mg/day.

Timely treatment of hypertension limits cognitive decline

Literature 9-1-2014 • Köhler S et al. Hypertension. 2013
Both prevalent and incident hypertension are linked to cognitive decline, specifically in those younger than 65 years. Uncontrolled hypertension had worse outcome.

Herpes zoster is a risk factor for stroke, especially when experienced between 18 and 40 years

Literature 9-1-2014 • Breuer et al., Neurology. 2014
Risk of stroke, TIA and MI are increased in people who had herpes zoster between age 18 and 40. Vascular risk factor management should be improved in this age group.

Starting warfarin treatment gives a higher ischaemic stroke risk in the first 30 days

Literature 8-1-2014 • Azoulay et al. Eur Heart J. 2013
AF patients who start warfarin initially have a nearly two-fold increased risk of ischaemic stroke, but after 30 days this risk is lower than in patients not on antithrombotics.

New CV health index inversely correlated with carotid intima media thickness

Literature 7-1-2014 • Kulshreshtha et al., J Am Heart Assoc. 2014
CIMT declines with increasing number of ideal health factors. The association is not affected by familial and genetic factors, shows twin study.

Heart failure and myocardial infarct depend differently on obesity and metabolic status

Literature 23-12-2013 • Mørkedal et al., JACC 2013
Risk of acute MI is increased in metabolically unhealthy individuals irrespective of BMI, while obesity is more important for the development of heart failure, irrespective of metabolic health.

European label of dabigatran use gives better efficacy and safety

Literature 18-12-2013 • Lip et al. Thromb Haemost. 2013
The preferred dose of dabigatran is 150 mg bid, but in contrast with the FDA, the EU label recommends 110 mg bid for patients with high risk of bleeding, which proves to be a relevant alternative.

If LDL-c and LDL-related measures are aberrant in different directions, coronary risk prediction is impaired

Literature 18-12-2013 • Mora et al., Circulation Dec 2013
When LDL-c levels are above the median, and NHDL-c, apoB or LDL-P are below the median, coronary risk was overestimated, and vice versa, in apparently healthy women.

Efficacy of dabigatran vs. warfarin in stroke prevention maintained with renal dysfunction

Literature 16-12-2013 • Hijazi et al., Circulation. Dec 2013
Generally, renal function did not affect the relative safety of dabigatran over warfarin, although estimation of eGFR with CKD-EPI showed a larger reduction of major bleeding risk when eGFR > 80 ml/min.

Stroke prevention through consumption tea and chocolate

Literature 16-12-2013 • Larsson S, Stroke. Dec 2013
Both green and black tea and chocolate have beneficial effects on CV health, and are associated with a reduced stroke risk. Moderate coffee consumption may have similar benefits.

No increased risk of major adverse CV events with smoking cessation pharmacotherapy

Literature 11-12-2013 • Mills EI, et al., Circulation. 2013 Dec 9
Network analysis examines CVD risk associated with three smoking cessation pharmacotherapies. No effects on MACE were found, but risk of mild CVD events  seems higher with nicotine replacement therapy.

Most hypertensive patients need combination therapy to achieve target blood pressure

Literature 11-12-2013 • Bakris et al., J Am Soc Hypertens. 2013
Historical literature overview shows that combination therapy approach improves the potential for timely BP control, without an increased incidence of adverse effects.

Guideline-recommended lipid goals not met in most patients despite statin treatment

Literature 10-12-2013 • Devroey et al., Int J Clin Pract. Dec 2013
DYSIS: Observational study in Belgian real-life setting shows that most patients at very high CV risk have residual dyslipidaemia despite statin therapy.

Favourable risk/benefit ratio of NOACs over warfarin in meta-analysis of large trials

Literature 9-12-2013 • Ruff et al., The Lancet 2013
Combined data from RE-LY, ROCKET-AF, ARISTOTLE and ENGAGE AF-TIMI 48 showed that NOACs safely reduce stroke and systemic embolism in comparison with warfarin, in atrial fibrillation.

Atrial fibrillation symptom burden and severity can be alleviated by weight loss

Literature 5-12-2013 • Abed et al., JAMA Nov 2013
Weight reduction and improvement of multiple cardiometabolic risk factors were beneficial for cardiac structure and reduced atrial fibrillation symptom burden.

Delayed progression of atherosclerosis with Mediterranean diet with nuts

Literature 4-12-2013 • Sala-Vila A et al., ATVB 2013
PREDIMED: Following a Mediterranean diet supplemented with nuts induces favourable changes in carotid artery intima media thickness.

Better prediction of recurrent CV events in very old patients with NT-proBNP measurement

Literature 3-12-2013 • Van Peet et al., PLoS One 2013
Measuring NT-proBNP might be used to identify older people with established CVD at the highest risk for recurrent CV events, who may benefit most from strict secondary prevention.

European Atherosclerosis Society guidance for improved screening and treatment of familial hypercholesterolaemia

Literature 3-12-2013 • Nordestgaard BG et al., Eur Heart J. 2013
The EAS consensus panel evaluated the underdiagnosis and undertreatment of FH, and provided guidance on how to manage FH patients, to prevent coronary heart disease.

Often eating nuts associated with lower all-cause and cause-specific mortality

Literature 26-11-2013 • Bao et al. N Engl J Med. 2013 Nov 21
Significantly reduced hazard of all-cause mortality and mortality due to heart disease associated with frequent nut consumption in two large prospective cohorts.

Doubts whether the new risk calculator accurately assesses CV risk

Literature 20-11-2013 • Ridker PM, Cook NR
In response to the new AHA/ACC guidelines Ridker and Cook wrote a comment in The Lancet in which they state that the risk calculator systematically overestimates CV risk.

Blood pressure fluctuations over time in diabetes type II patients predict CV events

Literature 4-11-2013 • Hata et al., Circulation Sept 2013
Visit-to-visit SBP variability and maximum SBP are associated with the risk of micro- and macrovascular complications and death, while mean SBP is not correlated to CV events.

Coronary Artery Calcium score can improve CVD risk assessment, also in absence of dyslipidemia

Literature 29-10-2013 • Martin et al., Circulation Oct 2013
Subclinical atherosclerosis also seen in patients without dyslipidemia. CAC measurement may improve CVD risk stratification.

More hypoglycaemia, but fewer CV outcomes on glargine than on standard care

Literature 28-10-2013 • ORIGIN Trial Investigators, Eur Heart J Oct 2013
People on insulin glargine experience more hypoglycaemic episodes, but fewer clinical CV outcomes than people on standard care. Severe but not non-severe hypoglycaemia predicts CV outcome.

Flu vaccination lowers CVD risk

Literature 23-10-2013 • Udell JA, Zawi R, Bhatt DL, et al.
Influenza vaccination reduced the risk of major adverse cardiovascular events among patients at high risk for heart disease.

Large differences between CV disease burden seen between European countries

Literature 21-10-2013 • Nichols M et al., Eur Heart J 2013 Oct
No consistent trends in cardiovascular disease burden across Europe. No consistent stabilisation of trends of CHD mortality rates observed.

Better outcome after exercise-related than after non-exercise-related cardiac arrest

Literature 21-10-2013 • Berdowski et al., Eur Heart J 2013
Incidence of exercise-related out-of-hospital cardiac arrest is low. Survival is better after exercise-related cardiac arrest.

Systematic case-finding by pharmacists improves identification of patients at CV risk

Literature 16-10-2013 • Yakiwchuk et al., Can Pharm J Sep 2013
CV risk factor control assessment and follow-up by pharmacist in a Canadian collaborative intervention, improves overall CV risk control in primary care.

Statin use reduces risk of dementia

Literature 10-10-2013 • Swiger et al., Mayo Clin Proc. Sept 2013
Systematic review and meta-analysis shows that statins do not affect cognitive function on short-term, but reduce risk of dementia in those without history of cognitive dysfunction.

People highly exposed to aircraft noise have increased CV risk

Literature 9-10-2013 • Hansell, Correia et al., BMJ Oct 2013
Two studies find high hospital admission rates for cardiovascular disease in people living near airports exposed to the highest  noise levels.

HAS-BLED score better predicts major bleeding in anticoagulated AF patients

Literature 3-10-2013 • Roldán V, Marín F, Manzano-Fernández S et al.
The HAS-BLED score better predicts major bleeding than stroke stratification scores CHADS2 and CHA2DS2-VASc, in atrial fibrillation patients on anticoagulants.

High dose statins also beneficial to reduce gum disease

Literature 3-10-2013 • Subramanian S, Emami H, Vucic E et al.
High-dose statin therapy reduced periodontal inflammation, suggestive of a cholesterol-independent beneficial effect of statins on non-arterial inflammation.

CKD-EPI equation reclassifies patients with low CV risk from CKD stage 3a to 2

Literature 1-10-2013 • van Gelder VA, Scherpbier-de Haan ND, de Grauw WJ et al.
Application of the CKD-EPI equation in primary care to calculate eGFR better stratifies CKD stage than the MDRD equation in most people, but a small subgroup with elevated risk will be missed.

Antithrombotic therapy only modestly reduces mortality in AF, thus management of CV comorbidities may be more effective

Literature 25-9-2013 • Marijon E, Le Heuzey JY, Connolly S, et al.
RE-LY: Dabigatran reduced vascular, but not other causes of mortality as opposed to warfarin. However important, anti- thrombotic treatment only modestly reduces mortality.

Primary care program to lower BP in hypertensive diabetics decreases BP, but not all meet targets

Literature 18-9-2013 • Viana LV, Leitão CB, Grillo MF, et al.
The Brazilian HiperDia System provides antihypertensive and antidiabetic treatment in primary care. Although BP drops, over half of participants do not reach BP targets.

Electronic cigarettes may help smokers to quit

Literature 18-9-2013 • Bullen C, Howe C, Laugesen M et al.
This randomised trial finds no significant differences between e-cigarettes with or without nicotine and patches, but results suggest favourable effect of nicotine e-cigarettes.

Men and women differently present with ACS, women more often without chest pain

Literature 18-9-2013 • Khan NA, Daskalopoulou SS, Karp I et al; for the GENESIS PRAXY Team
Chest pain is the predominant symptom in acute coronary syndrome in patients younger than 55 years, although it is more likely to be absent in women versus men.

Association between SBP and stroke or ischemic heart disease is the same for men and women

Literature 28-8-2013 • Peters S, Huxley R, Woodward M
Large meta-analysis revealed that both genders have approximately 25% extra risk of stroke and ~15% risk of IHD with each 10 mmHg increment in SBP.

Benefits of patient-centered care clearest in type 2 diabetes patients with high HbA1c

Literature 27-8-2013 • Slingerland AS, Herman WH, Redekop WK et al.
Patient-directed care is more effective and cost-effective than usual care for management of type 2 diabetes in patients with baseline HbA1c > 69mmol/mol.

Lifestyle counselling in primary care can improve cardiometabolic risk factors in obese patients

Literature 27-8-2013 • Vetter ML, Wadden TA, Chittams J, et al.
Regular visits, behavioural counselling and medicational therapy or meal replacements combined, yield the largest weight loss and improvements in cardiometabolic risk factors in obese patients.

Active commute associated with lower likelihood of CV risk factors

Literature 26-8-2013 • Laverty AA, Mindell JS, Webb EA.
People who take public transport, who walk or cycle to work are less often obese and have less diabetes and hypertension than people who use private transport to commute. Large sociodemographic differences exist.

Community-based multifactorial hypertension program almost doubles hypertension control rate

Literature 21-8-2013 • Jaffe MG, Lee GA, Young JD et al.
A large-scale hypertension program encompassing a registry, active monitoring of performance, guidelines, and single-pill combination pharmacotherapy was effective at improving hypertension control.

Simvastatin negatively influences both biochemical and functional effects of exercise training

Literature 21-8-2013 • Mikus CR, Boyle LJ; Borengasser SJ et al.
Simvastatin hampered the improved mitochondrial function that normally follows exercise and that improves cardiorespiratory fitness, in overweight people at risk of metabolic disease.

Walking and running reduce risk of CVD-related mortality in hypertensives

Literature 20-8-2013 • Williams PT
At the same energy expenditure, walking and running similarly reduce risk, but current exercise guidelines are inadequate to reduce CVD mortality.

Effect of obesity in pregnancy on cardiovascular outcome in offspring lasts until adulthood

Literature 19-8-2013 • Reynolds RM, Allan KM, Raja EA, et al.
Offspring of overweight and obese mothers have an increased risk of cardiovascular events and premature mortality in midlife.

Dynamic HF risk score can identify patients at high risk of hospitalisation for heart failure

Literature 14-8-2013 • Cowie MR, Sarkar S, Koehler J, et al.
Development and validation of a dynamic HF risk score based on combined diagnostic parameters monitored in implantable devices, as an aid to identify patients who may need closer follow-up.

Room for improvement in GP’s knowledge of guidelines for treatment of heart failure

Literature 14-8-2013 • Parnicka A, Wizner B, Fedyk-Łukasik M, Grodzicki T
Differences exist between younger and older primary care physicians in awareness and implementation of recommended diagnosis and treatment of heart failure.

Less cognitive decline after stroke if cardiovascular risk factors are managed adequately

Literature 13-8-2013 • Douiri A, McKevitt C, Emmett ES, et al.
Effective secondary cardiovascular prevention can avert or delay cognitive decline in stroke survivors.

Overtreatment with lipid-lowering therapy in ineligible patients, while eligible patients do not always get it

Literature 13-8-2013 • Wu J, Zhu S, Yao GL,et al.
Poor match between eligibility for lipid-lowering treatment and being prescribed it; GPs are guided more by individual CV risk factors, rather than overall calculated CV risk.

Persistence to medication affects clinical outcome, but the reverse is also true

Literature 9-8-2013 • Böhm M, Schumacher H, Laufs U
Nonpersistence to medication increases the risk of CV events, but events may also lead to nonpersistence, yielding a vicious cycle with higher risk of future CV outcomes.

Poor adherence to cardiovascular medication accounts for ~9% of all European CVD events

Literature 8-8-2013 • Chowdhury R, Khan H, Heydon E, et al.
Poor adherence to CVD medication is prevalent, irrespective of the type of agent, and leads to more CVD events and mortality.

Discontinuation of statin treatment associated with Parkinson’s disease, continued use reduces risk

Literature 6-8-2013 • Lee YC, Lin CH, Wu RM, et al.
Lipophilic, but not hydrophilic statins appear to reduce risk of Parkinson’s Disease, as compared to discontinuation of statins.

Intensive lifestyle intervention in overweight T2DM patients had no effect on CV outcome

Literature 30-7-2013 • Look AHEAD Research Group
Look AHEAD: Overweight and obese T2DM patients could lose weight and improved CV risk factors, without an effect on CV morbidity and mortality after about 10 years follow-up.

Skipping breakfast or eating late at night increases risk of coronary heart disease

Literature 24-7-2013 • Cahill LE, Chiuve SE, Mekary RA
Men who do not eat breakfast or who eat late at night have a modest but increased risk of CHD, while frequency of eating does not affect CHD risk.

Duration, but not degree of obesity matters for risk of atherosclerosis

Literature 22-7-2013 • Reis JP, Loria CM, Lewis CE et al.
Long term follow-up of young adults shows that longer duration of overall and abdominal obesity are associated with the development and progression of CAC in middle age.

Different effect of regular exercise on incident stroke risk for men and women

Literature 21-7-2013 • McDonnell MN, Hillier SL, Hooker SP et al.
Regular physical activity reduces incidence of stroke or TIA in men, but not in women.

Cigarette smoking is bad for HDL-c, in multiple ways

Literature 18-7-2013 • He BM, Zhao SP, Peng ZY
Overview of mechanisms via which cigarette smoke impairs HDL-c levels, composition and function, thereby likely reducing its atheroprotective effect.

Heart rate as a central and modifiable factor in cardiovascular disease

Literature 17-7-2013 • Custodis F, Reil JC, Laufs U, Böhm M
Overview of pathophysiological mechanisms involving elevated resting heart rate and their therapeutic implications.

Beta-blockers wrongly blamed for many listed side-effects

Literature 17-7-2013 • Barron AJ, Zaman N, Cole GD, et al.
Systematic review reveals that many side-effects commonly attributed to beta-blockers in heart failure patients, are not true drug effects. Better information may improve drug uptake and outcome.

Poor adherence to antihypertensive therapy increases stroke risk

Literature 17-7-2013 • Herttua K, Tabák AG, Martikainen P et al.
Population-based study highlights importance of good adherence to antihypertensive medication to reduce the risk of fatal or non-fatal stroke.

Prevalence of elevated BP in children has risen over time and is associated with sodium intake

Literature 16-7-2013 • Rosner B et al.
NHANES: in 1999-2008 more children had (pre)hypertension than in 1988-94, partly explained by obesity and Na intake.

Statin use is generally safe, and NOT associated with cancer and myopathy

Literature 10-7-2013 • Naci H, Brugts J, Ades T
A large network meta-analysis investigated the comparative tolerability and harm of individual statins, and the class as a whole.

Childhood hypertension does not increase risk of atherosclerosis in adulthood BP is normalised

Literature 9-7-2013 • Juhola J, Magnussen CG, Berenson GS, et al.
International childhood cohort study assesses link between BP and cIMT. Data suggest that childhood atherogenesis is reversible if childhood elevated BP is resolved.

Tailor-made primary prevention program can reduce cardiovascular risk

Literature 4-7-2013 • Cox JL, Vallis TM, Pfammatter A, et al.
ANCHOR: multidisciplinary behavioural and pharmacological intervention in a primary care setting is effective if intensity of intervention is weighted according to clinical risk and readiness to change.

Sleeping long enough further reduces CVD risk in people who have a healthy lifestyle

Literature 4-7-2013 • Hoevenaar-Blom MP, Spijkerman AMW, Kromhout D et al.
In addition to improving traditional risk factors, a good night’s sleep lowers risk of fatal or nonfatal CVD.

Small life style changes can reduce stroke risk

Literature 20-6-2013 • Kulshreshtha A, Vaccarino V, Judd SE et al.
A better LS7 CV health score based on health factors and health behaviour is associated with a lower risk of stroke. Improving at least one of the LS7  score components is beneficial.

High red meat consumption associated with higher risk of type 2 diabetes mellitus

Literature 19-6-2013 • Pan A, Sun Q, Bernstein AM et al.
Reducing red meat intake lowered T2DM risk. WJ Evans PhD argues in an invited commentary that the specific fatty acid content rather than the colour should be focussed on to reduce health risks.

Vegetarian diets associated with lower mortality, including CVD-related death

Literature 12-6-2013 • Orlich MJ, Singh PN, Sabaté J et al.
Vegetarian diets show a decreased risk of overall and CV-related death in Seventh-day Adventist vegetarians, with a stronger effect for men.

In addition to cardiovascular prevention, Mediterranean diet also has cognitive benefits

Literature 10-6-2013 • Martínez-Lapiscina EH, Clavero P, Toledo E, et al.
After 6.5 years of consumption of a Mediterranean diet supplemented with extra virgine olive oil or nuts, global cognition was better than after a control low-fat diet, in subjects at high vascular risk.

Importance of lifetime CV risk approach in diabetes

Literature 6-6-2013 • Rosner Preis S, Pencina MJ, Mann DM et al.
CVD risk factor burden was examined up to 30 years before diabetes diagnosis among individuals from the Framingham Heart Study Offspring cohort who did and did not develop diabetes.

Cognitive impairment better predicts stroke in the very old than Framingham Stroke risk score

Literature 28-5-2013 • Sabayan B, Gussekloo J, de Ruijter W et al.
MMSE score has better predictive value than conventional cardiovascular risk factors in subjects of 85 years and older. (with PPT)

Low levels of vitamin D associated with increased vascular mortality

Literature 27-5-2013 • Tomson J, Emberson J, Hill M, et al.
The Whitehall study establishes association between 25-hydroxyvitamin D and vascular risk factors, but precise nature of relationship remains unclear.

Long-term increase of systolic blood pressure upon exercise is a CV risk factor

Literature 21-5-2013 • Skretteberg PT, Grundvold I, Kjeldsen SE et al.
Change in blood pressure over time at moderate workload predicts long-term risk of coronary heart disease and mortality in healthy men.

Recent use of marijuana affects insulin resistance

Literature 17-5-2013 • Penner EA, Buettner H, Mittleman MA
Lower levels of fasting insulin, glucose and insulin resistance and lower BMI seen in current users of marijuana.

Majority of heart failure patients prefers quality of life over longevity

Literature 15-5-2013 • Kraai IH, Vermeulen KM, Luttik ML et al.
HF patients who suffer from more clinical symptoms are generally more willing to trade time for shorter time with perfect health; opening the conversation on patient preferences to provide optimal care.

Atherosclerosis already exists for over 5000 years

Literature 15-5-2013 • Thompson RC, Allam AH, Lombardi GP, et al.
Arterial calcifications seen in mummies from diverse preindustrial cultures: is atherosclerosis an inherent component of ageing, rather than a result of modern lifestyle?

Diagnosis of ‘genuine’ resistant hypertension and how it can be prevented

Literature 15-5-2013 • Solini A, Ruilope LM.
This opinion piece discusses the underlying causes of apparent and genuine resistant hypertension and its treatment options

Room for improvement in smoking cessation treatment in GP practices

Literature 1-5-2013 • BMC Public Health. 2013 Apr 18;13(1):362
CV-ASPIRE confirms that smoking is a significant predictor of long-term CV events thus underscores the importance of addressing this modifiable risk factor.

The benefits of regular exercise training are clear but exploited too little

Literature 12-4-2013 • Schuler G, Adams V, Goto Y.
We summarise the molecular consequences of exercise and strategies to increase compliance to frequent exercise.

Extent of second-hand tobacco smoke exposure predicts coronary artery calcification

Literature 20-3-2013 • Yankelevitz DF
Exposure to second-hand tobacco smoke is a risk factor for coronary artery calcification, at least as strong as other well-established risk factors.

CV outcomes in hypertensive patients are affected by BMI

Literature 13-3-2013 • Weber MA, Jamerson K, Bakris GL, et al.
Calcium-channel blocker-based therapy gives more protection to non-obese patients than does diuretic-based therapy, whereas both regimes are effective in obese patients.

Support for prescribing statins as primary prevention

Literature 6-3-2013 • Naci H, Brugts JJ, Fleurence R et al
Statins reduce all-cause mortality and major coronary events both in patients with cardiovascular disease and in high-risk individuals without disease.

Mediterranean diet diminishes cardiovascular risk

Literature 1-3-2013 • Estruch R et al.
Suggested protective effect of Mediterranean diet on cardiovascular disease now confirmed in randomised trial.

Apixaban for prevention of venous thromboembolism

Literature 22-2-2013 • Agnelli G, Buller HR, Cohen A, et al.
New oral factor Xa inhibitor studied for prevention of recurrent venous thromboembolism

Novel use for new anticoagulant dabigatran

Literature 22-2-2013 • Schulman S, Kearon O, Kakkar AK, et al
New information about the risks and benefits of extended prophylaxis with dabigatran in patients who have had venous thromboembolism (VTE)

Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing PCI

Literature 22-2-2013 • Dewilde WJ et al. for the WOEST study investigators
Omitting aspirin from antiplatelet regimen reduces the incidence of bleeding, without compromising safety in patients receiving oral anticoagulants undergoing PCI

ARISTOTLE: Consistent benefit of apixaban across range of patient risk scores

Literature 11-10-2012 • Lopes RD, Al-Khatib SM, Wallentin L, et al. Lancet. 2012 Oct 1
According to an analysis of the ARISTOTLE trial in patients with nonvalvular atrial fibrillation, apixaban was associated with consistent reductions in stroke or systemic embolism and mortality, compared with warfarin, irrespective of the patient’s risk for stroke or bleeding.

Global call for action to reduce cardiovascular risk

Literature 23-9-2012 • Smith SC Jr, Collins A, Ferrari R, et al. EHJ. 2012 Sep 17.
International cardiology group calls for aggressive public health goals. The Global Cardiovascular Disease Taskforce have proposed a set of aggressive measures to help achieve the goal to reduce premature mortality from non-communicable diseases by 25% by the year 2025.

New oral anticoagulants for preventing venous thromboembolism

Literature 24-6-2012 • Gómez-Outes A et al. BMJ. 2012;344:e3675. doi: 10.1136/bmj.e3675.
In this study, data from randomised controlled trials of the new oral anticoagulants for prophylaxis against venous thromboembolism in patients undergoing total hip or knee replacement were systematically reviewed and meta-analysed.

Online treatment beneficial to heart disease patients

Literature 15-6-2012 • Vernooij J W P et al. BMJ 2012;344:bmj.e3750
Patients with vascular disease are at higher risk of suffering a further event or death. Treatment of vascular risk factors by nurse practitioners is proven to be very effective in reducing this risk. This study looks at one year effect in a relatively large group of patients. The primary end point of the study was the relative change in Framingham risk score (FRS) after one year.

Heart rate as risk factor in patients with chronic heart failure

Literature 7-6-2012 • Cullington D, Goode KM, Clark AL, Cleland JG. Eur J Heart Fail. 2012 May 22.
Heart rate reduction is important to decrease the risk of cardiovascular events and improve prognosis. This study evaluated whether beta-blocker dose or heart rate was more strongly associated with mortality in patients with stable chronic heart failure.

Residual risk in secondary prevention of CVD

Literature 16-5-2012 • Mora S, Enger NK, et al., Circulation. 2012;125(16):1979-87
This analysis of the Treating to New Targets (TNT) trial aimed to identify determinants of residual risk above and beyond lipid-related risk factors among patients with stable coronary disease treated to low LDL-cholesterol targets.

New oral anticoagulants vs warfarin in patients with AF

Literature 27-4-2012 • Miller SC et al. Am J Cardiol 2012
This meta-analysis examined the long-term efficacy and safety of the new oral anticoagulants compared to warfarin in preventing stroke and systemic embolism in patients with atrial fibrillation.

ADA/EASD New Hyperglycemia Management Guidelines

Literature 19-4-2012 • Diabetes Care. 2012 Apr 19
The American Diabetes Association and the European Association for the Study of Diabetes have updated guidelines on the management of hyperglycemia in nonpregnant adults with type 2 diabetes. Individualized treatment is the cornerstone of success

Resistant hypertension: Incidence and prognosis

Literature 4-4-2012 • Daugherty SL et al. Circulation. 2012 Apr 3
This retrospective cohort study provides insight into the incidence and prognosis of resistant hypertension. Greater efforts should be made to improve outcomes in patients with resistant hypertension to decrease the risk of cardiovascular events.

Association between chlorthalidone treatment of systolic hypertension and long-term survival

Literature 11-1-2012 • Kostis JB et al, JAMA. 2011;306(23):2588-93
In the SHEP trial, treatment of isolated systolic hypertension with chlorthalidone stepped-care therapy for 4.5 years was associated with longer life expectancy at 22 years of follow-up.

ACE-I/ARBs beneficial in normotensive atherosclerotic patients

Literature 10-11-2011
It is unclear whether angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) are beneficial in individuals with, or at increased risk for, atherosclerotic vascular disease who are normotensive. This study attempted to answer this question. McAlister FA, Eur Heart J. 2011 Oct 31. [Epub ahead of print]

Hypertension and Heart Failure - the ALLHAT trial

Literature 27-10-2011
A long-term follow-up of the ALLHAT shows that hypertension control to prevent heart failure can be achieved in most patients; diuretics can be an effective part of the antihypertensive treatment regimen. Circulation. 2011;124:1811-1818

Cost-effectiveness in diagnosing hypertension

Literature 5-10-2011
Ambulatory blood pressure monitoring is more accurate than both clinic and home monitoring in diagnosing hypertension. This study compared the cost-effectiveness of different diagnostic strategies for hypertension. Lancet. 2011 Oct 1;378(9798):1219-30 .

The EURIKA Study

Literature 3-10-2011
The objective of this study was to estimate the excess risk attributable, firstly, to the presence of CVD risk factors and, secondly, to the lack of control of these risk factors in primary prevention care across Europe. BMC Public Health. 2011 Sep 18

Meta-analysis: CV effects of intensive glucose lowering

Literature 3-10-2011
Glucose lowering treatments are widely used to treat type 2 diabetes ant to prevent long term cardiovascular complications as well as impairment of renal and visual functions. This meta-analysis aimed to determine the benefit of such treatment on clinical end points. BMJ. 2011 Jul 26;343:d4169. doi: 10.1136/bmj.d4169

The role of the primary care physician in managing early stages of chronic kidney disease

Literature 13-9-2011
Recent increases in obesity, diabetes, and hypertension, along with the aging of the population, are driving a dramatic rise in the prevalence of chronic kidney disease (CKD). Primary care practices are at the forefront of detection and management of early CKD.

Withdrawal of Antithrombotic Agents and Its Impact on Ischemic Stroke Occurrence

Literature 19-8-2011
One in 20 ischemic strokes occurs soon after withdrawal of antithrombotic agents, warn researchers.

Hypertension and type 2 diabetes: What family physicians can do to improve control of blood pressure

Literature 16-8-2011
Family practice survey which identifies key factors for improvinh risk reduction in combination hypertension + T2DM - FREE PUBLICATION ATTACHED

CVPC: Epidemiological Cardio-Vascular Study in Primary Care (Greek study)

Literature 18-7-2011
Prevalence of target organ damage in hypertensive subjects attending primary care FREE PUBLICATION ATTACHED

Primary prevention of cardiovascular diseases (Dutch study)

Literature 18-7-2011
A  cost study in family practices - FREE PUBLICATION ATTACHED

ADDITION-Europe (Denmark/Netherlands/UK)

Literature 30-6-2011
Diabetes screening and early intensive intervention in general practice - SLIDES ATTACHED

Upcoming meetings

Meeting reports & resources

EPCCS 2017 Report of the Cardiovascular Summit held in Dublin, Ireland
EPCCS Guidance Documents Evidence- and meeting-based guidance for primary care
EPCCS 2015 Report of 8th Annual EPCCS meeting held in Prague.
EPCCS 2014 Report of 7th Annual EPCCS meeting held in Brussels.
All meeting reports...