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Cardiology Today's Top 10 articles posted in 2016
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Cardiology Today compiled a list of the top 10 stories posted to Healio.com/Cardiology in 2016.
This year, Cardiology Today’s readers were most interested in fragmented sleep and cerebral arteriolosclerosis, dementia risk for warfarin users, benefits of the DASH diet, the association between cerebral vascular disease and Alzheimer’s disease and much more.
Fragmented sleep in older adults may lead to severe cerebral arteriolosclerosis
Older adults with poor sleep quality appear to have a higher risk for severe arteriolosclerosis and subcortical macroscopic infarcts, both of which are contributors to stroke.
Andrew S.P. Lim, MD, assistant professor of neurology at the University of Toronto and neurologist and scientist at Sunnybrook Health Sciences Center in Toronto, and colleagues investigated the association between sleep fragmentation and microscopic measures of blood vessel damage and infarcts in autopsied brain tissue of 315 participants (70% women; mean age at death, 90 years) from the Rush Memory and Aging Project. All participants had undergone at least one full week of sleep monitoring before death. Average sleep disruption was seven times per hour.
Among warfarin users, patients with AF at increased risk for dementia
SAN FRANCISCO — In patients taking warfarin long term, those with atrial fibrillation had elevated risk for dementia, according to a presentation at the Heart Rhythm Society Annual Scientific Sessions.
“First, as physicians we have to understand that although we need to use anticoagulants for many reasons including to prevent stroke in AF patients, at the same time there are risks that need to be considered, some of which we are only beginning to understand,” T. Jared Bunch, MD, director of heart rhythm research at Intermountain Medical Center Heart Institute, Salt Lake City, medical director for heart rhythm services for the Intermountain Healthcare system and lead author of the study, said in a press release. “In this regard, only those that absolutely need blood thinners should be placed on them long term.”
DASH diet effective for BP reduction
While many dietary interventions are associated with reductions in BP, the Dietary Approaches to Stop Hypertension diet may product the greatest decline, according to new research published in Hypertension.
Researchers performed a systematic review and meta-analysis of 24 randomized controlled trials covering 23,858 participants that were conducted between January 1990 and March 2015. Their goal was to measure the combined effects of dietary interventions on BP and to determine whether effectiveness varied among the different approaches.
Alzheimer’s disease more likely in patients with cerebral vascular disease
Results from a cross-sectional study of older adults showed an association between cerebral vascular disease and Alzheimer’s disease.
“Both large and small vessel diseases have effects on dementia and thinking abilities, independently of one another, and independently of the common causes of dementia such as Alzheimer’s pathology and strokes,” Zoe Arvanitakis, MD, MS, neurologist and researcher at Rush Alzheimer’s Disease Center in Chicago, said in a press release. “We found that blood vessel diseases are very common in the brain, and are associated with dementia that is typically attributed to Alzheimer’s disease during life.”
AHA: Women may experience different MI causes, symptoms than men
The American Heart Association has issued a new scientific statement that underscores knowledge gaps in the causes, symptoms and outcomes of acute MI in women and outlines steps needed to better understand and treat CVD in women.
This release marks the first scientific statement from the AHA on MI in women. Writing group chair Laxmi S. Mehta, MD, FAHA, noninvasive cardiologist and director of the Women’s Cardiovascular Health Program at The Ohio State University, and colleagues noted that improvements in treatment, prevention and awareness in recent years have been associated with substantial decreases in deaths due to CVD. However, the annual CVD mortality rate has been higher in women than in men since 1984.
HOPE-3: Statins with or without BP-lowering drugs reduce CV events in intermediate-risk patients
CHICAGO — Data from the HOPE-3 trial support the expanded use of statins in intermediate-risk individuals who do not have CVD, and indicate that statin therapy in combination with antihypertensive medications offers a 30% reduction in CV events, but only in participants with high BP.
The findings could eventually lead to development and use of a polypill for primary prevention, researchers reported.
Score predicts 30-day death, readmission risk in patients with HF
A novel risk prediction model outperformed an existing model in predicting 30-day readmission or death in patients hospitalized for HF, according to a research letter published in JAMA Cardiology.
Unlike other prediction models, the new model includes factors such as echocardiographic results, mental health, cognitive function and socioeconomic status at the individual level, the researchers wrote.
Despite guideline changes, statin use unchanged or lower in patients with diabetes
NEW ORLEANS — The rate of statin use in adults with diabetes has remained steady or declined since 2014, according to findings presented at the National Lipid Association Scientific Sessions.
“There is enough evidence that statins decrease CVD outcomes in patients with diabetes. Nevertheless, statins remain underused. In real life setting, there could be multiple factors that could be preventing a wide adoption of statin use among endocrinologists and [primary care physicians],” Joanna Mitri, MD, MS, research associate, Section on Clinical, Behavioral and Outcomes Research, Lipid Clinic, Adult Diabetes Section, Joslin Diabetes Center, Boston, said in an interview with Cardiology Today.
Low-dose aspirin shows neutral CV benefit, increases bleeding risk in type 2 diabetes
NEW ORLEANS — In patients with type 2 diabetes, low-dose aspirin therapy did not affect the risk for CV events, but increased risk for gastrointestinal bleeding compared with patients not assigned aspirin therapy, according to data presented at the American Heart Association Scientific Sessions.
A team of researchers in Japan analyzed data on 1,621 patients with type 2 diabetes and no pre-existing CVD who participated in the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JAPD), a randomized, open-label, standard-care controlled trial examining the benefit of low-dose aspirin.
AHA: ‘Sit less, move more’
Sedentary behavior, even among those who are physically active, is associated with greater risk for CVD, diabetes, impaired insulin sensitivity and all-cause mortality, according to a new scientific statement from the American Heart Association.
“The state of the science right now is we don't know how much is too much,” Deborah Rohm Young, PhD, director of behavioral research at Kaiser Permanente Southern California in Pasadena and chair of the group that wrote the statement, told Cardiology Today. “But, we do know the evidence is highly suggestive that too much sitting or being sedentary is associated with increased CV morbidity and mortality.”