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4. Effects of glucose and blood pressure reduction on subclinical cardiac damage: Results from ADVANCE

Author

Juraschek, S, Wang, D, Mcevoy, J, Harrap, S, Harris, K, Mancia, G, Marre, M, Neal, B, Patel, A, Poulter, N, Williams, B, Chalmers, J, Woodward, M, Selvin, E, Juraschek S. P., Wang D., McEvoy J. W., Harrap S., Harris K., Mancia G., Marre M., Neal B., Patel A., Poulter N. R., Williams B., Chalmers J., Woodward M., Selvin E., Juraschek, S, Wang, D, Mcevoy, J, Harrap, S, Harris, K, Mancia, G, Marre, M, Neal, B, Patel, A, Poulter, N, Williams, B, Chalmers, J, Woodward, M, Selvin, E, Juraschek S. P., Wang D., McEvoy J. W., Harrap S., Harris K., Mancia G., Marre M., Neal B., Patel A., Poulter N. R., Williams B., Chalmers J., Woodward M., and Selvin E.

Abstract

Objective: Observational data suggest a potential for subclinical cardiac damage from intensive blood glucose or blood pressure (BP) control, particularly in adults with very low blood glucose and BP levels. However, this has not been tested in a randomized trial. Methods: The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Research Controlled Evaluation (ADVANCE) study was a factorial, randomized trial designed to test the effects of intensive blood glucose (hemoglobin A1c ≤6.5% versus usual care) and intensive BP (combination of perindopril-indapamide versus placebo) control on vascular events in adults with diabetes. Using mixed effects tobit models, we determined the effect of the randomized interventions on change in subclinical cardiac injury (high sensitivity cardiac troponin T [hs-cTnT]) and strain (N-terminal b-type pro natriuretic peptide [NT-proBNP]), 1 year after randomization. Results: Among the 682 participants, mean age was 66.1 (SD, 6.5) years; 40% were women. Mean baseline hemoglobin A1c was 7.4% (SD, 1.5) and systolic/diastolic BP was 147 (SD,21)/81 (SD,11) mmHg. After 1 year, intensive versus standard glucose control did not significantly change hs-cTnT (1.5%; 95%CI:-4.9,8.2) or NT-proBNP (−10.3%; 95%CI: −20.2%,0.9%). Intensive versus standard BP control also did not affect hs-cTnT (−2.9%; 95%CI: −8.9,3.6), but did significantly lower NT-proBNP by 21.6% (95%CI:-30.2%,-11.9%). Changes in systolic BP at 1 year (versus baseline) were strongly associated with NT-proBNP (P = 0.004), but not hs-cTnT (P = 0.95). Conclusions: In adults with diabetes, intensive BP control reduced NT-proBNP without increasing hs-cTnT, supporting the benefits and safety of intensive BP control in adults with diabetes. This trial is registered at clinicaltrials.gov, number: NCT00145925.

Published
2022

5. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Author

Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Back, M., Benetos, A., Biffi, A., Boavida, J. -M., Capodanno, D., Cosyns, B., Crawford, C., Davos, C. H., Desormais, I., DI Angelantonio, E., Franco, O. H., Halvorsen, S., Hobbs, F. D. R., Hollander, M., Jankowska, E. A., Michal, M., Sacco, S., Sattar, N., Tokgozoglu, L., Tonstad, S., Tsioufis, K. P., Van DIs, I., Van Gelder, I. C., Wanner, C., Williams, B., De Backer, G., Regitz-Zagrosek, V., Aamodt, A. H., Abdelhamid, M., Aboyans, V., Albus, C., Asteggiano, R., Borger, M. A., Brotons, C., Ielutkiene, J., Cifkova, R., Cikes, M., Cosentino, F., Dagres, N., De Backer, T., De Bacquer, D., Delgado, V., Den Ruijter, H., Dendale, P., Drexel, H., Falk, V., Fauchier, L., Ference, B. A., Ferrieres, J., Ferrini, M., Fisher, M., Fliser, D., Fras, Z., Gaita, D., Giampaoli, S., Gielen, S., Graham, I., Jennings, C., Jorgensen, T., Kautzky-Willer, A., Kavousi, M., Koenig, W., Konradi, A., Kotecha, D., Landmesser, U., Lettino, M., Lewis, B. S., Linhart, A., Lochen, M. -L., Makrilakis, K., Mancia, G., Marques-Vidal, P., Mcevoy, J. W., Mcgreavy, P., Merkely, B., Neubeck, L., Nielsen, J. C., Perk, J., Petersen, S. E., Petronio, A. S., Piepoli, M., Pogosova, N. G., Prescott, E. I. B., Ray, K. K., Reiner, Z., Richter, D. J., Ryden, L., Shlyakhto, E., Sitges, M., Sousa-Uva, M., Sudano, I., Tiberi, M., Touyz, R. M., Ungar, A., Verschuren, W. M. M., Wiklund, O., Wood, D., Zamorano, J. L., Crawford, C. A., Franco Duran, O. H., Richard Hobbs, F. D., Dis, I. V., Group, ESC Scientific Document, Clinical sciences, Cardio-vascular diseases, and Cardiology

Subjects
medicine.medical_specialty, Epidemiology, Population, air pollution, population, Guidelines, blood pressure, climate change, diabetes, healthy lifestyle, lifetime benefit, lifetime risk, lipids, nutrition, personalized, prevention, psychosocial factors, risk estimation, risk management, shared decision-making, smoking, stepwise approach, Risk Assessment, Humans, Primary Prevention, Risk Factors, Cardiovascular Diseases, Diabetes mellitus, medicine, Intensive care medicine, education, 610 Medicine & health, Risk management, education.field_of_study, business.industry, medicine.disease, Clinical Practice, Blood pressure, guidelines, Heart failure, Lifetime risk, Disease prevention, Cardiology and Cardiovascular Medicine, business, Stepwise approach, 360 Social problems & social services
Abstract

These are the clinical practice guidelines from the European Society of Cardiology on cardiovascular disease prevention in clinical practice, from 2021.

Published
2022
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6. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Author

Visseren, F, Mach, F, Smulders, Y, Carballo, D, Koskinas, K, Back, M, Benetos, A, Biffi, A, Boavida, J, Capodanno, D, Cosyns, B, Crawford, C, Davos, C, Desormais, I, Di Angelantonio, E, Duran, O, Halvorsen, S, Richard Hobbs, F, Hollander, M, Jankowska, E, Michal, M, Sacco, S, Sattar, N, Tokgozoglu, L, Tonstad, S, Tsioufis, K, van Dis, I, van Gelder, I, Wanner, C, Williams, B, De Backer, G, Regitz-Zagrosek, V, Aamodt, A, Abdelhamid, M, Aboyans, V, Albus, C, Asteggiano, R, Borger, M, Brotons, C, Celutkiene, J, Cifkova, R, Cikes, M, Cosentino, F, Dagres, N, De Backer, T, De Bacquer, D, Delgado, V, Ruijter, H, Dendale, P, Drexel, H, Falk, V, Fauchier, L, Ference, B, Ferrieres, J, Ferrini, M, Fisher, M, Fliser, D, Fras, Z, Gaita, D, Giampaoli, S, Gielen, S, Graham, I, Jennings, C, Jorgensen, T, Kautzky-Willer, A, Kavousi, M, Koenig, W, Konradi, A, Kotecha, D, Landmesser, U, Lettino, M, Lewis, B, Linhart, A, Lochen, M, Makrilakis, K, Mancia, G, Marques-Vidal, P, Mcevoy, J, Mcgreavy, P, Merkely, B, Neubeck, L, Nielsen, J, Perk, J, Petersen, S, Petronio, A, Piepoli, M, Pogosova, N, Prescott, E, Ray, K, Reiner, Z, Richter, D, Ryden, L, Shlyakhto, E, Sitges, M, Sousa-Uva, M, Sudano, I, Tiberi, M, Touyz, R, Ungar, A, Monique Verschuren, W, Wiklund, O, Wood, D, Zamorano, J, Visseren F., Mach F., Smulders Y. M., Carballo D., Koskinas K. C., Back M., Benetos A., Biffi A., Boavida J. -M., Capodanno D., Cosyns B., Crawford C. A., Davos C. H., Desormais I., Di Angelantonio E., Duran O. H. F., Halvorsen S., Richard Hobbs F. D., Hollander M., Jankowska E. A., Michal M., Sacco S., Sattar N., Tokgozoglu L., Tonstad S., Tsioufis K. P., van Dis I., van Gelder I. C., Wanner C., Williams B., De Backer G., Regitz-Zagrosek V., Aamodt A. H., Abdelhamid M., Aboyans V., Albus C., Asteggiano R., Borger M. A., Brotons C., Celutkiene J., Cifkova R., Cikes M., Cosentino F., Dagres N., De Backer T., De Bacquer D., Delgado V., Ruijter H. D., Dendale P., Drexel H., Falk V., Fauchier L., Ference B. A., Ferrieres J., Ferrini M., Fisher M., Fliser D., Fras Z., Gaita D., Giampaoli S., Gielen S., Graham I., Jennings C., Jorgensen T., Kautzky-Willer A., Kavousi M., Koenig W., Konradi A., Kotecha D., Landmesser U., Lettino M., Lewis B. S., Linhart A., Lochen M. -L., Makrilakis K., Mancia G., Marques-Vidal P., McEvoy J. W., McGreavy P., Merkely B., Neubeck L., Nielsen J. C., Perk J., Petersen S. E., Petronio A. S., Piepoli M., Pogosova N. G., Prescott E. I. B., Ray K. K., Reiner Z., Richter D. J., Ryden L., Shlyakhto E., Sitges M., Sousa-Uva M., Sudano I., Tiberi M., Touyz R. M., Ungar A., Monique Verschuren W. M., Wiklund O., Wood D., Zamorano J. L., Visseren, F, Mach, F, Smulders, Y, Carballo, D, Koskinas, K, Back, M, Benetos, A, Biffi, A, Boavida, J, Capodanno, D, Cosyns, B, Crawford, C, Davos, C, Desormais, I, Di Angelantonio, E, Duran, O, Halvorsen, S, Richard Hobbs, F, Hollander, M, Jankowska, E, Michal, M, Sacco, S, Sattar, N, Tokgozoglu, L, Tonstad, S, Tsioufis, K, van Dis, I, van Gelder, I, Wanner, C, Williams, B, De Backer, G, Regitz-Zagrosek, V, Aamodt, A, Abdelhamid, M, Aboyans, V, Albus, C, Asteggiano, R, Borger, M, Brotons, C, Celutkiene, J, Cifkova, R, Cikes, M, Cosentino, F, Dagres, N, De Backer, T, De Bacquer, D, Delgado, V, Ruijter, H, Dendale, P, Drexel, H, Falk, V, Fauchier, L, Ference, B, Ferrieres, J, Ferrini, M, Fisher, M, Fliser, D, Fras, Z, Gaita, D, Giampaoli, S, Gielen, S, Graham, I, Jennings, C, Jorgensen, T, Kautzky-Willer, A, Kavousi, M, Koenig, W, Konradi, A, Kotecha, D, Landmesser, U, Lettino, M, Lewis, B, Linhart, A, Lochen, M, Makrilakis, K, Mancia, G, Marques-Vidal, P, Mcevoy, J, Mcgreavy, P, Merkely, B, Neubeck, L, Nielsen, J, Perk, J, Petersen, S, Petronio, A, Piepoli, M, Pogosova, N, Prescott, E, Ray, K, Reiner, Z, Richter, D, Ryden, L, Shlyakhto, E, Sitges, M, Sousa-Uva, M, Sudano, I, Tiberi, M, Touyz, R, Ungar, A, Monique Verschuren, W, Wiklund, O, Wood, D, Zamorano, J, Visseren F., Mach F., Smulders Y. M., Carballo D., Koskinas K. C., Back M., Benetos A., Biffi A., Boavida J. -M., Capodanno D., Cosyns B., Crawford C. A., Davos C. H., Desormais I., Di Angelantonio E., Duran O. H. F., Halvorsen S., Richard Hobbs F. D., Hollander M., Jankowska E. A., Michal M., Sacco S., Sattar N., Tokgozoglu L., Tonstad S., Tsioufis K. P., van Dis I., van Gelder I. C., Wanner C., Williams B., De Backer G., Regitz-Zagrosek V., Aamodt A. H., Abdelhamid M., Aboyans V., Albus C., Asteggiano R., Borger M. A., Brotons C., Celutkiene J., Cifkova R., Cikes M., Cosentino F., Dagres N., De Backer T., De Bacquer D., Delgado V., Ruijter H. D., Dendale P., Drexel H., Falk V., Fauchier L., Ference B. A., Ferrieres J., Ferrini M., Fisher M., Fliser D., Fras Z., Gaita D., Giampaoli S., Gielen S., Graham I., Jennings C., Jorgensen T., Kautzky-Willer A., Kavousi M., Koenig W., Konradi A., Kotecha D., Landmesser U., Lettino M., Lewis B. S., Linhart A., Lochen M. -L., Makrilakis K., Mancia G., Marques-Vidal P., McEvoy J. W., McGreavy P., Merkely B., Neubeck L., Nielsen J. C., Perk J., Petersen S. E., Petronio A. S., Piepoli M., Pogosova N. G., Prescott E. I. B., Ray K. K., Reiner Z., Richter D. J., Ryden L., Shlyakhto E., Sitges M., Sousa-Uva M., Sudano I., Tiberi M., Touyz R. M., Ungar A., Monique Verschuren W. M., Wiklund O., Wood D., and Zamorano J. L.

Published
2021

7. Effects of Blood Pressure Lowering on Clinical Outcomes According to Baseline Blood Pressure and Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus

Author

Rahman, F, Mcevoy, J, Ohkuma, T, Marre, M, Hamet, P, Harrap, S, Mancia, G, Rodgers, A, Selvin, E, Williams, B, Muntner, P, Chalmers, J, Woodward, M, Rahman F., McEvoy J. W., Ohkuma T., Marre M., Hamet P., Harrap S., Mancia G., Rodgers A., Selvin E., Williams B., Muntner P., Chalmers J., Woodward M., Rahman, F, Mcevoy, J, Ohkuma, T, Marre, M, Hamet, P, Harrap, S, Mancia, G, Rodgers, A, Selvin, E, Williams, B, Muntner, P, Chalmers, J, Woodward, M, Rahman F., McEvoy J. W., Ohkuma T., Marre M., Hamet P., Harrap S., Mancia G., Rodgers A., Selvin E., Williams B., Muntner P., Chalmers J., and Woodward M.

Abstract

The optimal blood pressure (BP) goal in patients with diabetes mellitus remains controversial. We examined whether benefits and risks of intensified antihypertensive therapy in diabetes mellitus are influenced by either baseline BP or cardiovascular disease (CVD) risk. We studied 10 948 people with diabetes mellitus, at moderate-to-high risk, in the ADVANCE trial (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation). Cox models were used to determine whether baseline BP category or CVD risk modified the outcomes of combination perindopril-indapamide treatment, compared with placebo. During 4.3 years of follow-up, treatment with perindopril-indapamide versus placebo reduced mortality and major vascular (macrovascular or microvascular) events. There was no evidence of differences in these effects, regardless of baseline systolic BP (evaluated down to <120 mm Hg; P for heterogeneity, 0.85), diastolic BP (evaluated down to <70 mm Hg; P=0.49), or whether 10-year CVD risk was ≥20% or <20% ( P=0.08). The effects of randomized treatment on discontinuation of treatment because of cough or hypotension/dizziness were also statistically consistent across subgroups defined by baseline BP and CVD risk (all P ≥0.08). Adults with diabetes mellitus appear to benefit from more intensive BP treatment even at levels of BP and CVD risk that some guidelines do not currently recommend for intervention. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT00751972.

Published
2019

10. SOCIETY AFFAIRS

Author

Finch, R. M., Kepner, Dana E., Klevorn, W. J., Johnson, W. Scott, Haskins, C. A., Towne, W. W., McEvoy, J. W., and Waterman, Earle L.

Published
1933

16. High-sensitivity troponins and mortality in the general population.

Author

McEvoy, J. W.

Subjects
CARDIOVASCULAR disease related mortality, TROPONIN
Abstract

This study investigated correlations between four high-sensitivity cardiac troponin assays and mortality in the general population. 9810 adults without cardiovascular disease in the 1999-2004 NHANES wave had high-sensitivity (hs)-troponin T levels measured using one assay (Roche) and hs-troponin I levels measured using three assays (Abbott, Siemens, and Ortho). Cox regression analysis showed that all of the hs-troponin assays were independently associated with all-cause mortality and cardiovascular mortality during follow-up. Associations of hs-troponin T and all-cause and cardiovascular mortality remained significant after adjustment for hs-troponin I. [ABSTRACT FROM AUTHOR]

Published
2023

17. Coronary artery calcium for the prediction of mortality in young adults <45 years old and elderly adults >75 years old

Author

Tota-Maharaj, R., primary, Blaha, M. J., additional, McEvoy, J. W., additional, Blumenthal, R. S., additional, Muse, E. D., additional, Budoff, M. J., additional, Shaw, L. J., additional, Berman, D. S., additional, Rana, J. S., additional, Rumberger, J., additional, Callister, T., additional, Rivera, J., additional, Agatston, A., additional, and Nasir, K., additional

Published
2012
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