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Fibrates for secondary prevention of cardiovascular disease and stroke.
CONCLUSIONS: Moderate evidence showed that the fibrate class can be effective in the secondary prevention of composite outcome of non-fatal stroke, non-fatal MI, and vascular death. However, this beneficial effect relies on the inclusion of clofibrate data, a drug that was discontinued in 2002 due to its unacceptably large adverse effects. Further trials of the use of fibrates in populations with previous stroke and also against a background treatment with statins (standard of care) are required. PMID: 26497361 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 25, 2015 Category: Journals (General) Authors: Wang D, Liu B, Tao W, Hao Z, Liu M Tags: Cochrane Database Syst Rev Source Type: research

First-line drugs for hypertension.
CONCLUSIONS: First-line low-dose thiazides reduced all morbidity and mortality outcomes in adult patients with moderate to severe primary hypertension. First-line ACE inhibitors and calcium channel blockers may be similarly effective, but the evidence was of lower quality. First-line high-dose thiazides and first-line beta-blockers were inferior to first-line low-dose thiazides. PMID: 29667175 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - April 18, 2018 Category: General Medicine Authors: Wright JM, Musini VM, Gill R Tags: Cochrane Database Syst Rev Source Type: research

Hormone therapy for preventing cardiovascular disease in post-menopausal women.
CONCLUSIONS: Our review findings provide strong evidence that treatment with hormone therapy in post-menopausal women overall, for either primary or secondary prevention of cardiovascular disease events has little if any benefit and causes an increase in the risk of stroke and venous thromboembolic events. PMID: 25754617 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 10, 2015 Category: Journals (General) Authors: Boardman HM, Hartley L, Eisinga A, Main C, Roqué I Figuls M, Bonfill Cosp X, Gabriel Sanchez R, Knight B Tags: Cochrane Database Syst Rev Source Type: research

Antibiotics for secondary prevention of coronary heart disease
CONCLUSIONS: Our present review indicates that antibiotics (macrolides or quinolones) for secondary prevention of coronary heart disease seem harmful when assessing the risk of all-cause mortality, cardiovascular mortality, and stroke at maximum follow-up and all-cause mortality, cardiovascular mortality, and sudden cardiac death at 24±6 months follow-up. Current evidence does, therefore, not support the clinical use of macrolides and quinolones for the secondary prevention of coronary heart disease. Future trials on the safety of macrolides or quinolones for the secondary prevention in patients with coronary heart diseas...
Source: Cochrane Database of Systematic Reviews - March 11, 2021 Category: General Medicine Authors: Naqash J Sethi Sanam Safi Steven Kwasi Korang Asbj ørn Hróbjartsson Maria Skoog Christian Gluud Janus C Jakobsen Source Type: research

First-line diuretics versus other classes of antihypertensive drugs for hypertension
CONCLUSIONS: When used as first-line agents for the treatment of hypertension, thiazides and thiazide-like drugs likely do not change total mortality and likely decrease some morbidity outcomes such as cardiovascular events and withdrawals due to adverse effects, when compared to beta-blockers, calcium channel blockers, ACE inhibitors, and alpha-blockers.PMID:37439548 | DOI:10.1002/14651858.CD008161.pub3
Source: Cochrane Database of Systematic Reviews - July 13, 2023 Category: General Medicine Authors: Marcia Reinhart Lorri Puil Douglas M Salzwedel James M Wright Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Statins for acute coronary syndrome.
CONCLUSIONS: Based on moderate quality evidence, due to concerns about risk of bias and imprecision, initiation of statin therapy within 14 days following ACS does not reduce death, myocardial infarction, or stroke up to four months, but reduces the occurrence of unstable angina at four months following ACS. Serious side effects were rare. PMID: 25178118 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 1, 2014 Category: Journals (General) Authors: Vale N, Nordmann AJ, Schwartz GG, de Lemos J, Colivicchi F, den Hartog F, Ostadal P, Macin SM, Liem AH, Mills EJ, Bhatnagar N, Bucher HC, Briel M Tags: Cochrane Database Syst Rev Source Type: research

Smoking cessation for secondary prevention of cardiovascular disease
CONCLUSIONS: There is moderate-certainty evidence that smoking cessation is associated with a reduction of approximately one-third in the risk of recurrent cardiovascular disease in people who stop smoking at diagnosis. This association may be causal, based on the link between smoking cessation and restoration of endothelial and platelet function, where dysfunction of both can result in increased likelihood of CVD events. Our results provide evidence that there is a decreased risk of secondary CVD events in those who quit smoking compared with those who continue, and that there is a suggested improvement in quality of life...
Source: Cochrane Database of Systematic Reviews - August 8, 2022 Category: General Medicine Authors: Angela Difeng Wu Nicola Lindson Jamie Hartmann-Boyce Azizia Wahedi Anisa Hajizadeh Annika Theodoulou Elizabeth T Thomas Charlotte Lee Paul Aveyard Source Type: research

Systematic versus opportunistic risk assessment for the primary prevention of cardiovascular disease.
CONCLUSIONS: The results are limited by the heterogeneity between trials in terms of participants recruited, interventions and duration of follow-up. Limited data suggest that systematic risk assessment for CVD has no statistically significant effects on clinical endpoints. There is limited evidence to suggest that CVD systematic risk assessment may have some favourable effects on cardiovascular risk factors. The completion of the five ongoing trials will add to the evidence base. PMID: 26824223 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 29, 2016 Category: Journals (General) Authors: Dyakova M, Shantikumar S, Colquitt JL, Drew C, Sime M, MacIver J, Wright N, Clarke A, Rees K Tags: Cochrane Database Syst Rev Source Type: research

Beta-blockers for hypertension.
CONCLUSIONS: Most outcome RCTs on beta-blockers as initial therapy for hypertension have high risk of bias. Atenolol was the beta-blocker most used. Current evidence suggests that initiating treatment of hypertension with beta-blockers leads to modest CVD reductions and little or no effects on mortality. These beta-blocker effects are inferior to those of other antihypertensive drugs. Further research should be of high quality and should explore whether there are differences between different subtypes of beta-blockers or whether beta-blockers have differential effects on younger and older people. PMID: 28107561 [PubMe...
Source: Cochrane Database of Systematic Reviews - January 19, 2017 Category: Journals (General) Authors: Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH Tags: Cochrane Database Syst Rev Source Type: research

Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.
CONCLUSIONS: This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and high-quality evidence suggests that increasing EPA and DHA has little or no effect on mortality or cardiovascular health (evidence mainly from supplement trials). Previous suggestions of benefits from EPA and DHA supplements appear to spring from trials with higher risk of bias. Low-quality evidence suggests ALA may slightly reduce CVD event risk, CHD mortality and arrhythmia. PMID: 30019766 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 18, 2018 Category: General Medicine Authors: Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, AlAbdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L Tags: Cochrane Database Syst Rev Source Type: research

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