Posts Tagged ‘primary prevention’

April 9th, 2015

Selections from Richard Lehman’s Literature Review: April 9th

This week’s topics include the PROMISE trial, the efficacy of folic acid therapy in primary prevention of stroke among patients with hypertension in China, and more.

February 12th, 2015

Discontinuing Aspirin for Primary Prevention: What Do You Say to Your Patient?

In this scenario based on a study that found once-daily, low-dose aspirin did not significantly reduce the risk for CV events among older patients with atherosclerotic risk factors, Harlan Krumholz asks, “What do you say to your patient?”

January 12th, 2015

High Rate of Inappropriate Use of Aspirin for Primary Prevention

More than a third of U.S. adults — more than 50 million people — now take aspirin for the primary and secondary prevention of cardiovascular disease. Although it was once broadly recommended, aspirin for the primary prevention of cardiovascular disease is now only indicated in people who have a moderate-to-high 10-year risk. Now a new report published in […]

November 17th, 2014

Large Japanese Trial Casts Further Doubt on Aspirin for Primary Prevention

A large trial from Japan failed to provide any evidence to support the use of routine aspirin in high-risk elderly people to prevent a first cardiovascular event. The Japanese Primary Prevention Project (JPPP),  presented at the American Heart Association meeting in Chicago and published simultaneously in JAMA, enrolled patients between 60 and 85 years of age with hypertension, dyslipidemia, or […]

July 7th, 2014

Statins Are a Mess: We Need Better Data, and Shared Decision Making

The following open letter was originally published on The British Medical Journal‘s editorial page regarding the adverse effects of statins for patients with low risk of cardiovascular disease. It was written in response to an analysis by Abramson et al, and more information on the subject can be found here. I have two observations to […]

May 5th, 2014

FDA Comes Out Against Aspirin for Primary Prevention

In the latest development in a long-simmering debate, the FDA has announced that aspirin should not be marketed for primary prevention for heart attack or stroke. The announcement follows the FDA’s rejection on Friday of Bayer Healthcare’s decade-old petition requesting approval of a primary prevention indication. [PDF of FDA rejection letter] Aspirin is still widely used for primary prevention. Many physicians, […]

March 17th, 2014

Meta-Analysis Finds Few Side Effects Caused by Statins

Although clinical trials have consistently demonstrated the benefits of statins, especially in secondary prevention, the perception that the drugs can cause serious side effects has prompted some patients to discontinue or not take the drugs. Now, in a paper published in the European Journal of Preventive Cardiology, a new meta-analysis of existing trials offers some […]

February 3rd, 2014

Selections from Richard Lehman’s Literature Review: February 3rd

This week’s topics include biomarkers for systemic sclerosis, the effectiveness of ICDs for primary prevention of sudden cardiac death, and more.

December 16th, 2013

Selections from Richard Lehman’s Literature Review: December 16th

This week’s topics include several trials of genotyping to guide starting doses of vitamin K antagonists, statins for primary prevention of CVD, and more.

December 13th, 2013

Dispatch From the Wild Frontier of the Statin Wars

The long simmering controversy over the relative benefits and harms of statins has heated to a high boil with the release of the new AHA/ACC U.S. guidelines. But nowhere is the battle more intense right now than in Australia, where, according to the National Heart Foundation, a TV show may be the cause of 2,000 heart attacks […]