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The Apple Heart Study demonstrates that the Apple Watch can detect atrial fibrillation inferred from the smartwatch heart-rate sensor with a high positive predictive value. However, we must now contend with many clinically relevant unknowns that were not addressed by the study, such as the ramifications of a false-positive result.
Findings from a large, international study comprising 4.9 million people with mild hypertension suggest that thiazide and thiazide-like diuretics might be more effective and safer than other first-line antihypertensive drugs. However, the study was not randomized, and the findings might be explained by a phenomenon known as ‘confounding by indication’.
Results from a prospective study by Santema and colleagues suggest that women with heart failure and reduced ejection fraction might need lower doses of standard heart failure drugs than men. However, this conclusion was formed on the basis of data from a small proportion of the population studied and might only be relevant to participants taking β-blockers.
The myocardial viability substudy from the STICH trial has reaffirmed the 10-year survival benefit of CABG surgery in patients with left ventricular dysfunction, but whether myocardial viability must be present for the long-term benefits of revascularization to be realized remains inconclusive.
Preclinical data and small clinical trials suggest that remote ischaemic conditioning (RIC) therapy protects patients with acute myocardial infarction undergoing percutaneous coronary intervention. In the CONDI-2/ERIC-PPCI trial, RIC proved to be safe but did not have any short-term benefits in reducing cardiac-related death and hospitalization for heart failure.
In a 15-year follow-up of the VADT study, no differences in major cardiovascular outcomes were found among individuals with type 2 diabetes mellitus who underwent either intensive or standard glucose control. These results indicate that intensification of glycaemic control might not be expected to mitigate the risk of cardiovascular events.
The global burden of cardiovascular disease morbidity and mortality demands increased awareness of effective prevention strategies by patients, communities and health-care providers. The new 2019 ACC/AHA guidelines provide evidence-based, preventive recommendations for patients without known cardiovascular disease, focusing on risk estimation, a healthy lifestyle and selective indications for pharmacotherapy.
Nonresolving inflammation underpins several prevalent diseases, including atherosclerosis and Alzheimer disease. The resolution of inflammation is an active process that tempers pro-inflammatory pathways and promotes tissue repair. Understanding the mechanisms that boost endogenous resolution is important for the design of new treatment strategies for nonresolving diseases.
