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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

Pharmacotherapy for hypertension in adults aged 18 to 59 years.
CONCLUSIONS: Antihypertensive drugs used to treat predominantly healthy adults aged 18 to 59 years with mild to moderate primary hypertension have a small absolute effect to reduce cardiovascular mortality and morbidity primarily due to reduction in cerebrovascular mortality and morbidity. All-cause mortality and coronary heart disease were not reduced. There is lack of good evidence on withdrawal due to adverse events. Future trials in this age group should be at least 10 years in duration and should compare different first-line drug classes and strategies. PMID: 28813123 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 16, 2017 Category: General Medicine Authors: Musini VM, Gueyffier F, Puil L, Salzwedel DM, Wright JM 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

Fibrates for primary prevention of cardiovascular disease events.
CONCLUSIONS: Moderate-quality evidence suggests that fibrates lower the risk for cardiovascular and coronary events in primary prevention, but the absolute treatment effects in the primary prevention setting are modest (absolute risk reductions < 1%). There is low-quality evidence that fibrates have no effect on overall or non-CVD mortality. Very low-quality evidence suggests that fibrates are not associated with increased risk for adverse effects. PMID: 27849333 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 15, 2016 Category: Journals (General) Authors: Jakob T, Nordmann AJ, Schandelmaier S, Ferreira-González I, Briel M Tags: Cochrane Database Syst Rev 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

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

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

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

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

Stem cell therapy for chronic ischaemic heart disease and congestive heart failure.
CONCLUSIONS: This systematic review and meta-analysis found moderate quality evidence that BMSC treatment improves LVEF. Unlike in trials where BMSC were administered following acute myocardial infarction (AMI), we found some evidence for a potential beneficial clinical effect in terms of mortality and performance status in the long term (after at least one year) in people who suffer from chronic IHD and heart failure, although the quality of evidence was low. PMID: 24777540 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 3, 2014 Category: Journals (General) Authors: Fisher SA, Brunskill SJ, Doree C, Mathur A, Taggart DP, Martin-Rendon E Tags: Cochrane Database Syst Rev Source Type: research

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