Widespread aspirin use despite few benefits, high risks

Medical consensus once supported daily use of low dose aspirin to prevent heart attack and stroke in people at increased risk for cardiovascular disease (CVD). But in 2018, three major clinical trials cast doubt on that conventional wisdom, finding few benefits and consistent bleeding risks associated with daily aspirin use. Taken together, the findings led the American Heart Association and American College of Cardiology to change clinical practice guidelines earlier this year, recommending against the routine use of aspirin in people older than 70 years or people with increased bleeding risk who do not have existing cardiovascular disease.

Aspirin use is widespread among groups at risk for harm including older adults and adults with peptic ulcers — painful sores in the lining of the stomach that are prone to bleeding that affect about one in ten people. In a research report published today in Annals of Internal Medicine, researchers from Beth Israel Deaconess Medical Center (BIDMC) report on the extent to which Americans 40 years old and above use aspirin for primary prevention of cardiovascular disease.

Full story at Science Daily

‘Healthy’ obese people still at higher risk of cardiovascular disease events than general population

New research presented at this year’s European Congress on Obesity (ECO) in Porto, Portugal (17-20) May shows that so called ‘metabolically healthy’ obese people are still at higher risk of cardiovascular disease events such as heart failure or stroke than normal weight people. The study is by Dr Rishi Caleyachetty and colleagues at The Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK.

People with metabolically healthy obesity (MHO) are clinically obese in terms of their body mass index (BMI) (more than 30 kg/m2), but do not have metabolic complications that usually come with obesity, such as abnormal blood fats, poor blood sugar control or diabetes, and high blood pressure. Whether MHO is associated with excess risk of cardiovascular disease (CVD) events is a subject of debate. Important limitations in the evidence to date include inconsistent definitions of metabolic health, inconsistent control for other factors (confounders), and small sample sizes. In this new study, the authors address these limitations in a large contemporary cohort, based on linked primary care electronic health records.

Recommendations regarding use of statins for the prevention of cardiovascular disease

The U.S. Preventive Services Task Force (USPSTF) has issued a recommendation statement regarding the use of statins for primary prevention of cardiovascular disease in adults. The report appears in the November 15 issue of JAMA.

Recommendations

  • The USPSTF recommends initiating use of low- to moderate-dose statins in adults ages 40 to 75 years without a history of cardiovascular disease (CVD) who have 1 or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10 percent or greater (B recommendation, indicating that there is high certainty that the net benefit is moderate, or there is moderate certainty that the net benefit is moderate to substantial).

Full story of statins and cardiovascular disease at Science Daily

Moderate physical activity linked with 50 percent reduction in cardiovascular death in over-65s

Moderate physical activity is associated with a greater than 50% reduction in cardiovascular death in over-65s, according to research presented at ESC Congress 2016 today. The 12 year study in nearly 2500 adults aged 65 to 74 years found that moderate physical activity reduced the risk of an acute cardiovascular event by more than 30%. High levels of physical activity led to greater risk reductions.

“The role of physical activity in preventing cardiovascular disease (CVD) in people of working age is well established,” said Professor Riitta Antikainen, professor of geriatrics at the University of Oulu, Finland. “But relatively little is known about the effect of regular physical activity on CVD risk in older people.”

The present study assessed the association between leisure time physical activity and CVD risk and mortality in 2456 men and women aged 65 to 74 years who were enrolled into the National FINRISK Study between 1997 and 2007.

Full story of moderate activity and reduction in cardiovascular death at Science Daily

More dietary calcium may lower risk of cardiovascular disease

In older people, higher dietary calcium intake may lower the risk of cardiovascular disease, but not of stroke and fracture, new research from South Korea suggests. The results will be presented in a poster Saturday, April 2, at ENDO 2016, the annual meeting of the Endocrine Society, in Boston.

“The role of dietary calcium intake in cardiovascular disease, stroke and fracture is controversial. Moreover, participants in previous studies were from populations that had calcium-rich diets. We aimed to evaluate whether high dietary calcium intake increases the risk of CVD, stroke and fracture in a population with low calcium intake,” said lead author Sung Hye Kong, MD, resident physician in the Department of Internal Medicine of Seoul National University Hospital in Seoul, South Korea.

Kong and colleagues conducted their research among individuals in Korea’s ongoing prospective community-based Ansung and Ansan Cohort Study that began in 2001. Of the 4,589 men and 5,042 women in the cohort study’s database who were 40 years of age and above at baseline and were followed up for an average of 13 years, the authors performed their analyses in 2,199 men and 2,704 women over 50 years of age without previous cardiovascular disease and stroke.

Full story of dietary calcium and cardiovascular disease at Science Daily

African-Americans at lower socioeconomic levels have increased risk of heart disease

African Americans at lower socioeconomic levels, particularly women and younger adults, are at greater risk of heart disease and stroke than those in higher socioeconomic positions, according to research in the Journal of the American Heart Association.

Cardiovascular disease (CVD) is the No. 1 killer of all Americans, but the burden is greater for African Americans. According to the American Heart Association 2014 Statistical Update, nearly half of all African American adults have some form of CVD, and they are twice as likely as white adults to have a first-ever stroke.

Full story of African-Americans and heart disease risk at Science Daily

Fruit consumption cuts cardiovascular disease risk by up to 40 percent

Daily fruit consumption cuts the risk of cardiovascular disease (CVD) by up to 40%, according to research presented at ESC Congress by Dr Huaidong Du from Oxford, UK. The findings from the seven year follow-up study of nearly 0.5 million people in the China Kadoorie Biobank found that the more fruit people ate, the more their risk of CVD declined.

Dr Du said: “CVD, including ischaemic heart disease (IHD) and stroke, is the leading cause of death worldwide. Improving diet and lifestyle is critical for CVD risk reduction in the general population but the large majority of this evidence has come from western countries and hardly any from China.”

She added: “China has a different pattern of CVD, with stroke as the main cause compared to western countries where IHD is more prevalent. Previous studies have combined ischaemic and haemorrhagic stroke probably due to the limited number of stroke cases in their datasets. Given their different physiology and risk factors, we have conducted the first large prospective study on the association of fruit with subtypes of stroke in Chinese adults from both rural and urban areas.”

Full story of fruits and cardiovascular disease reduction at Science Daily