New American Heart Association (AHA) methods for estimating 10-year risk of atherosclerotic cardiovascular disease (ASCVD) could limit preventive treatment eligibility among 15.8 billion US patients, potentially leading to more than 100,000 additional myocardial infarctions (MIs) or strokes, researchers have warned.
Researchers comparing the PREVENT and the Pooled Cohort Equations (PCEs) tools said adults with stage 1 hypertension may not be given antihypertensives if a 10-year atherosclerotic cardiovascular disease (ASCVD) risk is estimated by the PREVENT equations instead of the PCEs.
The influence of a social-business diet, comprising high consumption of red meat, pre-made foods, snacks, alcohol and sugary beverages, upon the development of sub-clinical atherosclerotic has not been studied. Data from the Progression of Early Subclinical Atherosclerosis study appear to indicate that such a diet is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis.
PCSK9 inhibitors have been shown to be effective in reducing LDL cholesterol in heterozygous familial hypercholesterolemia and atherosclerotic cardiovascular disease. It has not been confirmed whether such agents provide value for money in an increasingly cash-limited health system. A stimulation model of US adults aged 35-94 years to evaluate the cost-effectiveness of PCSK9 inhibitors or ezetimibe has indicated that based upon 2015 prices PCSK9 inhibitors did not meet the incremental cost effectiveness thresholds, placing a significant increase on the US health care cost.
The target for systolic BP in older adults with hypertension is uncertain. A multicenter randomized study comparing intensive (<120 mmHg) with standard (<140 mmHg) targets in adults ≥ 75 years has indicated that an intensive target is associated with lower rates of fatal and non-fatal major cardiovascular events and mortality. The intensive target was associated with hypotension, syncope, and renal injury.
Nicole Lou Reporter, MedPage Today/CRTonline.org
Michael Mahmoudi, MD - C Gyldenkerne, et al.; Circ 2023; 147:469-481
J Penalvo, et al.; JACC 2016; 68:805-814
J wing, et al.; Circ 2016; 134:504-513
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