Preventive Cardiology
M-A | Mediterranean & low-fat diets may reduce mortality and non-fatal MI in patients with high cardiovascular risk
3 Apr, 2023 | 13:59h | UTCSummary: This systematic review and network meta-analysis aimed to determine the relative efficacy of different diets for preventing mortality and major cardiovascular events in patients at increased risk of cardiovascular disease. The study identified 40 randomized trials with 35,548 participants across seven dietary programs.
Moderate certainty evidence showed that Mediterranean and low-fat diets, with or without physical activity or other interventions, reduced all-cause mortality and non-fatal myocardial infarction in patients with increased cardiovascular risk. Mediterranean diet programs were also likely to reduce stroke risk.
Other dietary programs generally were not superior to minimal intervention. When compared with one another, no convincing evidence was found that the Mediterranean diet was superior to the low-fat diets in preventing mortality or non-fatal myocardial infarction.
News Release: Benefits of Mediterranean and low fat diet programmes in patients at risk of cardiovascular disease – BMJ Newsroom
Commentary: Mediterranean, Low-Fat Diets Both Good for Health: Network Meta-analysis – TCTMD
Consensus Statement | Promotion of healthy nutrition in primary and secondary cardiovascular disease prevention
28 Mar, 2023 | 14:50h | UTC
Commentary on Twitter
#EJPC 🌞 – Healthy #nutrition is important! Read the #EAPC_ESC Clinical Consensus Statement on promotion of healthy nutrition in primary & secondary #CVD prevention!https://t.co/kx7MnQxruS
#CardioTwitter #EJPC #CVPrev #CardioTwitter #Rehabilitation @paolo_emilio @EAPCPresident pic.twitter.com/LIDarfvw7b— European Society of Cardiology Journals (@ESC_Journals) March 27, 2023
M-A | Ionizing radiation and cardiovascular disease
14 Mar, 2023 | 13:49h | UTCIonising radiation and cardiovascular disease: systematic review and meta-analysis – The BMJ
News Release: Low dose radiation linked to increased lifetime risk of heart disease – BMJ Newsroom
WHO urges countries to implement comprehensive sodium reduction policies to combat cardiovascular disease
10 Mar, 2023 | 14:43h | UTCSummary:
A new report from the World Health Organization (WHO) has shown that the world needs to catch up to achieve its global target of reducing sodium intake by 30% by 2025. The report highlights that only 5% of WHO member states have mandatory and comprehensive sodium reduction policies.
Sodium, found in table salt and other condiments, increases the risk of heart disease, stroke, and premature death when eaten in excess. Implementing highly cost-effective sodium reduction policies could save an estimated seven million lives globally by 2030.
WHO suggests a number of policies, such as reducing the amount of sodium in food products, introducing front-of-pack labeling, launching mass media campaigns, and enforcing public policies related to food service and sales.
The report urges member states to implement sodium intake reduction policies without delay, and calls on food manufacturers to set ambitious targets for sodium reduction in their products.
Article: WHO global report on sodium intake reduction – World Health Organization
News Release: Massive efforts needed to reduce salt intake and protect lives – World Health Organization
Related:
Adding salt to foods and hazard of premature mortality – European Heart Journal
New WHO benchmarks help countries reduce salt intake and save lives – World Health Organization
WHO global sodium benchmarks for different food categories – World Health Organization
Commentary on Twitter
Eating too much salt is one of the top risk factors for heart disease, stroke, and death.
WHO’s first global report on sodium intake reduction shows only 5% of WHO Member States are protected by mandatory and comprehensive sodium reduction policies👉https://t.co/hiocdiXUiy pic.twitter.com/NXSv0oe7fn
— World Health Organization (WHO) (@WHO) March 9, 2023
WHO Meta-Analysis | Saturated fat and trans-fat intakes and their replacement with other macronutrients
9 Mar, 2023 | 14:24h | UTC
Commentary on Twitter
Saturated fat and trans-fat intakes
and their replacement with other
macronutrients
published on behalf @WHO https://t.co/fNXmKwWOMQ pic.twitter.com/0Qi8PNqyqq— Lukas Schwingshackl (@LSchwingshackl) March 6, 2023
RCT | Bempedoic acid shows modest reduction in cardiovascular events for statin-intolerant patients
8 Mar, 2023 | 14:39h | UTCSummary:
Bempedoic acid is an ATP citrate lyase inhibitor that reduces LDL cholesterol levels and is associated with a low incidence of muscle-related adverse events. The study enrolled 13,970 patients at increased cardiovascular risk, with 6,992 randomized to bempedoic acid and 6,978 randomized to placebo, with a median duration of follow-up of 40.6 months.
The study found that bempedoic acid was associated with a statistically significant 13% reduction in the primary endpoint of major adverse cardiovascular events, which included death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization. However, the absolute risk reduction of events was modest, at 1.6% over nearly four years.
The study also reported higher incidences of gout and cholelithiasis with bempedoic acid compared to placebo, as well as small increases in serum creatinine, uric acid, and hepatic-enzyme levels.
Article: Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
CLEAR Positives and Cautions With Bempedoic Acid for Statin Intolerance – Medscape (recommended reading – free registration required)
Cardiovascular Outcomes After “Statin-Intolerant” Patients Take Bempedoic Acid – NEJM Journal Watch (free for a limited period)
Commentary on Twitter
Bempedoic acid showed a modest absolute reduction in CV outcomes, relative to placebo, in patients “unable or unwilling” to take a statin. https://t.co/hQUfvFwz68 #ACC23 @hmkyale @NEJM #CardioTwitter pic.twitter.com/YMoNsce8MI
— NEJM Journal Watch (@JWatch) March 7, 2023
M-A | Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes
8 Mar, 2023 | 14:33h | UTCSummary:
The study aimed to determine the association between non-occupational physical activity and chronic disease and mortality outcomes in the general adult population. The systematic review and meta-analysis included 196 articles covering 94 cohorts and over 30 million participants.
The results showed that higher activity levels were associated with a lower risk of all outcomes. The strongest associations were observed for all-cause and cardiovascular disease mortality, with weaker associations for cancer incidence.
The study also found that appreciable population health benefits could be gained from increasing physical activity levels of people who are inactive to just half the current health recommendations; doing that could prevent one in 10 premature deaths.
The findings support the current physical activity recommendations and suggest that even small increases in non-occupational physical activity in inactive adults can provide substantial protection against chronic disease outcomes.
It’s worth noting, however, that this study has the usual limitations of observational studies since all the included studies are cohort studies. Therefore, the results are subject to residual confounding, meaning that other factors not measured or accounted for in the studies could influence the observed associations.
News Releases:
1 in 10 early deaths averted if everyone met physical activity targets – BMJ Newsroom
M-A | Long-term consumption of 10 food groups and cardiovascular mortality
7 Mar, 2023 | 12:58h | UTCSummary:
This systematic review and meta-analysis of 22 prospective cohort studies evaluated the association between the consumption of 10 food groups and cardiovascular mortality.
The researchers found that a long-term high intake of whole grains, fruits and vegetables, and nuts was associated with reduced cardiovascular mortality, while a high intake of red/processed meat was associated with increased risk. On the other hand, the consumption of dairy products and legumes did not show a significant association with cardiovascular risk.
The researchers acknowledge the limitations of observational studies and the need for further research on the long-term effects of specific food groups on cardiovascular mortality.
Artificial sweetener erythritol possibly implicated in increased cardiovascular risk
1 Mar, 2023 | 14:08h | UTCSummary: A recent study published in Nature Medicine found that erythritol, a popular artificial sweetener, is possibly implicated with an increased risk of major adverse cardiovascular events (MACE) such as heart attack and stroke. Analyzing data from over 4,000 people in the US and Europe, the researchers found that those with higher blood erythritol levels were at a greater risk of MACE. The researchers also examined the effects of adding erythritol to whole blood or isolated platelets and found that it made platelets easier to activate and form clots. In addition, a pilot intervention study with healthy volunteers showed that erythritol ingestion led to a marked and sustained increase in plasma erythritol levels above those associated with heightened platelet reactivity and thrombosis potential. The authors note that further studies are needed to confirm their findings and assess the long-term safety of erythritol.
Article: The artificial sweetener erythritol and cardiovascular event risk – Nature Medicine (free for a limited period)
News Release: Cleveland Clinic study finds common artificial sweetener linked to higher rates of heart attack and stroke
Commentaries:
Zero-calorie sweetener linked to heart attack and stroke, study finds – CNN
Could a Common Sweetener Raise Heart Risks? – HealthDay
Commentary on Twitter
A study in @NatureMedicine suggests that a commonly used artificial sweetener—erythritol—may be linked to cardiovascular disease events. https://t.co/QrbtvCFDJ4 pic.twitter.com/WpM9cLnXh7
— Nature Portfolio (@NaturePortfolio) February 27, 2023
M-A | Consumption of whole vs. refined grains and risk of cardiovascular disease and all-cause mortality
20 Feb, 2023 | 12:23h | UTCSummary: This systematic review and meta-analysis of prospective cohort studies found that consuming whole grains was associated with a reduced risk of coronary heart disease, cardiovascular disease, and all-cause mortality, while consuming refined grains had no significant influence on these outcomes. Residual confounding can’t be excluded and the association found does not necessarily imply causation.
M-A | Aspirin with or without statin in individuals without atherosclerotic CVD across risk categories
17 Feb, 2023 | 13:22h | UTCSummary: This meta-analysis examined the effects of aspirin in adults without atherosclerotic cardiovascular disease (ASCVD), stratified by statin use across different ASCVD risks. The analysis found that aspirin reduced myocardial infarction but increased major bleeding, and was not associated with total or cardiovascular survival benefits. In adults without ASCVD, concomitant statin appeared to significantly reduce absolute risk reduction for MI associated with aspirin without influencing bleeding risk. The study highlights that the risk-benefit equilibrium may be tilted towards more harm for primary prevention, and that the expected absolute risk of major bleeding exceeds absolute MI benefits by aspirin for every level of ASCVD risk. The findings have implications for the use of aspirin in those already on statin therapy for primary ASCVD prevention.*
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
AHA Statement | Optimizing prepregnancy cardiovascular health improves outcomes for pregnant women, offspring
15 Feb, 2023 | 16:14h | UTCSummary: This statement highlights the need to optimize cardiovascular health before pregnancy to reduce the risk for adverse pregnancy outcomes and cardiovascular disease in mothers and children. It emphasizes the role of clinicians in promoting early cardiovascular health, clinical trials to investigate interventions, and the use of a life course framework to monitor health. By targeting cardiovascular health before pregnancy, interventions can improve health outcomes across generations.*
News Release: Does risk for heart disease start before birth? – American Heart Association
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
Updated Guideline | Cardiovascular disease risk assessment and reduction, including lipid modification
13 Feb, 2023 | 12:47h | UTCRelated Guidelines:
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease – Circulation
#ESCCongress – 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias
#ESCCongress – 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.
Abbreviated lipid guidelines for clinical practice
13 Feb, 2023 | 12:46h | UTCOriginal Guidelines
#ESCCongress – 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias
#ESCCongress – 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.
Related:
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease – Circulation
Machine learning-based marker for coronary artery disease: derivation and validation in two longitudinal cohorts
8 Feb, 2023 | 12:14h | UTCMachine learning-based marker for coronary artery disease: derivation and validation in two longitudinal cohorts – The Lancet (link to abstract – $ for full-text)
News Release: Digital marker for coronary artery disease built by researchers at Mount Sinai
Commentary: Machine learning used to generate a new holistic model for coronary artery disease – News Medical
Commentary from the author on Twitter (thread – click for more)
Christmas came early… my first paper of my postdoc is officially published @TheLancet!! https://t.co/pozEyRKkD0
This was a wild journey with the @DoGenetics lab to build a digital marker for heart disease using AI + electronic health records🫀🤖 Here's why:
1/🧵— Iain S. Forrest, PhD (@IainSForrest) December 21, 2022
M-A | Effects of GLP-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes and CKD
1 Feb, 2023 | 13:06h | UTC
WHO | Five billion people unprotected from trans-fat leading to heart disease
24 Jan, 2023 | 14:44h | UTCNews Release: Five billion people unprotected from trans fat leading to heart disease – World Health Organization
Report: Countdown to 2023: WHO report on global trans-fat elimination 2022 – World Health Organization
Commentary: Five Billion People Exposed to Industrially Produced Trans Fats – Health Policy Watch
Related:
WHO: More than 3 billion people protected from harmful trans-fat in their food
Action Package: WHO Plan to Eliminate Trans-fatty Acids from Global Food Supply
WHO Draft Guideline: Saturated Fatty Acid and Trans-fatty Intake for Adults and Children
Banning trans fats in New York prevented thousands of heart attacks
Review | Cardiovascular outcomes in type 1 and type 2 diabetes
23 Jan, 2023 | 13:18h | UTCCardiovascular outcomes in type 1 and type 2 diabetes – Diabetologia
Commentary on Twitter
Useful review of Cardiovascular outcomes in type 1 and type 2 diabeteshttps://t.co/mDECkFbZCq pic.twitter.com/q7J74FkNgJ
— Prof Kamlesh Khunti (@kamleshkhunti) January 20, 2023
Article under a http://creativecommons.org/licenses/by/4.0/. License
M-A | Prospective association of daily steps with cardiovascular disease
10 Jan, 2023 | 14:29h | UTCProspective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis – Circulation (link to abstract – $ for full-text)
Commentaries:
CVD Benefits of Activity Seen Below Widely Quoted Step Goal in Older Adults – TCTMD
Heart health tip for older adults in 2023: Step it up a bit – University of Massachusetts Amherst
Commentary on Twitter
#OriginalResearch: In a meta-analysis of 8 studies, 6,000 to 9,000 steps/day was associated with 40% to 50% lower risk of CVD among older adults #AHAJournals https://t.co/fEA1EFyhTI pic.twitter.com/T6LXFGZoVb
— Circulation (@CircAHA) December 21, 2022
Cohort Study | Association of the triglyceride glucose index as a measure of insulin resistance with mortality and CVD
9 Jan, 2023 | 13:42h | UTCInvited Commentary: The triglyceride glucose index and cardiovascular disease outcomes – The Lancet Health Longevity
RCT | Chlorthalidone (12.5-25 mg) and Hydrochlorothiazide (25-50 mg) are similarly effective for the prevention of CVD in hypertensive patients.
16 Dec, 2022 | 13:49h | UTCChlorthalidone vs. Hydrochlorothiazide for Hypertension–Cardiovascular Events – New England Journal of Medicine (link to abstract – $ for full-text)
Related (news release and commentaries before publication): RCT | Chlortalidone and Hydrochlorothiazide resulted in similar reductions of CVD in older patients with hypertension.
Commentary on Twitter
Patients 65 years or older with hypertension who switched from chlorthalidone to hydrochlorothiazide did not have fewer major cardiovascular events or non–cancer-related deaths than those who continued receiving hydrochlorothiazide. https://t.co/9xAiSZzxio pic.twitter.com/bIVOOiVDve
— NEJM (@NEJM) December 14, 2022
Cohort Study | Lipoprotein(a) in youth and prediction of major cardiovascular outcomes in adulthood.
9 Dec, 2022 | 13:11h | UTCLipoprotein(a) in Youth and Prediction of Major Cardiovascular Outcomes in Adulthood – Circulation
Commentary: Lp(a) in Youth and Risk of ASCVD Outcomes in Adulthood – American College of Cardiology
Commentary on Twitter
#OriginalResearch Childhood Lp(a) levels are associated with significantly increased risk of develping ASCVD as adults @UTUpophealth @olraita #AHAJournals https://t.co/oqHv19QU6l pic.twitter.com/ByZmtRrXqy
— Circulation (@CircAHA) November 30, 2022
Cohort Study | Adding salt to foods linked to increased risk of cardiovascular disease.
6 Dec, 2022 | 14:04h | UTCAdding Salt to Foods and Risk of Cardiovascular Disease – Journal of the American College of Cardiology (link to abstract – $ for full-text)
News Release: Shaking less salt on your food at the table could reduce heart disease risk – American College of Cardiology
Commentaries:
Adding Salt to Food and Risk of Cardiovascular Disease – American College of Cardiology
Lower Frequency of Adding Salt to Food Linked to Lower CVD Risk – HealthDay
M-A | Cardioprotective effects of influenza vaccination in patients with high risk of cardiovascular disease.
25 Nov, 2022 | 12:47h | UTCCardioprotective effects of influenza vaccination among patients with established cardiovascular disease or at high cardiovascular risk: a systematic review and meta-analysis – European Journal of Preventive Cardiology (free for a limited period)
Related:
RCT | Influenza vaccine to reduce adverse vascular events in patients with heart failure.
Cohort Study | Race-dependent association of HDL-C levels with incident coronary artery disease.
23 Nov, 2022 | 14:02h | UTCNews Release: Study challenges “good” cholesterol’s role in universally predicting heart disease risk – National Institutes of Health