A more conservative approach to aspirin for primary prevention in adults with diabetes is called for in a joint statement issued today by diabetes and cardiovascular associations.
Low-dose aspirin can be considered reasonable for diabetes patients with a cardiovascular disease risk above 10% over 10 years and no excess bleeding risk, according to the statement released by the American Heart Association, the American Diabetes Association, and American College of Cardiology.
Conclusions: The investigators concluded that these findings do not support the use of NT-proBNP as a cardiovascular biomarker in healthy normal subjects, and have important implications for NT-proBNP–based strategies for early detection and primary prevention of cardiovascular disease.
On-the-job pressure significantly increases the likelihood that women will develop ischemic heart disease, a large Danish study found.
Compared with women who felt their workplace pressure was suitable, those who reported that the pressure was much too high had a nearly 50% increased risk of developing ischemic heart disease (HR 1.47, 95% CI 1.14 to 1.88), according to Karen Allesøe, PhD, and colleagues from Glostrup University Hospital.
Conclusion: In this multi-ethnic cohort, addition of CACS to a prediction model based on traditional risk factors significantly improved the classification of risk and placed more individuals in the most extreme risk categories.
After reading this article I remain in a state of disbelief.
F.D.A. Says Millions Got Unapproved Nitroglycerin – NYTimes.com
The problem of the unapproved tablets stems from a longstanding ambiguity about the rules for drugs whose use predates the establishment of the F.D.A. in 1938. Only one brand of nitroglycerin pills is federally approved: Nitrostat, made by Pfizer, on the market since 2000.
A proximal location significantly increases the risk of poor outcomes in peripheral arterial disease (PAD), independent of risk factors and comorbidities, a review of records on 400 patients showed.
Proximal (aortoiliac) involvement tripled the risk of cardiovascular events compared with distal disease. The findings contrast with evidence of poorer limb prognosis in patients with distal PAD, according to an article published online in the Journal of the American College of Cardiology.
Drinking just one cup of coffee a day — either regular or decaffeinated — was associated with a 30% reduced risk of stroke, a large, prospective study showed.
Newer Blood Test Predicts Diabetes, Heart Disease – BusinessWeek
For the current study, Selvin and her colleagues measured A1C from more than 11,000 stored blood samples from the Atherosclerosis Risk in Communities Study, which began in 1990. None of the study volunteers had diabetes or cardiovascular disease at the time the blood samples were taken.
The researchers then compared the A1C levels to fasting blood sugar levels and to the 15 years of overall health follow-up information gathered for the previous study.
During that time, 2,251 people were diagnosed with diabetes, nearly 1,200 were diagnosed with heart disease and 358 people had an ischemic (non-bleeding) stroke, according to the study.
As expected, the researchers found that elevated A1C levels were associated with an increased risk of being diagnosed with diabetes. Those with an A1C of less than 5 percent had a 48 percent reduced risk of diabetes, while people whose A1Cs were between 5 and 5.5 percent had a normal risk of diabetes. From there, however, the risk quickly went up. Those with an A1C of 5.5 to 6 percent had an 86 percent increased risk of diabetes. For those between 6 and 6.5 percent, the risk more than quadrupled. For people with levels above 6.5 percent, the odds of being diagnosed were more than 16 times higher than for someone with levels under 5.5 percent. These results were similar to those for fasting glucose levels, the study authors noted.
Where fasting glucose and A1C differed greatly, however, was in the prediction of future heart disease and stroke risk. While fasting glucose failed to predict future risk, the study found that A1C levels accurately did so.
People with A1Cs under 5.5 percent had an average risk of heart disease and stroke, but for people with an A1C between 5.5 and 6 percent, the risk went up 23 percent. For those with an A1C between 6 and 6.5 percent, the risk of cardiovascular disease jumped to 78 percent. When A1C went over 6.5 percent, the risk of cardiovascular disease went up nearly twofold.
Results of the study are published in the March 4 issue of the New England Journal of Medicine.
The strongest predictors of mortality were structural heart disease or an abnormal electrocardiogram (hazard ratio [HR], 5.6), hypertension (HR, 3.0), and trauma from syncope (HR, 2.24).
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