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Pharmacological interventions for asymptomatic carotid stenosis
CONCLUSIONS: Although there is no high-certainty evidence to support pharmacological intervention, this does not mean that pharmacological treatments are ineffective in preventing ischaemic cerebral events, morbidity, and mortality. High-quality RCTs are needed to better inform the best medical treatment that may reduce the burden of carotid stenosis. In the interim, clinicians will have to use other sources of information.PMID:37565307 | PMC:PMC10401652 | DOI:10.1002/14651858.CD013573.pub2
Source: Cochrane Database of Systematic Reviews - August 11, 2023 Category: General Medicine Authors: Caroline Nb Clezar Carolina Dq Flumignan Nicolle Cassola Luis Cu Nakano Virginia Fm Trevisani Ronald Lg Flumignan Source Type: research

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease
CONCLUSIONS: There is currently insufficient evidence to determine the effectiveness of ACEi or ARB in patients with stage 1 to 3 CKD who do not have DM. The available evidence is overall of very low certainty and high risk of bias. We have identified an area of large uncertainty for a group of patients who account for most of those diagnosed as having CKD.PMID:37466151 | DOI:10.1002/14651858.CD007751.pub3
Source: Cochrane Database of Systematic Reviews - July 19, 2023 Category: General Medicine Authors: Tess E Cooper Claris Teng David J Tunnicliffe Brydee A Cashmore Giovanni Fm Strippoli 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

Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis
CONCLUSIONS: This review provides moderate-certainty evidence that ET plus CMT compared with CMT alone increases the risk of short-term stroke and death in people with recent symptomatic severe ICAS. This effect was still apparent at long-term follow-up but appeared to be due to the early risks of ET; therefore, there may be no clear difference between the interventions in terms of their effects on long-term stroke and death. The impact of delayed ET intervention (more than three weeks after a qualifying event) warrants further study.PMID:36738471 | PMC:PMC9897029 | DOI:10.1002/14651858.CD013267.pub3
Source: Cochrane Database of Systematic Reviews - February 4, 2023 Category: General Medicine Authors: Jichang Luo Tao Wang Kun Yang Xue Wang Ran Xu Haozhi Gong Xiao Zhang Jie Wang Renjie Yang Peng Gao Yan Ma Liqun Jiao Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular...
Source: Cochrane Database of Systematic Reviews - January 10, 2023 Category: General Medicine Authors: Jia Liu Lu-Ning Wang Source Type: research

Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease
CONCLUSIONS: HIF stabiliser management of anaemia had uncertain effects on CV death, fatigue, death (any cause), CV outcomes, and kidney failure compared to placebo or ESAs. Compared to placebo or ESAs, HIF stabiliser management of anaemia probably decreased the proportion of patients requiring blood transfusions, and probably increased the proportion of patients reaching the target Hb when compared to placebo.PMID:36005278 | DOI:10.1002/14651858.CD013751.pub2
Source: Cochrane Database of Systematic Reviews - August 25, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Allison Jaure Elisabeth M Hodson Marinella Ruospo Tess E Cooper Deirdre Hahn Valeria M Saglimbene Jonathan C Craig Giovanni Fm Strippoli Source Type: research

Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis
CONCLUSIONS: This Cochrane Review provides low- to moderate-certainty evidence indicating that there are no significant differences in either short- or long-term risks of stroke, death, or TIA between people with symptomatic vertebral artery stenosis treated with ET plus MT and those treated with MT alone.PMID:35579383 | DOI:10.1002/14651858.CD013692.pub2
Source: Cochrane Database of Systematic Reviews - May 17, 2022 Category: General Medicine Authors: Ran Xu Xiao Zhang Sihua Liu Xue Wang Wenjiao Wang Kun Yang Tao Wang Adam A Dmytriw Xuesong Bai Yan Ma Liqun Jiao Bin Yang Source Type: research

Effects of a gluten-reduced or gluten-free diet for the primary prevention of cardiovascular disease
CONCLUSIONS: Very low-certainty evidence suggested that it is unclear whether gluten intake is associated with all-cause mortality. Our findings also indicate that low-certainty evidence may show little or no association between gluten intake and cardiovascular mortality and non-fatal myocardial infarction. Low-certainty evidence suggested that a lower compared with a higher gluten intake may be associated with a slightly increased risk to develop type 2 diabetes - a major cardiovascular risk factor. For other cardiovascular risk factors it is unclear whether there is a difference between a gluten-free and normal diet. Giv...
Source: Cochrane Database of Systematic Reviews - February 24, 2022 Category: General Medicine Authors: Christine Schmucker Angelika Eisele-Metzger Joerg J Meerpohl Cornelius Lehane Daniela Kuellenberg de Gaudry Szimonetta Lohner Lukas Schwingshackl Source Type: research

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