disease, cardiovascular

MeSH

blood pressure

hypertension

This is the material used in the Healthy Hearts for OK project to update clinicians on the role of BP control to prevent cardiovascular events.

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An update for clinicians on the role of blood pressure for prevention of cardiiovascular events from the Healthy Hearts for OK project.

Author/s:

Mold, James W.

Cholesterol Management in Primary Care

Tracy Ashby — Fri, 25 Jan 2019 06:00:00 +0000

Date Added:

January 25, 2019

Journal/Publication:

Healthy Hearts for Oklahoma (H2O)

Publisher:

The Oklahoma Cooperative

Publication Date:

January 25, 2019

Type:

Clinical Decision Aids

Format:

Article

Keywords

statins

cardiovascular disease

MeSH

Hydroxymethylglutaryl-CoA Reductase Inhibitors

This is the material used in the Healthy Hearts for OK project to update clinicians on the use of statins to prevent cardiovascular events.

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An update for clinicians on the use of statins to prevent cardiiovascular events from the Healthy Hearts for OK project.

Author/s:

Mold, James W.

Smoking Cessation in Primary Care

Tracy Ashby — Fri, 25 Jan 2019 06:00:00 +0000

Date Added:

January 25, 2019

Journal/Publication:

Healthy Hearts for Oklahoma (H2O)

Publisher:

The Oklahoma Cooperative

Publication Date:

January 25, 2019

Type:

Clinical Decision Aids

Format:

Article

Keywords

smoking cessation

MeSH

smoking cessation

Effect of glycaemic control on cardiovascular disease in individuals with type 2 diabetes with pre-existing cardiovascular disease: A systematic review and meta-analysis

This is the material used in the Healthy Hearts for OK project to update clinicians on the importance of smoking cessation for prevention of cardiovascular events.

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An update for clinicians on the importance of smoking cessation for the prevention of cardiiovascular events from the Healthy Hearts for OK project.

Author/s:

Mold, James W.

Effect of glycaemic control on cardiovascular disease in individuals with type 2 diabetes with pre-existing cardiovascular disease: A systematic review and meta-analysis

Tracy Ashby — Sun, 06 Jan 2019 06:00:00 +0000

Date Added:

January 6, 2019

Journal/Publication:

Diabetes, Obesity and Metabolism

Publisher:

John Wiley & Sons, Inc.

Publication Date:

November 13, 2018

Pages:

1-4

URL:

Type:

Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1111/dom.13581

Keywords

cardiovascular disease

glucose control

intensive

type 2 diabetes

PMID (1):

30426626

MeSH

diabetes mellitus, type 2

Effects of an Angiotensin-Converting–Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients

blood glucose

Glycemic control in patients with type 2 diabetes mellitus and cardiovascular disease did not reduce the rate of subsequent adverse cardiovascular events in this large meta-analysis which included patients on metformin but not some of the newest hypoglycemic agents. Reasons to control blood sugar levels in type 2 diabetics are: 1) to reduce symptoms related to dehydration; 2) to reduce the risk or severity of certain infections (e.g. Monilial infections and possibly UTIs), 3) to reduce the risk of hyperosmolar non-ketotic coma; and 4) to reduce the risk of microvascular complications over the long term.

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The role of intensive glucose control in people with type 2 diabetes and pre‐existing cardiovascular disease (CVD) is controversial. The aim of this systematic review and meta‐analysis was to determine in a subset of people with type 2 diabetes and pre‐existing CVD, the CV effect of intensive glucose control versus standard of care. We searched Medline, the Cochrane library, EMBASE and the National Institutes of Health Trial registration database for randomized controlled trials that evaluated the effect of intensive glucose control versus standard glucose control in people with type 2 diabetes on incident CVD. Data were extracted using a structured form. When data were not available in the publications, authors were contacted. Eight trials involving 8339 participants were included. Among adults with type 2 diabetes and pre‐existing CVD, there was no difference in the risk of CV events in those allocated to intensive glucose control compared with those in the standard care arm (relative risk 0.98, 95% confidence interval 0.87‐1.09). In conclusion, in people with diabetes and pre‐existing CVD, intensive glucose control versus standard care had a neutral effect on incident CV events.

Author/s:

Barer, Yael, Cohen, Ohad, Cukierman-Yaffe, Tali

Effects of an Angiotensin-Converting–Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients

Jeffrey Wilson — Wed, 26 Sep 2018 13:40:47 +0000

Date Added:

September 26, 2018

Journal/Publication:

New England Journal of Medicine

Publisher:

Massachusetts Medical Society

Publication Date:

January 20, 2000

Issue:

Volume:

342

Pages:

145-153

URL:

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1056/NEJM200001203420301

Keywords

rampril

PMID (1):

10639539

MeSH

rampril

ventricular dysfunction, left

This article was published in 2000. We have added it to RPR because of its importance. In patients at high risk for cardiovascular events, ramipril reduced all-cause mortality and a variety of adverse cardiovascular events by about 20%. The effects were largely independent of blood pressure reduction. Ramipril was chosen because of its intracellular ACEI effects.

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BACKGROUND:

Angiotensin-converting-enzyme inhibitors improve the outcome among patients with left ventricular dysfunction, whether or not they have heart failure. We assessed the role of an angiotensin-converting-enzyme inhibitor, ramipril, in patients who were at high risk for cardiovascular events but who did not have left ventricular dysfunction or heart failure.

METHODS:

A total of 9297 high-risk patients (55 years of age or older) who had evidence of vascular disease or diabetes plus one other cardiovascular risk factor and who were not known to have a low ejection fraction or heart failure were randomly assigned to receive ramipril (10 mg once per day orally) or matching placebo for a mean of five years. The primary outcome was a composite of myocardial infarction, stroke, or death from cardiovascular causes. The trial was a two-by-two factorial study evaluating both ramipril and vitamin E. The effects of vitamin E are reported in a companion paper.

RESULTS:

A total of 651 patients who were assigned to receive ramipril (14.0 percent) reached the primary end point, as compared with 826 patients who were assigned to receive placebo (17.8 percent) (relative risk, 0.78; 95 percent confidence interval, 0.70 to 0.86; P<0.001). Treatment with ramipril reduced the rates of death from cardiovascular causes (6.1 percent, as compared with 8.1 percent in the placebo group; relative risk, 0.74; P<0.001), myocardial infarction (9.9 percent vs. 12.3 percent; relative risk, 0.80; P<0.001), stroke (3.4 percent vs. 4.9 percent; relative risk, 0.68; P<0.001), death from any cause (10.4 percent vs. 12.2 percent; relative risk, 0.84; P=0.005), revascularization procedures (16.3 percent vs. 18.8 percent; relative risk, 0.85; P<0.001), cardiac arrest (0.8 percent vs. 1.3 percent; relative risk, 0.62; P=0.02), [corrected] heart failure (9.1 percent vs. 11.6 percent; relative risk, 0.77; P<0.001), and complications related to diabetes (6.4 percent vs. 7.6 percent; relative risk, 0.84; P=0.03).

CONCLUSIONS:

Ramipril significantly reduces the rates of death, myocardial infarction, and stroke in a broad range of high-risk patients who are not known to have a low ejection fraction or heart failure.

Author/s:

Yusuf, Salim

Aspirin Use in Primary Care

Jeffrey Wilson — Wed, 05 Sep 2018 15:37:53 +0000

Date Added:

September 5, 2018

Journal/Publication:

Healthy Hearts for Oklahoma

Publisher:

Agency for Healthcare Research and Quality

Type:

Clinical Decision Aids

Keywords

cardiovascular disease

secondary prevention

primary prevention

MeSH

Effects of Aspirin on Risks of Vascular Events and Cancer According to Bodyweight and Dose: Analysis of Individual Patient Data from Randomised Trials

secondary prevention

primary prevention

This is the decision aid for low-dose aspirin use developed for the Healthy Hearts for OK Project. For that project, we emphasized secondary prevention. Primary prevention is still controversial and situation-dependent.

The benefit of aspirin is not dose-dependent; use low-dose aspirin (81 mg) when indicated.

Effects of Aspirin on Risks of Vascular Events and Cancer According to Bodyweight and Dose: Analysis of Individual Patient Data from Randomised Trials

Jeffrey Wilson — Tue, 28 Aug 2018 19:33:50 +0000

Date Added:

September 26, 2018

Journal/Publication:

Lancet

Publisher:

Elsevier

Publication Date:

August 4, 2018

Issue:

10145

Volume:

392

Pages:

387-399

URL:

Type:

Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/S0140-6736(18)31133-4

Keywords

cancer

PMID (1):

30017552

MeSH