Meta-Analysis Affirms Safety and Efficacy of Catheter-Based Renal Denervation for Blood Pressure Reduction

A meta-analysis conducted by Sardar et al. evaluated the change in blood pressure in response to catheter-based renal sympathetic denervation (RSD). The data, published in the Journal of the American College of Cardiology (JACC), suggested that RSD reduces ambulatory systolic blood pressure (ASBP) in patients with hypertension as compared with sham controls. Continue reading →

U.S. Food and Drug Administration (FDA) Continues To Investigate Recall of Contaminated Blood Pressure Medication Potentially carcinogenic nitrosamine impurities found in angiotensin receptor blockers (ARBs)

The US food and drug Administration (FDA) has recently been conducting an investigation on voluntary recalls of multiple generic angiotensin II receptor blocker (ARB) drug products used to treat high blood pressure and heart failure. The recalls initiated in July 2018 and continue to date due to the presence of Nitrosamine impurities, including N-Nitrosodimethylamine (NDMA) and N-Nitrosodiethylamine (NDEA), which are potential human carcinogens in different ARB products. Last week, AurobindoPharma USA notified that it is expanding its recall to include 38 more lots of valsartan and amlodipine/valsartan tablets due to objectionable levels of N-Nitrosodiethylamine (NDEA). This was later followed by an expanded voluntary recall of losartan potassium produced by Hetero Labs (India) when they were found to be contaminated by N-Nitroso-N-methyl-4-aminobutyric acid (NMBA). Camber Pharmaceuticals called back 87 lots of losartan potassium tablets (25 mg, 50 mg and 100 mg), 114 lots of losartan potassium or losartan potassium/hydrochlorothiazide tablets, and one lot of losartan potassium/hydrochlorothiazide tablets. Continue reading →

Does Aggressive Control of Blood Pressure Decrease the Risk of Cognitive Impairment? Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia- A Randomized Clinical Trial

So far, there has been no definitive treatment for dementia. There are medications that provide symptomatic relief but there has been an advance towards developing disease-modifying medications. Due to the long preclinical period of most neurodegenerative diseases, prevention as a mode of treatment seems to be an important area of exploration. The relation between high blood pressure and cognitive impairment is one important aspect. In a recent randomized controlled trial called Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition in Decreased Hypertension (MIND) study published in JAMA NETWORK, researchers from the SPRINT group embarked to ascertain if intensive blood pressure control could decrease the risk of Alzheimer disease and related dementias. This was the first trial ever to demonstrate an effectual strategy for preventing of age-related cognitive impairment as it compared the effectiveness of intensive blood pressure control (targeting a systolic blood pressure of less than 120 mm Hg) to standard blood pressure control (targeting a systolic blood pressure of less than 140 mm Hg) towards the prevention of probable dementia. Continue reading →

2018: Cardiology News at A Glance Most important trials published in 2018

COAPT trial

This prospective, multicenter, open-label, randomized trial aimed to assess the use of transcatheter mitral valve repair in heart failure (HF) patients with mitral regurgitation due to left ventricular dysfunction. A total of 614 patients were randomized to either receiving guideline-directed medical therapy (GDMT) alone or GDMT in addition to transcatheter mitral-valve repair. The primary efficacy endpoint was all hospitalizations due to heart failure at 24 months of follow-up, while the primary safety endpoint was freedom from device-related complications at 12 months of follow-up. The study showed that the device group had a lower risk of hospitalization for HF (HR 0.53, 95% CI 0.4-0.7) and all-cause mortality (HR 0.62, 95% CI 0.46-0.82) at 24 months. Moreover, the rate of freedom from device complications at 12 months was 96.6% which exceeded the prespecified safety threshold. Continue reading →

Physical Fitness Associated with Lower Mortality? Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing

A recent study published in the Journal of American Medical Association showed that higher level of cardiorespiratory fitness (CRF) was associated with decreased long-term mortality with no observed upper limit of the CRF level that could induce the benefit. Moreover, extremely high aerobic fitness was associated with the greatest survival and was associated with benefit in older patients and those with hypertension. Continue reading →

From Barbershops to Churches: Are Community-Based Interventions the Best Way to Engage Vulnerable Populations? Cluster Randomized Clinical Trial of FAITH (Faith-Based Approaches in the Treatment of Hypertension) in Blacks

The FAITH study (Faith-Based Approaches in the Treatment of Hypertension) has portrayed how a community-based lifestyle intervention delivered in churches can lead to a significantly greater reduction in systolic BP in hypertensive blacks in comparison with Health Education (HE) alone. The results were published online in Circulation. Continue reading →

Variability in Metabolic Parameters: A Prognostic Surrogate Marker for MI, Stroke and Death? Associations of Variability in Blood Pressure, Glucose and Cholesterol Concentrations, and Body Mass Index With Mortality and Cardiovascular Outcomes in the General Population

A study by Mee Kyoung Kim and her colleagues published in Circulation has shown that there is a graded association between the number of high variability parameters like fasting blood glucose and total cholesterol levels, systolic blood pressure, and body mass index and cardiovascular outcomes. They showed that the mentioned variables may be considered as independent predictors of mortality and cardiovascular events. Continue reading →

UK based RCT Emphasizes on Long Term Cardiovascular Benefits of Antihypertensives and Statins Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study: 16 year follow up results

The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study is a UK based trial that reports long-term beneficial effects of antihypertensives and statins in terms of mortality and cardiovascular outcomes after 16 years of follow-up in patients with hypertension. Continue reading →

Smartphone App May Improve Medication Adherence in Hypertension

A new study published in the Journal of American Medical Association finds that use of a smartphone app can result in a small, but significant improvement in self-reported medication adherence, although it does not affect blood pressure control in patients with hypertension.

Continue reading →

More Benefit of Intensive BP Control in Patients with Higher CVD Risk

In a predictive model based substudy of the SPRINT trial published in the Journal of American College of Cardiology, Dr. Robert A. Phillips and his colleagues from Houston Methodist Hospital were able to show that patients with a higher 10-year cardiovascular disease (CVD) risk could achieve more benefit than harm from intensive blood pressure control, with a set target of systolic blood pressure (SBP) of < 130mm Hg. Continue reading →