Featured
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Research Highlight |
Apixaban triumphs over aspirin for stroke prevention in patients with atrial fibrillation
- Alexandra King
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Review Article |
Lipid control in patients with diabetes mellitus
Patients with type 1 or type 2 diabetes mellitus are at increased risk of cardiovascular disease (CVD). In this Review, the author discusses available data from randomized controlled trials of statins and other dyslipidemia-management agents that provide a framework to guide primary and secondary prevention of CVD in these populations.
- D. John Betteridge
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Research Highlight |
Is CRP level useful to guide statin therapy? Lack of evidence from HPS fuels the debate
- Joana Osório
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Review Article |
Pharmacological strategies for lowering LDL cholesterol: statins and beyond
The relationship between an elevated level of LDL cholesterol (LDL-C) and increased risk of cardiovascular disease is well established. National and international guidelines are continuously being revised to recommend increasingly lower LDL-C targets for cardiovascular disease prevention. In this Review, Drs. Brautbar and Ballantyne examine the evidence and recommendations for optimal LDL-C levels and the agents currently available or under development to achieve these levels.
- Ariel Brautbar
- & Christie M. Ballantyne
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Review Article |
Utility of genetic determinants of lipids and cardiovascular events in assessing risk
Genetic testing is an attractive tool for CHD risk prediction; however, the process of harnessing genetic information to improve population health is in its infancy. In this article, Dr Holmes and colleagues discuss the numerous challenges faced by researchers and clinicians, and suggest a change of focus to better exploit the opportunities offered by the unique properties of genetic information.
- Michael V. Holmes
- , Seamus Harrison
- & Steve E. Humphries
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Review Article |
Diagnostic and therapeutic strategies for small abdominal aortic aneurysms
Abdominal aortic aneurysm (AAA) is a common condition that can result in aortic rupture and death. AAA-related mortality continues to rise, highlighting the growing need for effective management strategies. In this Review, the authors discuss the current and future diagnostic and therapeutic strategies for the management of AAA, including the potential of new imaging techniques and novel pharmacological agents.
- Ahmed Klink
- , Fabien Hyafil
- & Zahi A. Fayad
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Research Highlight |
Supplements not cardioprotective for patients with a history of CVD
- Rowan Higgs
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Review Article |
The evolving epidemiology of acute coronary syndromes
The prevalence of coronary artery disease, and its manifestation as acute coronary syndromes (ACS), has reached a pandemic level as a consequence of modernization of the developing world. Drs. Ruff and Braunwald discuss the evolving demographics of ACS, including the impact of the introduction of troponin testing and the change in the definition of myocardial infarction. They also highlight the importance of modifiable risk factors and adherence to guideline-recommended therapy.
- Christian T. Ruff
- & Eugene Braunwald
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Research Highlight |
Telemonitoring vs usual care? No good putting your heart on the line
- Helene Myrvang
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Research Highlight |
High-dose, prescription omega-3 fatty acids do not prevent recurrent AF
- Alexandra King
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Review Article |
Blood pressure lowering in patients with diabetes—one level might not fit all
Blood pressure (BP) targets in patients with hypertension and diabetes mellitus have generally been based on global guidelines. However, these targets are often aggressive, and do not consider the patient's individual risk. Some studies have indicated that intensive BP lowering might not always reduce the risk of cardiovascular events. The authors of this Review present the evidence both for and against intensive BP lowering therapy, and suggest a personalized approach to treatment in the future.
- Rhonda M. Cooper-DeHoff
- , Eric F. Egelund
- & Carl J. Pepine
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Review Article |
The relationship between blood pressure and cognitive function
Both hypertension and hypotension have been associated with late-life cognitive decline and dementia. Novak and Hajjar discuss evidence supporting the relationship between blood pressure and cognition and its underlying pathophysiological mechanisms. The role that antihypertensive therapy may have in the prevention of cognitive decline is also explored.
- Vera Novak
- & Ihab Hajjar
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Correspondence |
Sedentary versus inactive: distinctions for disease prevention
- Brigid M. Lynch
- , Genevieve N. Healy
- & Neville Owen
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Research Highlight |
Low-dose omega-3 supplementation—no beneficial effect in patients with prior MI
- Alexandra King
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Research Highlight |
Neuropsychiatric adverse effects signal the end of the line for rimonabant
- Alexandra King
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Correspondence |
Authors' reply: Disease prevention and sedentary lifestyle
- Olivier L. Charansonney
- & Jean-Pierre Després
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News & Views |
B vitamins and CVD—failure to find a simple solution
The hope that a simple, affordable, and safe homocysteine-lowering intervention with folic acid and vitamin B12 would improve outcomes for patients with established cardiovascular or renal disease has been crushed by the null results from large B-vitamin treatment trials completed to date.
- Marta Ebbing
- & Per Magne Ueland
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Research Highlight |
Eating for two? Maternal weight gain and offspring cardiovascular risk
- Alexandra King
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News & Views |
Reducing the risk of CVD in patients with periodontitis
The association between periodontitis and other chronic diseases, such as cardiovascular disease (CVD) and type 2 diabetes mellitus, could be related to systemic inflammation initiated by a local inflammatory challenge. Oliveira et al. have added lack of oral hygiene, and its link with systemic inflammation, to the spectrum of risk factors for CVD.
- Robert J. Genco
- & Thomas E. Van Dyke
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News & Views |
Blockade of the renin–angiotensin system in atrial fibrillation
The effectiveness of existing strategies for management of atrial fibrillation is limited, which has stimulated research into novel therapeutic approaches. A new meta-analysis of randomized controlled trials of inhibitors of the renin–angiotensin system highlights the clinical benefits of these agents and underscores their potential in the prevention and treatment of this disease.
- Nadzeya Kuzniatsova
- , Eduard Shantsila
- & Gregory Y. H. Lip
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News & Views |
Aspirin for asymptomatic atherosclerosis?
The ankle–brachial index (ABI) can be used to assess the risk of cardiovascular events. The AAA trial aimed to determine whether low-dose aspirin was of net benefit among apparently healthy people with an ABI ≤0.95. The largely negative findings of this study raise important mechanistic and practical questions.
- Carlo Patrono
- & Colin Baigent
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Opinion |
Disease prevention—should we target obesity or sedentary lifestyle?
Obesity is a major health challenge that is associated with chronic disease. The authors of this Perspectives article put forward a model that places sedentary behavior and calorie overload upstream of numerous disease processes. The authors highlight the importance of physical activity and cardiorespiratory fitness, which are possibly stronger predictors of risk than traditional factors, such as obesity.
- Olivier L. Charansonney
- & Jean-Pierre Després
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Review Article |
Early detection of myocardial dysfunction and heart failure
To date, treatment strategies for heart failure have focused on the symptomatic stage of disease, often after irreversible remodeling and functional impairment have occurred. Early identification of cardiac dysfunction would allow implementation of early intervention strategies to delay the progression or to prevent the onset of heart failure altogether. This Review highlights the utility of a staged approach for patients with predisposing risk factors, which uses serological biomarkers followed by noninvasive imaging techniques.
- Geoffrey de Couto
- , Maral Ouzounian
- & Peter P. Liu
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Review Article |
Early identification of atherosclerotic disease by noninvasive imaging
Current strategies for prevention of cardiovascular disease (CVD) are focused on identifying individuals at high risk by recognizing and managing established cardiovascular risk factors. Early detection of subclinical atherosclerosis is a promising opportunity for CVD prevention. In this article, the authors review the role of noninvasive imaging techniques in understanding the mechanisms of atherosclerosis and in identifying early stages of disease, and highlight their potential impact on CVD prevention.
- Valentin Fuster
- , Fátima Lois
- & Manuel Franco
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Opinion |
Short-term vascular risk: time to take notice?
The current guidelines for prevention of cardiovascular disease are based on estimates of long-term risk. Smeeth and Hingorani recommend awareness of the importance of fluctuations of risk over short periods of time and suggest a new paradigm for management of cardiovascular disease that is based on targeting therapy to short periods of enhanced risk.
- Liam Smeeth
- & Aroon D. Hingorani
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Review Article |
Early identification of cardiovascular risk using genomics and proteomics
In this Review, Drs Kullo and Cooper discuss the role of genomics and proteomics in cardiovascular risk assessment, using the specific example of atherosclerosis. The availability of good markers for risk stratification might enable the health-care system to become more proactive, moving the focus away from treatment of end-stage coronary heart disease and towards early detection of disease risk and prevention of adverse outcomes.
- Iftikhar J. Kullo
- & Leslie T. Cooper
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Review Article |
Intensive glycemic control and cardiovascular disease: an update
This Review discusses the effects of intensive glycemic control on cardiovascular disease in patients with diabetes, and examines key factors in recent intervention trials that might have contributed to their disparate findings. The authors suggest that care of these patients should focus on achieving current treatment goals, rather than on changes to glycemic targets.
- Aparna Brown
- , L. Raymond Reynolds
- & Dennis Bruemmer
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Research Highlight |
Omega-3 supplements do not prevent atrial fibrillation after CABG surgery
- Alexandra King
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Review Article |
Novel oral anticoagulants to prevent stroke in atrial fibrillation
Although currently available anticoagulants, such as warfarin, can prevent stroke in patients with atrial fibrillation, the drug-related bleeding risk remains unacceptably high, and therapy could be contraindicated if the risk exceeds that for stroke. In this Review, Freek Verheugt assesses the performance of new anticoagulants that directly inhibit different stages of the coagulation cascade.
- Freek W. A. Verheugt
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Targeting levels and functions of blood lipids in the prevention of CVD
Everything in moderation—binge drinking increases CVD risk
A new model to estimate lifetime risk of CVD
COPPS trial heralds new indication for colchicine
Group medical clinics to manage diabetes and hypertension
Fibrates reduce risk of coronary events
Children are key to CVD prevention
Potential benefits of ECG screening in young athletes
Biological ageing—a potentially modifiable risk factor for CAD?
Benefits of dietary advice in patients with HFpSF