Twenty years of research show that generic CVD drugs across nine classes are just as good as brand-name agents, yet editorials often boost superiority of brand-name agents. (Kesselheim AS et al. JAMA 2008; 300:2514-2526.)
It's not just the amount of alcohol is drunk, but the way that it is drunk that is important when it comes to cardiovascular health. New research suggests a precise mechanism by which binge drinking might contribute to atherosclerosis. (Redmond EM et al. Atherosclerosis; published online before print October 18, 2008.)
Six years after the 44 000-patient trial was reported, use of generic diuretics never reached the levels that investigators expected. Reasons include patents ending, new drugs emerging, and the advent of combination pills, but also the millions of dollars spent by companies making brand-name antihypertensives.
Two new studies published online this week help shed light on the off-target toxicity of the CETP inhibitor torcetrapib, but the studies conflict regarding the atheroprotective functionality of the HDL cholesterol resulting with the drug. (Vergeer M et al. Nicholls SJ et al. Circulation; published online before print November 25, 2008.)
In the largest study of its kind to date, Brazilian researchers have shown that ambulatory BP monitoring is a predictor of future cardiovascular events in patients with resistant hypertension, but office BP is not. (Salles GF et al. Arch Intern Med 2008; 168:2340-2346.)
One of the largest and most comprehensive studies of heart failure to date in Africa has shown that the disease is a big problem and that although the traditional causes of HFwhich differ from those seen in Western nationsstill predominate, there are signs that the range of etiologies is broadening (Stewart S et al. Circulation 2008; published online before print November 24, 2008.)
The first study to ever assess the prognostic value of a change in heart rate over a number of years has found that increasing HR over time can increase mortality, by around 20%. Conversely, a decline in HR was accompanied by reduced rate of death over the five-year study period. (Jouven et al. Am J Cardiol; published online before print November 7, 2008.)
Chlorthalidone and lisinopril as initial antihypertensive agents were about equally effective at reducing the risk of new systolic heart failure, an analysis suggests; the thiazide was superior at preventing heart failure with preserved EF. (Davis BR et al. Circulation; published online before print November 10, 2008.)
Researchers who fitted study subjects with "air-pollution vests" to continuously monitor exposure to both indoor and outdoor air pollutants say that people are probably exposed to much higher levels of pollutants than community monitoring stations typically indicate and that this exposure affects both endothelial function and systolic blood pressure. (American Heart Association 2008 Scientific Sessions.)
The use of beta blockers perioperatively to prevent cardiovascular events in patients undergoing noncardiac surgery is not justified by current evidence, according to the authors of a new meta-analysis. An update to the guidelines on this issue is under way, says one member of the writing committee, who incidentally does not agree with this overall conclusion. (Bangalore S et al. Lancet; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)
Four years of treatment with irbesartan, usually on top of other drugs that affect the renin-angiotensin-aldosterone system, didn't improve outcomes in patients with the common but poorly understood form of heart failure. The trial follows previous negative studies of an ACE inhibitor and a different angiotensin-receptor blocker, respectively, in similar populations. (American Heart Association 2008 Scientific Sessions.)
Results of a small randomized trial show that hibiscus tea given three times daily reduced systolic blood pressure by about 7 mm Hg in prehypertensive and mildly hypertensive subjects. (American Heart Association 2008 Scientific Sessions.)
Focusing on the classic risk factors for coronary heart disease and ensuring that best-practice interventions to reduce absolute risk are implemented across the board could largely eliminate socioeconomic differences in CHD deaths, a new British study predicts (Kivimäki M et al. Lancet 2008; 372:1648-1654.)
OSA not accompanied by daytime symptoms might still suggest increased cardiovascular risk, according to researchers. (Kohler M et al. Am J Respir Crit Care Med 2008; 178:984-988.)
Race per se shouldn't be a barrier to lowering the risk of new heart failure in African Americans, because the main causes are treatable, according to investigators for the longitudinal cohort study. (Bahrami H et al. Arch Intern Med 2008; 168:2138-2145.)
Rest easy for now: MI rates appear to increase in the spring but dip marginally with the end of DST in autumn, due likely to the extra hour of sleep. (Janszky et al. N Engl J Med 2008; 359:1966-1967.)
A new retrospective cohort study has found that those taking beta blockers prior to noncardiac surgery had higher rates of MI and death at 30 days than those not taking beta blockers. The findings are similar to those of the landmark POISE study, says the senior author, although he acknowledges that there are some differences and that the new study has limitations. (Kaafarani HMA et al. Arch Surg 2008; 143:940-944.)
Nitric oxide, it turns out, is not alone in controlling blood-pressure levels. A new study points to hydrogen sulfide, a gas responsible for some noxious smells, as a major physiologic vasodilator and regulator of blood pressure. (Yang G et al. Science 2008; 322:587-590.)
Slowing the heart rate with beta blockers in people with hypertension is associated with an increased risk of cardiovascular events and death, a new systematic review shows. But one expert points out the analysis was done mainly with studies that used atenolol and that it remains to be determined whether it is this drug per se or the reduction in heart rate that is harmful. (Bangalore S et al. J Am Coll Cardiol 2008; 52:1482-1489.)
A new study, POPADAD, has found no evidence that aspirin or antioxidants are of any benefit in the primary prevention of cardiovascular events in diabetic patients with asymptomatic peripheral arterial disease. The authors and accompanying editorialist say guidelines should be changed; others say more evidence is needed. (Belch Jet al. BMJ; published online before print October 16, 2008.)
New results from the extended follow-up of the APPROVE trial provide a more complete assessment of the cardiovascular toxicity of the COX-2 inhibitor rofecoxib than previously reported. The findings are still very relevant, because this is a class effect, say the researchers and editorialists. (Baron JA et al. Lancet; published online before print October 13, 2008.)
A new report shows that more US adults have hypertension than ever before, and the increase is primarily due to the rising rates of obesity in recent times, say the NHLBI researchers. However, awareness, treatment, and control of blood pressure have also improved. Nevertheless, much work remains, specifically with certain subgroups, they say. (Cutler JA et al. Hypertension; published online October 13, 2008.)
The Indian government appears to have heeded the warnings of medical experts highlighting the immense problem of smoking in the country, with the introduction this week of a nationwide ban on smoking in public places.
Data on ARBs continue to impress. Stay informed on the implications of late-breaking trial data from the 2008 ESC meeting with interviews conducted by Dr Weber with Drs Pfeffer, McMurray, Swedberg, and Agabati-Rosei.
Hypertension, hypercholesterolemia, insulin resistance, atherosclerosis, coronary heart disease, heart failure: are they all at the mercy of nitric oxide? Join Drs Weber, Cohn, Mason and Cockcroft in a discussion on the role nitric oxide plays in vascular health.
The assessment of microalbuminuria (MAU) is an important prognostic indicator for CVD and renal damage and should be an element in an overall cardiometabolic fitness approach.